Peter S. Ndow,

Author Of 3 Presentations

DECLINING TRENDS IN MENINGITIS AMONG CHILDREN LESS THAN FIVE YEARS OF AGE FOLLOWING THE INTRODUCTION OF THE PNEUMOCOCCAL CONJUGATE VACCINES IN WEST AND CENTRAL AFRICA (ID 973)

Abstract

Background

By 2015, pneumococcal conjugate vaccines (PCVs) had been introduced into the infant immunization programmes of most countries in West and Central Africa. We modelled the trends in meningitis cases and deaths among children before and after PCV introduction.

Methods

A total of 36,901 children under 5 years of age with suspected meningitis were enrolled at sentinel hospitals across 10 West and Central African countries between 2010 and 2016 through the Paediatric Bacterial Meningitis (PBM) Surveillance Network . To assess disease and mortality trends before and after PCV introduction, we applied interrupted time-series models and random effects meta-analysis.

Results

Across the sub-regions, there was a decline of 35% (95% CI 2-57%, p=0.04) in annual suspected meningitis cases and 26% (95% CI 3-44%, p=0.03) in laboratory confirmed meningitis in the post vs. pre-PCV period. Likewise, there was a decreased trend in mortality among suspected meningitis cases (33% decline, 95% CI -23-52%, p=0.27) post PCV introduction. There was considerable heterogeneity among countries with the larger and more precise reduction estimates in countries with >2 years post-PCV surveillance.

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Conclusions

We observed significant declines in suspected and confirmed pediatric meningitis across the sub-regions following PCV implementation. Continued monitoring, particularly in countries with more recent PCV introduction is needed.

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BIOMASS SMOKE EXPOSURE AND INFLAMMATION ARE ASSOCIATED WITH PNEUMOCOCCAL CARRIAGE AMONG PCV13 VACCINATED INFANTS (ID 983)

Abstract

Background

Despite widespread use of PCV13, pneumococcal carriage remains high among Gambian infants. We investigated the role of biomass smoke exposure and inflammation in modulating pneumococcal carriage in The Gambia.

Methods

Rural Gambian children (n=120) were followed up at regular intervals from birth to two years of age. All infants received PCV13. Pneumococcal carriage was determined by quantitative PCR and inflammation by measuring plasma alpha-1 glycoprotein (AGP). Smoke exposure was self-reported by the mothers. Adjusted random effects regression models were applied to investigate the relationships between pneumococcal carriage, smoke exposure, and inflammation.

Results

Exposure to biomass smoke was significantly associated with a nearly 3-fold increase in the odds of pneumococcal carriage (OR 2.9, 95% CI: 1.13 - 7.5) and, in independent models, a 1/3-log10 increase in pneumococcal load (Coefficient 0.35, 95% CI: 0.11 - 0.59), compared to non-exposure. Inflammation (AGP) was significantly associated with an increased pneumococcal load (Coefficient 0.22, 95% CI: 0.03 - 0.41) in a model unadjusted for smoke exposure. Mediation analysis suggests that there are age, inflammation and smoke exposure interactions that may modify the effects of smoke exposure on pneumococcal carriage.

Conclusions

Biomass smoke exposure may be an important environmental factor driving pneumococcal carriage and loads among PCV-vaccinated Gambian children.

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