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High residual carriage of vaccine-serotype Streptococcus pneumoniae after introduction of pneumococcal conjugate vaccine in Malawi.

Abstract：

:There are concerns that pneumococcal conjugate vaccines (PCVs) in sub-Saharan Africa sub-optimally interrupt Streptococcus pneumoniae vaccine-serotype (VT) carriage and transmission. Here we assess PCV carriage using rolling, prospective nasopharyngeal carriage surveys between 2015 and 2018, 3.6-7.1 years after Malawi's 2011 PCV13 introduction. Carriage decay rate is analysed using non-linear regression. Despite evidence of reduction in VT carriage over the study period, there is high persistent residual carriage. This includes among PCV-vaccinated children 3-5-year-old (16.1% relative reduction from 19.9% to 16.7%); PCV-unvaccinated children 6-8-year-old (40.5% reduction from 26.4% to 15.7%); HIV-infected adults 18-40-years-old on antiretroviral therapy (41.4% reduction from 15.2% to 8.9%). VT carriage prevalence half-life is similar among PCV-vaccinated and PCV-unvaccinated children (3.26 and 3.34 years, respectively). Compared with high-income settings, there is high residual VT carriage 3.6-7.1 years after PCV introduction. Rigorous evaluation of strategies to augment vaccine-induced control of carriage, including alternative schedules and catch-up campaigns, is required.

journal_name

Nat Commun

journal_title

Nature communications

authors

Swarthout TD,Fronterre C,Lourenço J,Obolski U,Gori A,Bar-Zeev N,Everett D,Kamng'ona AW,Mwalukomo TS,Mataya AA,Mwansambo C,Banda M,Gupta S,Diggle P,French N,Heyderman RS

doi

10.1038/s41467-020-15786-9

subject

Has Abstract

pub_date

2020-05-06 00:00:00

pages

2222

issue

1

issn

2041-1723

pii

10.1038/s41467-020-15786-9

journal_volume

11

pub_type

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