A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East

Introduction: Invasive pneumococcal disease (IPD) poses an enormous burden for developing countries. The introduction of pneumococcal conjugate vaccines (PCVs) has resulted in global declines in invasive pneumococcal disease (IPD), and the World Health Organization recommends PCV inclusion in all na...

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Main Authors: Hammam Haridy, Ghassan Dbaibo, Prakash Jeena, Amina Al-Jardani
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Vaccine: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590136225000828
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author Hammam Haridy
Ghassan Dbaibo
Prakash Jeena
Amina Al-Jardani
author_facet Hammam Haridy
Ghassan Dbaibo
Prakash Jeena
Amina Al-Jardani
author_sort Hammam Haridy
collection DOAJ
description Introduction: Invasive pneumococcal disease (IPD) poses an enormous burden for developing countries. The introduction of pneumococcal conjugate vaccines (PCVs) has resulted in global declines in invasive pneumococcal disease (IPD), and the World Health Organization recommends PCV inclusion in all national immunization programs (NIPs). This review assesses the pneumococcal serotypes causing IPD in North Africa and the Middle East and the potential prevention of IPD by different serotype-specific PCVs. Methods: A search was conducted in PubMed for articles published from 2012 to 2025 evaluating the serotypes causing IPD in North Africa and the Middle East. Results: Of 263 articles retrieved, the 30 that met inclusion criteria investigated IPD in 10 countries from 1994 through 2022: Algeria, Iran, Jordan, Kuwait, Lebanon, Morocco, Oman, Qatar, Saudi Arabia, and Tunisia. The studies showed that the serotypes most responsible for IPD varied widely over time and across countries and often demonstrated an inverse relationship to vaccine uptake. The most common IPD-causing serotypes were 14 (≤57.0 %), 19A (≤46.2 %) and 19F (≤30.8 %), but the prevalence of serotypes 14, 19A, and 19F tended to decline after the introduction of 7-valent PCV and 13-valent PCV (PCV13) into NIPs. In contrast, percentages of IPD caused by non-vaccine serotypes remained high in some countries. Discussion: Although limited data and variable results made major serotype distribution trends difficult to determine, IPD caused by PCV13 serotypes clearly declined after vaccine introduction whereas IPD caused by serotypes not included in the available vaccines tended to remain high or increase. Conclusion: In North Africa and the Middle East, improved IPD serotype surveillance is needed. The introduction of higher valency vaccines into regional NIPs may alleviate IPD burden.
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spelling doaj-art-c66cc415be4b4db0bb92029fbc8808472025-08-20T03:38:24ZengElsevierVaccine: X2590-13622025-08-012510068810.1016/j.jvacx.2025.100688A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle EastHammam Haridy0Ghassan Dbaibo1Prakash Jeena2Amina Al-Jardani3Pfizer Gulf FZ LLC, Medical & Scientific Affairs, Pfizer Gulf FZ LLC, Dubai, United Arab Emirates; Corresponding author at: Medical & Scientific Affairs, Pfizer Gulf FZ LLC, PO Box 502749, Atlas Building, Dubai Media City, Dubai, United Arab Emirates.Center for Infectious Diseases Research, American University of Beirut, Beirut, LebanonDepartment of Paediatrics, King Edward VIII Hospital, Durban, South AfricaCentral Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, OmanIntroduction: Invasive pneumococcal disease (IPD) poses an enormous burden for developing countries. The introduction of pneumococcal conjugate vaccines (PCVs) has resulted in global declines in invasive pneumococcal disease (IPD), and the World Health Organization recommends PCV inclusion in all national immunization programs (NIPs). This review assesses the pneumococcal serotypes causing IPD in North Africa and the Middle East and the potential prevention of IPD by different serotype-specific PCVs. Methods: A search was conducted in PubMed for articles published from 2012 to 2025 evaluating the serotypes causing IPD in North Africa and the Middle East. Results: Of 263 articles retrieved, the 30 that met inclusion criteria investigated IPD in 10 countries from 1994 through 2022: Algeria, Iran, Jordan, Kuwait, Lebanon, Morocco, Oman, Qatar, Saudi Arabia, and Tunisia. The studies showed that the serotypes most responsible for IPD varied widely over time and across countries and often demonstrated an inverse relationship to vaccine uptake. The most common IPD-causing serotypes were 14 (≤57.0 %), 19A (≤46.2 %) and 19F (≤30.8 %), but the prevalence of serotypes 14, 19A, and 19F tended to decline after the introduction of 7-valent PCV and 13-valent PCV (PCV13) into NIPs. In contrast, percentages of IPD caused by non-vaccine serotypes remained high in some countries. Discussion: Although limited data and variable results made major serotype distribution trends difficult to determine, IPD caused by PCV13 serotypes clearly declined after vaccine introduction whereas IPD caused by serotypes not included in the available vaccines tended to remain high or increase. Conclusion: In North Africa and the Middle East, improved IPD serotype surveillance is needed. The introduction of higher valency vaccines into regional NIPs may alleviate IPD burden.http://www.sciencedirect.com/science/article/pii/S2590136225000828Invasive pneumococcal diseaseMiddle EastNorth AfricaPneumococcal conjugate vaccinesSerotypes
spellingShingle Hammam Haridy
Ghassan Dbaibo
Prakash Jeena
Amina Al-Jardani
A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East
Vaccine: X
Invasive pneumococcal disease
Middle East
North Africa
Pneumococcal conjugate vaccines
Serotypes
title A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East
title_full A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East
title_fullStr A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East
title_full_unstemmed A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East
title_short A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East
title_sort narrative review of pneumococcal serotypes causing invasive disease in north africa and the middle east
topic Invasive pneumococcal disease
Middle East
North Africa
Pneumococcal conjugate vaccines
Serotypes
url http://www.sciencedirect.com/science/article/pii/S2590136225000828
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