Estimating the vaccine-preventable burden of hospitalized pneumonia among young Mozambican children.
Polysaccharide-protein conjugate vaccines against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae have proven efficacy against radiologically confirmed pneumonia. Measurement of pneumonia incidence provides a platform to estimate of the vaccine-preventable burden. Over 24 months, we conducted surveillance for radiologically confirmed severe pneumonia episodes among children <2 years of age admitted to a rural hospital in Manhiça, southern Mozambique. Study children were tested for HIV during the second year of surveillance. Severe pneumonia accounted for 15% of 5132 hospital admissions and 32% of in-hospital mortality among children <2 years of age. Also, 43% of chest radiographs were interpreted as radiologically confirmed pneumonia. HIV-infection was associated with 81% of fatal pneumonia episodes among children tested for HIV. The minimum incidence rate of radiologically confirmed pneumonia requiring hospitalization was 19 episodes/1000 child-years. Incidence rates among HIV-infected children were 9.3-19.0-fold higher than HIV-uninfected. Introduction of Hib and pneumococcal conjugate vaccines would have a substantial impact on pneumonia hospitalizations among African children if vaccine effects are similar to those observed in clinical trials.
Roca
A
A
Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain. aroca@clinic.ub.es
Sigaúque
B
B
Quintó
Ll
L
Morais
L
L
Berenguera
A
A
Corachan
M
M
Ribó
J L
JL
Naniche
D
D
Bassat
Q
Q
Sacoor
Ch
Ch
Nhalungo
D
D
Macete
E
E
Schuchat
A
A
Soriano-Gabarró
M
M
Flannery
B
B
Alonso
P L
PL
D017281:Cost of Illness; D003627:Data Interpretation, Statistical; D023381:Endpoint Determination; D015658:HIV Infections / Q000453:epidemiology; D018073:Haemophilus Vaccines / Q000627:therapeutic use*; D019741:Haemophilus influenzae type b / Q000276:immunology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009073:Mozambique / Q000453:epidemiology; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control*; D011159:Population Surveillance; D011859:Radiography; D009626:Terminology as Topic; D018074:Vaccines, Conjugate
D018073:Haemophilus Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate