title: Impact of pneumococcal conjugate vaccines on the incidence of pneumonia in hospitalized children after five years of its introduction in Uruguay.
abstract: BACKGROUND
  Data on the burden of pneumococcal disease and the most frequent serotypes demonstrated that invasive disease and pneumonia were important manifestations affecting children under 5 years of age. Therefore, pneumococcal diseases prevention became a public health priority. Uruguay was the first Latin American country to incorporate PCV7 into its National Immunization Program. The aim of this study is to compare the incidence rates for hospitalized pneumonia in children from the pre PCV introduction period and the following five years of PCVs application in Uruguay.
  
  
  RESULTS
  Population-based surveillance of pneumonia hospitalization rates, in children, less than 14 years of age, had been performed prior pneumococcal vaccination, and continued following PCV7 introduction and PCV13 replacement, using the same methodology. Hospitalized children with pneumonia were enrolled from January 1, 2009 through December 31st, 2012. The study was carried out in an area with a population of 238,002 inhabitants of whom 18, 055 were under five years of age. Patients with acute lower respiratory infections for whom a chest radiograph was performed on admission were eligible. Digitalized radiographs were interpreted by a reference radiologist, using WHO criteria. Pneumonia was confirmed in 2,697 patients, 1,267 with consolidated and 1,430 with non consolidated pneumonia of which incidence decrease, between 2009 and 2012, was 27.3% and 46.4% respectively. 2001-2004 and 2009-2012 comparison showed a significant difference of 20.4% for consolidated pneumonia hospitalizations. A significant incidence decline was recorded among children 6 to 35 months of age.
  
  
  CONCLUSIONS
  An overall significant reduction in pneumonia hospitalizations was observed following the introduction of PCV7 and furthermore following the change to PCV13.
authors.affiliation: Basic Sciences Development, National University, Montevideo, Uruguay.
authors.forename: María
authors.initials: M
authors.lastname: Hortal
authors.affiliation: Radiology Department, Children's Hospital, Ministry of Health, Montevideo, Uruguay.
authors.forename: Miguel
authors.initials: M
authors.lastname: Estevan
authors.affiliation: Statistics Department, Montevideo Municipality, Uruguay.
authors.forename: Miguel
authors.initials: M
authors.lastname: Meny
authors.affiliation: Pediatric Department, Social Security, Montevideo, Uruguay.
authors.forename: Inés
authors.initials: I
authors.lastname: Iraola
authors.affiliation: Immunization Department, CHLAP, Montevideo, Uruguay.
authors.forename: Hilda
authors.initials: H
authors.lastname: Laurani
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control*; D014583:Uruguay; D018074:Vaccines, Conjugate / Q000627:therapeutic use
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate