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Pneumococcal conjugate vaccine--a health priority

, : Pneumococcal conjugate vaccine--a health priority. South African Medical Journal 98(6): 463-467

Pneumonia is a major cause of childhood mortality and morbidity. Streptococcus pneumoniae is the most important bacterial pathogen causing pneumonia in children. The HIV epidemic has increased the burden and severity of childhood pneumococcal pneumonia and invasive disease fortyfold. Pneumococcal conjugate vaccine (PCV) is a highly effective intervention to reduce invasive pneumococcal disease and pneumonia. Studies evaluating a 9-valent PCV in South Africa and The Gambia reported a 72 - 77% reduction in vaccine-serotype-specific invasive disease in vaccinated children. As many of the pneumococcal serotypes associated with antibiotic resistance are included in PCV, vaccination has also been associated with a reduction in antimicrobial-resistant invasive disease. PCV may also reduce childhood mortality, especially in places with limited access to health care, as shown in Gambian study in which PCV reduced childhood mortality by 16%. In addition to the direct effects of PCV, there is a substantial reduction in disease burden through indirect protection of non-vaccinated populations. PCV is immunogenic in HIV-infected children and provides protection against invasive disease or pneumonia in a substantial number of children. Although the efficacy of PCV for prevention of invasive disease or pneumonia is lower in HIV-infected compared to -uninfected children, the overall burden of disease prevented is much greater in HIV-infected children because of the higher burden of pneumococcal disease in these children. Consequently, vaccine-preventable invasive disease is almost 60 times higher in HIV-infected compared to -uninfected children, while the reduction in pneumonia in HIV-infected children is 15 times greater. However, the long-term efficacy of PCV wanes in HIV-infected children who are not taking antiretroviral therapy, and booster doses are probably indicated. Although there is concern about the potential for replacement disease due to non-vaccine serotypes, a substantial and sustained reduction in invasive disease has occurred overall in populations with widespread childhood immunisation. Routine childhood immunisation is now the standard of care in most developed countries. However, PCV is much less accessible to children in developing countries due to cost and availability. Cost-effectiveness analysis indicates that use of PCV is potentially highly cost-effective, at tiered pricing, even in very low-income countries. Widespread availability and vaccination with PCV is urgently needed for all children under 2 years of age in South Africa. In addition, the use of PCV for all HIV-infected children under 9 years should be prioritised.


PMID: 18683380

Other references

Oleinikova, T.A.; Shkidchenko, A.N.; Verbina, N.M., 1975: Use of malt extract as a nitrogen source for continuous cultivation of yeast candida utilis. The effect of an aqueous extract from malt sprouts on the growth and development of fodder yeast was investigated during its continuous cultivation. The extract can be used as a N source during continuous cultivation of fodder yeast. It is assumed...

Rolston, LH., 1984: Pellaea santarosensis (Hemiptera: Pentatomidae), a new species from Costa Rica. P. candens (Distant, 1890) is placed in the synonymy of P. stictica (Dallas, 1851), and P. santarosensis, a new species from Costa Rica, is described. A lectotype is designated for Rhapigaster sticticus Dallas, 1851.

Hirai H., 1981: In vitro effect of prednisolone on antibody production by human lymphocytes. The effect of steroid hormone (SH) [prednisolone] on immunocompetent cells and antibody producing cells was studied to elucidate the mechanism of the immune response. Human peripheral blood lymphocytes (PBL), and the T cell fraction and B cell fra...

Kamal, H.A.; Doha, S.A.; El-Hosary, S.S.; Shehata, M.G.; E.S.waf, B.M., 2003: Human zoonotic cutaneous leishmaniasis and associated sand flies (Diptera: Psychodidae) in Sheikh Atiya Village, southern Sinai, Egypt. Zoonotic cutaneous leishmaniasis is endemic in Sinai Peninsula. Human cases were recorded from the northern Sinai, however little was known about the disease in southern Sinai. During entomological surveys conducted southern Sinai in summers of 19...

Schumer, W., 1974: Metabolic aspects of shock. Surgery Annual 6: 1-16

Ingram, A.; Rushton, S.; Kett, M., 2012: Terrorism, conflict and the after effects of war. Medicine, Conflict, and Survival 28(2): 107-109

Kellam, P.; Boucher, C.A.; Tijnagel, J.M.; Larder, B.A., 1994: Zidovudine treatment results in the selection of human immunodeficiency virus type 1 variants whose genotypes confer increasing levels of drug resistance. High level resistance to 3'-azido-3'-deoxythymidine (AZT, zidovudine or Retrovir) is conferred by the presence of four or five mutations (Met-41 fwdarw Leu; Asp-67 fwdarw Asn; Lys-70 fwdarw Arg; Thr-215 fwdarw Tyr or Phe; Lys-219 fwdarw...

Sato, T., 2001: Topology and recognition function of glycolipids. Tanpakushitsu Kakusan Koso. Protein, Nucleic Acid, Enzyme 46(9): 1247-1253

Bulatovic, S.; Tarailo, B., 1977: Studies on physical and chemical changes in Golden Delicious apples during storage. Changes in fruit weight and composition were studied in apples of 3 size grades (60, 70 and 80 mm in diameter) stored, immediately or 4 or 10 days after harvest, at 0-0.5 deg C and 85% RH for 5 months. The results are tabulated and discussed. In g...

Poupard, B., 1964: On 2 Technics Of Correction Of Protruding Ears. Annales de Chirurgie Plastique 9: 125-129