title: Prevalence of Pneumococcal Nasopharyngeal Carriage Among Children 2-18 Months of Age: Baseline Study Pre Introduction of Pneumococcal Vaccination in Cuba.
abstract: A new vaccine candidate against pneumococcus is being developed in Cuba, and it is a priority of the national health system. There is limited information on nasopharyngeal colonization burden, though it is essential for monitoring the impact of the vaccine. The study aims to estimate the prevalence of nasopharyngeal colonization in children 2-18 months of age and identify circulating serotypes, antimicrobial resistance and its association with selected risk factors.
  
  
  
  A cross-sectional study was conducted between October and December 2013 in Cienfuegos municipality. Inclusion criteria were evaluated, and informed consent was obtained from the parents. Clinical and epidemiologic data were collected through a semistructured questionnaire. Nasopharyngeal swabs according to established protocols were taken. Data analysis included frequency distributions and comparison of proportions. The association between colonization and selected risk factors was assessed by multivariate analysis.
  
  
  
  A total of 984 children (87.2% living in urban areas) were included. The overall prevalence of colonization was 21.6%. The most frequent serotypes isolated were 6A (23.1%), 23F (10.8%), 6B (10.3%), 19F (8.5%) and 14 (3.3%). We found no resistance to β-lactamases in circulating serotypes. Living with sibling younger than 5 years, previous respiratory infections, previous hospitalization and day-care attendance were determinants of nasopharyngeal carriage.
  
  
  
  The findings suggest that the burden of pneumococcal disease and colonization in Cuba could be significantly affected after vaccine introduction.
authors.affiliation: From the *Tropical Medicine Institute "Pedro Kourí" (IPK), Havana, Cuba; †Pediatric Hospital "Paquito González Cueto," Cienfuegos, Cuba; ‡Finlay Vaccine Institute, Havana, Cuba; and §Medical University of Cienfuegos, Cienfuegos, Cuba.
authors.forename: María E
authors.initials: ME
authors.lastname: Toledo
authors.forename: Maria F
authors.initials: MF
authors.lastname: Casanova
authors.forename: Nivaldo
authors.initials: N
authors.lastname: Linares-Pérez
authors.forename: Dagmar
authors.initials: D
authors.lastname: García-Rivera
authors.forename: Gilda
authors.initials: G
authors.lastname: Toraño Peraza
authors.forename: Indira
authors.initials: I
authors.lastname: Barcos Pina
authors.forename: Martha
authors.initials: M
authors.lastname: Montes de Oca
authors.forename: Laura M
authors.initials: LM
authors.lastname: Rodriguez-Noda
authors.forename: Mayelín
authors.initials: M
authors.lastname: Mirabal
authors.forename: Beatriz
authors.initials: B
authors.lastname: Paredes
authors.forename: Dunia M
authors.initials: DM
authors.lastname: Chávez Amaro
authors.forename: Darielys
authors.initials: D
authors.lastname: Santana Mederos
authors.forename: Yury
authors.initials: Y
authors.lastname: Valdés-Balbín
authors.forename: Vicente
authors.initials: V
authors.lastname: Verez-Bencomo
mesh_terms: D002353:Carrier State / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D003430:Cross-Sectional Studies; D003462:Cuba / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology*; D015995:Prevalence; D012307:Risk Factors; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000276:immunology / Q000302:isolation & purification*; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022242:Pneumococcal Vaccines