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.

<h4>Background</h4>Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs.<h4>Objectives</h4>We aimed to summarize the evidence of PCV impact and effectiveness in c...

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Main Authors: Lucia Helena de Oliveira, Luiz Antonio B Camacho, Evandro S F Coutinho, Martha S Martinez-Silveira, Ana Flavia Carvalho, Cuauhtemoc Ruiz-Matus, Cristiana M Toscano
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0166736
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author Lucia Helena de Oliveira
Luiz Antonio B Camacho
Evandro S F Coutinho
Martha S Martinez-Silveira
Ana Flavia Carvalho
Cuauhtemoc Ruiz-Matus
Cristiana M Toscano
author_facet Lucia Helena de Oliveira
Luiz Antonio B Camacho
Evandro S F Coutinho
Martha S Martinez-Silveira
Ana Flavia Carvalho
Cuauhtemoc Ruiz-Matus
Cristiana M Toscano
author_sort Lucia Helena de Oliveira
collection DOAJ
description <h4>Background</h4>Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs.<h4>Objectives</h4>We aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region.<h4>Methods</h4>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, meningitis 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: randomized 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 reviewers, 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.<h4>Results</h4>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 Nicaragua. 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 hospitalizations, and 56-83.3% for IPD hospitalization, varying by age, outcome definition, type of vaccine and study design.<h4>Conclusions</h4>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 pneumonia, IPD or meningitis hospitalization reduction in children under 5 years old.
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spelling doaj-art-7bee0053e8124f9cbaeab10f6a9043e92025-08-20T03:28:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011112e016673610.1371/journal.pone.0166736Impact 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.Lucia Helena de OliveiraLuiz Antonio B CamachoEvandro S F CoutinhoMartha S Martinez-SilveiraAna Flavia CarvalhoCuauhtemoc Ruiz-MatusCristiana M Toscano<h4>Background</h4>Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs.<h4>Objectives</h4>We aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region.<h4>Methods</h4>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, meningitis 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: randomized 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 reviewers, 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.<h4>Results</h4>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 Nicaragua. 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 hospitalizations, and 56-83.3% for IPD hospitalization, varying by age, outcome definition, type of vaccine and study design.<h4>Conclusions</h4>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 pneumonia, IPD or meningitis hospitalization reduction in children under 5 years old.https://doi.org/10.1371/journal.pone.0166736
spellingShingle Lucia Helena de Oliveira
Luiz Antonio B Camacho
Evandro S F Coutinho
Martha S Martinez-Silveira
Ana Flavia Carvalho
Cuauhtemoc Ruiz-Matus
Cristiana M Toscano
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
title 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.
title_full 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.
title_fullStr 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.
title_full_unstemmed 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.
title_short 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.
title_sort 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
url https://doi.org/10.1371/journal.pone.0166736
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