Lien Anh Ha Do , Naranzul Tsedenbal , Chimidregzen Khishigmunkh , Bazarkhuu Tserendulam , Lkhagvadorj Altanbumba , Dashtseren Luvsantseren , Munkhchuluun Ulziibayar , Bujinlkham Suuri , Dorj Narangerel , Bilegtsaikhan Tsolmon , Sodbayar Demberelsuren , Cattram Nguyen , Tuya Mungun , Claire von Mollendorf , Darmaa Badarch , Kim Mulholland
{"title":"在蒙古乌兰巴托住院儿童中引入肺炎球菌结合疫苗 13 (PCV13) 对与呼吸道合胞病毒或流感病毒相关的严重下呼吸道感染的影响。","authors":"Lien Anh Ha Do , Naranzul Tsedenbal , Chimidregzen Khishigmunkh , Bazarkhuu Tserendulam , Lkhagvadorj Altanbumba , Dashtseren Luvsantseren , Munkhchuluun Ulziibayar , Bujinlkham Suuri , Dorj Narangerel , Bilegtsaikhan Tsolmon , Sodbayar Demberelsuren , Cattram Nguyen , Tuya Mungun , Claire von Mollendorf , Darmaa Badarch , Kim Mulholland","doi":"10.1016/j.ijregi.2024.100357","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>Limited data indicate a beneficial effect of pneumococcal conjugate vaccines (PCVs) on respiratory syncytial virus (RSV) and influenza infections in young children. We evaluated the impact of 13-valent PCV (PCV13) introduction on the incidence of severe lower respiratory tract infections (LRTIs) associated with RSV or influenza in hospitalized children.</p></div><div><h3>Methods</h3><p>Our study was restricted to children aged <2 years with arterial oxygen saturation <93% and children with radiologically confirmed pneumonia nested in a pneumonia surveillance project in four districts of Ulaanbaatar city, Mongolia. We tested nasopharyngeal swabs collected on admission for RSV and influenza using quantitative reverse transcription-polymerase chain reaction. The impact of PCV13 on the incidence of LRTI outcomes associated with RSV or with influenza for the period April 2015-March 2020 was estimated. Incidence rate ratios comparing pre- and post-vaccine periods were estimated for each outcome for each district using negative binomial models and for all districts combined with a mixed-effects negative binomial model. Adjusted models accounted for seasonality. Sensitivity analyses were conducted to assess the robustness of our findings.</p></div><div><h3>Results</h3><p>Among 5577 tested cases, the adjusted incidence rate ratios showed a trend toward a reduction in RSV-associated outcomes: all LRTIs (0.77, 95% confidence interval [CI] 0.44-1.36), severe LRTIs (0.88, 95% CI 0.48-1.62), very severe LRTIs (0.76, 95% CI 0.42-1.38), and radiologically confirmed pneumonia (0.66, 95% CI 0.32-1.38) but inconsistent trends in outcomes associated with influenza.</p></div><div><h3>Conclusions</h3><p>No significant reductions were observed in any outcomes associated with RSV and influenza after PCV introduction.</p></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772707624000286/pdfft?md5=f145956ba1a3fba96253377c1aefc50a&pid=1-s2.0-S2772707624000286-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Impact of pneumococcal conjugate vaccine 13 introduction on severe lower respiratory tract infections associated with respiratory syncytial virus or influenza virus in hospitalized children in Ulaanbaatar, Mongolia\",\"authors\":\"Lien Anh Ha Do , Naranzul Tsedenbal , Chimidregzen Khishigmunkh , Bazarkhuu Tserendulam , Lkhagvadorj Altanbumba , Dashtseren Luvsantseren , Munkhchuluun Ulziibayar , Bujinlkham Suuri , Dorj Narangerel , Bilegtsaikhan Tsolmon , Sodbayar Demberelsuren , Cattram Nguyen , Tuya Mungun , Claire von Mollendorf , Darmaa Badarch , Kim Mulholland\",\"doi\":\"10.1016/j.ijregi.2024.100357\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>Limited data indicate a beneficial effect of pneumococcal conjugate vaccines (PCVs) on respiratory syncytial virus (RSV) and influenza infections in young children. We evaluated the impact of 13-valent PCV (PCV13) introduction on the incidence of severe lower respiratory tract infections (LRTIs) associated with RSV or influenza in hospitalized children.