Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev Study
Purpose In the setting of an established childhood pneumococcal vaccination programme with immediate initiation and treatment of antiretroviral therapy (ART) for people living with HIV (PLWH), the risk of adult pneumococcal community-acquired pneumonia (CAP) is not recently described. We aimed to in...
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2024-12-01
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| author | Jo Southern Kennedy Otwombe Eileen Dunne Khuthadzo Hlongwane Bradford D Gessner Michelle Wong Cheryl Cohen Anne von Gottberg Elizabeth Begier Sharon Gray Ebrahim Variava Tumelo Moloantoa Neil Martinson Firdaus Nabeemeeah Nadia Sabet Lebohang M Mlambo Phetho Mangena Pattamukkil Abraham Floris Swanepoel Fahima Moosa Mark Fletcher Bha Ndungane-Tlakula Jerusha Naidoo Minja Milovanovic |
| author_facet | Jo Southern Kennedy Otwombe Eileen Dunne Khuthadzo Hlongwane Bradford D Gessner Michelle Wong Cheryl Cohen Anne von Gottberg Elizabeth Begier Sharon Gray Ebrahim Variava Tumelo Moloantoa Neil Martinson Firdaus Nabeemeeah Nadia Sabet Lebohang M Mlambo Phetho Mangena Pattamukkil Abraham Floris Swanepoel Fahima Moosa Mark Fletcher Bha Ndungane-Tlakula Jerusha Naidoo Minja Milovanovic |
| author_sort | Jo Southern |
| collection | DOAJ |
| description | Purpose In the setting of an established childhood pneumococcal vaccination programme with immediate initiation and treatment of antiretroviral therapy (ART) for people living with HIV (PLWH), the risk of adult pneumococcal community-acquired pneumonia (CAP) is not recently described. We aimed to investigate CAP incidence, recurrence, mortality, risk factors and microbiology before and during the COVID-19 pandemic.Participants Adults aged ≥18 years were enrolled in three South African provinces from March 2019 to October 2021, with a brief halt during the initial COVID-19 lockdown. The first group, PdCAP, a surveillance cohort, had their data abstracted to estimate the population incidence of physician-diagnosed CAP by counting incident CAP patients presenting to emergency rooms (ER) and mapping them to catchment areas linked to census data. From those admitted to wards from ERs, a prospective cohort (HospCAP) was enrolled and followed up to 1 year after discharge. Microbiology testing was performed and data were abstracted and collected for economic assessments. A third group (StART) of PLWH without respiratory illness at enrolment, attending primary healthcare clinics to initiate or reinitiate ART, was prospectively enrolled and followed. HospCAP and StART participants (totalling 2950 participants) were followed for at least 1 year and assessed for CAP episodes, hospitalisations and mortality.Findings to date Surveillance identified 6546 patients attending ERs with physician-diagnosed CAP; 61/6546 (0.9%) died in the ER. We prospectively enrolled 2000 hospitalised patients with CAP of whom 1079/2000 (54.0%) were PLWH. Overall, 271/2000 (13.6%) hospitalised CAP patients died during their first admission and 298/2000 (14.9%) died during follow-up. Among StART cohort, 18/950 (1.9%) died during follow-up.Future plans Planned analyses include incidence estimates of pneumococcal serotype-specific adult CAP and its recurrence, using Urinary Antigen Detection assay results to model the burden of pneumococcal CAP better and health economics analyses. |
| format | Article |
| id | doaj-art-9b08514c80554281a3c5f2a05cb2876a |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-9b08514c80554281a3c5f2a05cb2876a2025-01-14T15:35:11ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2023-080553Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev StudyJo Southern0Kennedy Otwombe1Eileen Dunne2Khuthadzo Hlongwane3Bradford D Gessner4Michelle Wong5Cheryl Cohen6Anne von Gottberg7Elizabeth Begier8Sharon Gray9Ebrahim Variava10Tumelo Moloantoa11Neil Martinson12Firdaus Nabeemeeah13Nadia Sabet14Lebohang M Mlambo15Phetho Mangena16Pattamukkil Abraham17Floris Swanepoel18Fahima Moosa19Mark Fletcher20Bha Ndungane-Tlakula21Jerusha Naidoo22Minja Milovanovic239 Global Biopharmaceutical Business, Pfizer Inc, Collegeville, Pennsylvania, USA1 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Diepkloof, Gauteng, South Africa9 Global Biopharmaceutical Business, Pfizer Inc, Collegeville, Pennsylvania, USA1 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Diepkloof, Gauteng, South Africa9 Global Biopharmaceutical Business, Pfizer Inc, Collegeville, Pennsylvania, USA4 Division of Pulmonology, Chris Hani Baragwanath Hospital, Johannesburg, South Africa8 National Institute for Communicable Diseases, Johannesburg, South Africa8 National Institute for Communicable Diseases, Johannesburg, South