Impact and effectiveness of 10 and 13-valent pneumococcal conjugate vaccines on hospitalization and mortality in children aged less than 5 years in Latin American countries: a systematic review
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2016
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Background
Several Latin American and Caribbean (LAC) countries have introduced pneumococcal
conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs.
Objectives
We aimed to summarize the evidence of PCV impact and effectiveness in children under 5
years old in the LAC Region.
Methods
We conducted a systematic review of the literature on impact or effectiveness of PCVs on
deaths or hospitalizations due to invasive pneumococcal disease (IPD), pneumonia, menin gitis and sepsis. We searched Medline, WoS, Lilacs, Scopus, Central and gray literature
published in any language from 2009 to January 2016. We included studies addressing the
outcomes of interest in children in the target age group, and with the following designs: ran domized trials, cohort or case-control, interrupted time series with at least three data points
before and after the intervention, and before-after studies. Screening of citations, data
extraction, and risk of bias assessment were conducted in duplicate by independent review ers, according to the study protocol registered on PROSPERO. Descriptive analysis of the
effectiveness measurements and sensitivity analysis were conducted. Effectiveness is
reported as 1-OR or 1-RR for case control or cohort/clinical trials, and as percent change of
disease incidence rates for before-after studies.
Results
We identified 1,085 citations, 892 from databases and 193 from other sources. Of these, 22
were further analyzed. Studies were from Brazil, Chile, Uruguay, Argentina, Peru and Nica ragua. Effectiveness ranged from 8.8–37.8% for hospitalizations due to X-ray confirmed
pneumonia, 7.4–20.6% for clinical pneumonia, and 13.3–87.7% for meningitis hospitaliza tions, and 56–83.3% for IPD hospitalization, varying by age, outcome definition, type of vac cine and study design.
Conclusions
Available evidence to date indicates significant impact of both PCV-10 and PCV-13 in the
outcomes studied, with no evidence of the superiority of one vaccine over the other on pneu monia, IPD or meningitis hospitalization reduction in children under 5 years old.
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OLIVEIRA, Lucia Helena de et al. Impact and effectiveness of 10 and 13-valent pneumococcal conjugate vaccines on hospitalization and mortality in children aged less than 5 years in Latin American countries: a systematic review. Plos One, San Francisco, v. 11, n. 12, e0166736, 2016. DOI: 10.1371/journal.pone.0166736. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166736. Acesso em: 4 dez. 2024.