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O001 - MENINGITIS AND MORTALITY TRENDS AMONG HOSPITALISED UNDER-FIVES FOLLOWING THE INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINES: A TIME-SERIES ANALYSIS IN WEST AND CENTRAL AFRICA (ID 769)
Abstract
Background
Pneumococcal conjugate vaccines (PCVs) have been introduced into the infant immunization programmes across West and Central Africa. We modelled trends in numbers of meningitis cases and deaths among children before and after PCV introduction, using WHO-supported sentinel surveillance.
Methods
A total of 36,901 children under five years with suspected meningitis were enrolled at sentinel hospitals across ten West and Central African countries through the Paediatric Bacterial Meningitis (PBM) Surveillance Network between 2010 and 2016. Laboratory testing of cerebrospinal fluid (CSF) specimens was performed using standard microbiologic and molecular methods. To assess trends in disease and mortality case counts before and after 10- and 13-valent PCV introduction, we applied interrupted time-series models and random effects meta-analysis, accounting for seasonality and secular trends.
Results
Across the countries, 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; there was a non-significant decrease in suspected meningitis deaths (23% decline, 95% CI -23-52%, p=0.27) post PCV introduction. There was considerable heterogeneity in post-PCV meningitis trends among the different countries; larger and more precise reductions were observed in countries with at least 2 years post-PCV introduction surveillance.
Conclusions
We observed overall declines in paediatric meningitis cases and deaths, but impact was most evident in countries with a longer duration of surveillance post-PCV-introduction. The heterogeneity in the trends across the countries following PCV implementation warrants continued monitoring and surveillance.