Africa12 Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, USA9 Global Biopharmaceutical Business, Pfizer Inc, Collegeville, Pennsylvania, USA15 University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, Gauteng, South Africa2 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Klerksdorp, North West, South Africa17 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Johannesburg, Gauteng, South Africa1 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Diepkloof, Gauteng, South Africa2 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Klerksdorp, North West, South Africa1 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Diepkloof, Gauteng, South Africa6 Department of Internal Medicine, University of Limpopo Faculty of Health Sciences, Sovenga, Limpopo, South Africa2 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Klerksdorp, North West, South Africa1 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Diepkloof, Gauteng, South Africa8 National Institute for Communicable Diseases, Johannesburg, South Africa10 Emerging Markets Region Medical Affairs, Vaccines, Pfizer Inc, Paris, France11 Pfizer Inc, Johannesburg, South Africa13 Vaccines, GSK, Singapore1 Perinatal HIV Research Unit (PHRU), University of the Witwatersrand Johannesburg, Diepkloof, Gauteng, South AfricaPurpose In the setting of an established childhood pneumococcal vaccination programme with immediate initiation and treatment of antiretroviral therapy (ART) for people living with HIV (PLWH), the risk of adult pneumococcal community-acquired pneumonia (CAP) is not recently described. We aimed to investigate CAP incidence, recurrence, mortality, risk factors and microbiology before and during the COVID-19 pandemic.Participants Adults aged ≥18 years were enrolled in three South African provinces from March 2019 to October 2021, with a brief halt during the initial COVID-19 lockdown. The first group, PdCAP, a surveillance cohort, had their data abstracted to estimate the population incidence of physician-diagnosed CAP by counting incident CAP patients presenting to emergency rooms (ER) and mapping them to catchment areas linked to census data. From those admitted to wards from ERs, a prospective cohort (HospCAP) was enrolled and followed up to 1 year after discharge. Microbiology testing was performed and data were abstracted and collected for economic assessments. A third group (StART) of PLWH without respiratory illness at enrolment, attending primary healthcare clinics to initiate or reinitiate ART, was prospectively enrolled and followed. HospCAP and StART participants (totalling 2950 participants) were followed for at least 1 year and assessed for CAP episodes, hospitalisations and mortality.Findings to date Surveillance identified 6546 patients attending ERs with physician-diagnosed CAP; 61/6546 (0.9%) died in the ER. We prospectively enrolled 2000 hospitalised patients with CAP of whom 1079/2000 (54.0%) were PLWH. Overall, 271/2000 (13.6%) hospitalised CAP patients died during their first admission and 298/2000 (14.9%) died during follow-up. Among StART cohort, 18/950 (1.9%) died during follow-up.Future plans Planned analyses include incidence estimates of pneumococcal serotype-specific adult CAP and its recurrence, using Urinary Antigen Detection assay results to model the burden of pneumococcal CAP better and health economics analyses.https://bmjopen.bmj.com/content/14/12/e080553.full |
| spellingShingle | Jo Southern Kennedy Otwombe Eileen Dunne Khuthadzo Hlongwane Bradford D Gessner Michelle Wong Cheryl Cohen Anne von Gottberg Elizabeth Begier Sharon Gray Ebrahim Variava Tumelo Moloantoa Neil Martinson Firdaus Nabeemeeah Nadia Sabet Lebohang M Mlambo Phetho Mangena Pattamukkil Abraham Floris Swanepoel Fahima Moosa Mark Fletcher Bha Ndungane-Tlakula Jerusha Naidoo Minja Milovanovic Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev Study BMJ Open |
| title | Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev Study |
| title_full | Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev Study |
| title_fullStr | Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev Study |
| title_full_unstemmed | Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev Study |
| title_short | Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic – the multicentre, multimethod PotPrev Study |
| title_sort | cohort profile the potentially preventable burden of community acquired pneumonia in south african adults in the era of widespread pcv13 immunisation and antiretroviral therapy roll out before and during the covid 19 pandemic the multicentre multimethod potprev study |
| url | https://bmjopen.bmj.com/content/14/12/e080553.full |
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