Incidence of paediatric pneumococcal meningitis and emergence of new serotypes: a time-series analysis of a 16-year French national survey
2018
Summary Background Successive implementation of seven-valent then 13-valent
pneumococcal conjugate vaccines(PCVs) led to a marked decrease in pneumococcal disease burden, including pneumococcal
meningitis. We assessed the long-term effect of implementation of PCVs on incidence of pneumococcal
meningitisin children in France over a 16-year period. Methods We did a quasi-experimental, population-based
interrupted time-seriesanalysis with a nationwide prospective survey over 16 years in France, recruiting children aged younger than 15 years from 227 paediatric wards from January, 2001, to December, 2016. The main outcome by the time-series model was the estimated incidence of pneumococcal
meningitisper 100 000 children (of a population of 12·6 million children in 2017) before and after PCV7 and PCV13 implementation. The time-series model was based on
segmented regressionwith autoregressive error. Findings We enrolled 1778 children with pneumococcal
meningitis. PCV13 implementation led to a significant reduction in monthly incidence of pneumococcal
meningitisfrom 0·12 per 100 000 children before PCV13 to a nadir of 0·07 in December, 2014 (−38%, 95% CI −56·1 to −20·4; p Interpretation The
early effectof PCV13 implementation greatly reduced the incidence of pneumococcal
meningitisin children less than 15 years old. However, a sharp rebound in incidence linked to the emergence of serotype 24F compromised the long-term PCV efficacy. If confirmed in future studies and in other countries, pneumococcal
meningitisincidence rebound and 24F emergence should be considered when developing next-generation PCVs. Funding The French Pediatric Infectious Diseases Group, Association Clinique et Therapeutique Infantile du Val de Marne, Pfizer, and for the National Reference Centre for Pneumococci, the French National Health Agency.
Keywords:
-
Correction
-
Source
-
Cite
-
Save
31
References
49
Citations
NaN
KQI