</p></div><div><h3>Methods</h3><p>Our study was restricted to children aged <2 years with arterial oxygen saturation <93% and children with radiologically confirmed pneumonia nested in a pneumonia surveillance project in four districts of Ulaanbaatar city, Mongolia. We tested nasopharyngeal swabs collected on admission for RSV and influenza using quantitative reverse transcription-polymerase chain reaction. The impact of PCV13 on the incidence of LRTI outcomes associated with RSV or with influenza for the period April 2015-March 2020 was estimated. Incidence rate ratios comparing pre- and post-vaccine periods were estimated for each outcome for each district using negative binomial models and for all districts combined with a mixed-effects negative binomial model. Adjusted models accounted for seasonality. Sensitivity analyses were conducted to assess the robustness of our findings.</p></div><div><h3>Results</h3><p>Among 5577 tested cases, the adjusted incidence rate ratios showed a trend toward a reduction in RSV-associated outcomes: all LRTIs (0.77, 95% confidence interval [CI] 0.44-1.36), severe LRTIs (0.88, 95% CI 0.48-1.62), very severe LRTIs (0.76, 95% CI 0.42-1.38), and radiologically confirmed pneumonia (0.66, 95% CI 0.32-1.38) but inconsistent trends in outcomes associated with influenza.</p></div><div><h3>Conclusions</h3><p>No significant reductions were observed in any outcomes associated with RSV and influenza after PCV introduction.</p></div>\",\"PeriodicalId\":73335,\"journal\":{\"name\":\"IJID regions\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-03-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2772707624000286/pdfft?md5=f145956ba1a3fba96253377c1aefc50a&pid=1-s2.0-S2772707624000286-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IJID regions\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772707624000286\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJID regions","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772707624000286","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Impact of pneumococcal conjugate vaccine 13 introduction on severe lower respiratory tract infections associated with respiratory syncytial virus or influenza virus in hospitalized children in Ulaanbaatar, Mongolia
Objectives
Limited data indicate a beneficial effect of pneumococcal conjugate vaccines (PCVs) on respiratory syncytial virus (RSV) and influenza infections in young children. We evaluated the impact of 13-valent PCV (PCV13) introduction on the incidence of severe lower respiratory tract infections (LRTIs) associated with RSV or influenza in hospitalized children.
Methods
Our study was restricted to children aged <2 years with arterial oxygen saturation <93% and children with radiologically confirmed pneumonia nested in a pneumonia surveillance project in four districts of Ulaanbaatar city, Mongolia. We tested nasopharyngeal swabs collected on admission for RSV and influenza using quantitative reverse transcription-polymerase chain reaction. The impact of PCV13 on the incidence of LRTI outcomes associated with RSV or with influenza for the period April 2015-March 2020 was estimated. Incidence rate ratios comparing pre- and post-vaccine periods were estimated for each outcome for each district using negative binomial models and for all districts combined with a mixed-effects negative binomial model. Adjusted models accounted for seasonality. Sensitivity analyses were conducted to assess the robustness of our findings.
Results
Among 5577 tested cases, the adjusted incidence rate ratios showed a trend toward a reduction in RSV-associated outcomes: all LRTIs (0.77, 95% confidence interval [CI] 0.44-1.36), severe LRTIs (0.88, 95% CI 0.48-1.62), very severe LRTIs (0.76, 95% CI 0.42-1.38), and radiologically confirmed pneumonia (0.66, 95% CI 0.32-1.38) but inconsistent trends in outcomes associated with influenza.
Conclusions
No significant reductions were observed in any outcomes associated with RSV and influenza after PCV introduction.