title: Pneumococcal meningitis: epidemiological profile pre- and post-introduction of the pneumococcal 10-valent conjugate vaccine.
abstract: OBJECTIVE
  To evaluate the possible effects of the introduction of the pneumococcal conjugate 10-valent vaccine schedule in the state of Parana on pneumococcal meningitis cases and to assess the distribution of serotypes among cases.
  
  
  METHODS
  Cross-sectional study with retrospective data collection of cases of pneumococcal meningitis in the state of Paraná reported to Sistema de Informação de Agravos de Notificação (SINAN), from 1998 to 2011. A total of 1,339 cases of pneumococcal meningitis were analyzed; 1,205 cases from the pre-vaccine period (1998-2009) were compared to 134 cases from the post-vaccine period (2010-2011). Descriptive and comparative statistical analyses (chi-squared test and prevalence ratio) were performed using JMP 5.1.2 statistical software (JMP Statistical Discovery, North Carolina, USA) and EPI INFO 6 (Centers for Disease Control and Prevention, Georgia, EUA).
  
  
  RESULTS
  There was a significant reduction in the mean rates of incidence and mortality in the general population. The analysis of cases in the pre- and post-vaccination periods in the age groups covered by vaccination (younger than 2 years) showed significant reductions in incidence rates (6.01 cases/100,000 to 2.49 cases/100,000 individuals) and mortality (1.85 cases/100,000 population to 0.47 cases/100,000 population), while the mean lethality rate did not change significantly. There was a significant reduction in cases whose serotypes are included in the vaccine (80.7% to 53.3%).
  
  
  CONCLUSIONS
  Even after a short time of use, the 10-valent pneumococcal conjugate vaccine has already had a significant impact in reducing the incidence and mortality of meningitis cases among infants, as well as the reduction of cases whose serotypes are included in the vaccine.
authors.affiliation: Department of Pediatrics, Health Sciences Section, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil. Electronic address: tatiane_hirose@hotmail.com.
authors.forename: Tatiane E
authors.initials: TE
authors.lastname: Hirose
authors.affiliation: Department of Internal Medicine, Health Sciences Section, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Discipline of Family Health, Maternal-Child Section, Universidade Positivo, Curitiba, PR, Brazil.
authors.forename: Eliane M C P
authors.initials: EM
authors.lastname: Maluf
authors.affiliation: Department of Pediatrics, Health Sciences Section, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: Cristina O
authors.initials: CO
authors.lastname: Rodrigues
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D045142:Cross-Priming / Q000276:immunology; D003430:Cross-Sectional Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D015995:Prevalence; D012189:Retrospective Studies; D012703:Serotyping; D018074:Vaccines, Conjugate / Q000008:administration & dosage
chemical_list: C586648:10-valent pneumococcal conjugate vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Doença pneumocócica invasiva; Invasive pneumococcal disease; Meningite pneumocócica; Pneumococcal meningitis; Streptococcus pneumoniae; Vaccines; Vacinas