TY - JOUR
T1 - The burden of pneumococcal disease among Latin American and Caribbean children
T2 - Review of the evidence
AU - Valenzuela, Maria Teresa
AU - O'Loughlin, Rosalyn
AU - De La Hoz, Fernando
AU - Gomez, Elizabeth
AU - Constenla, Dagna
AU - Sinha, Anushua
AU - Valencia, Juan Esteban
AU - Flannery, Brendan
AU - De Quadros, Ciro A.
PY - 2009/3
Y1 - 2009/3
N2 - Objective. To conduct a comprehensive review of data on pneumococcal disease incidence in Latin America and the Caribbean and project the annual number of pneumococcal disease episodes and deaths among children < 5 years of age in the region. Methods. We carried out a systematic review (1990 to 2006) on the burden of pneumococcal disease in children < 5 years of age in the region. We summarized annual incidence rates and case fatality ratios using medians and interquartile ranges for invasive pneumococcal disease (IPD) (including all-IPD and separately abstracting pneumococcal meningitis, pneumonia, bacteremia, and sepsis data), pneumonia (all cause and radiologically confirmed), and acute otitis media by age group: < 1 year, < 2 years, and < 5 years. We modeled age-specific cumulative incidence of disease obtained from standard Kaplan-Meier analysis and projected data to obtain regional estimates of disease burden. We adjusted burden estimates by serotype coverage, vaccination coverage, and vaccine efficacy to estimate the number of cases and deaths averted. Results. Of 5998 citations identified, 26 papers from 10 countries were included. The estimated annual burden of pneumonia, meningitis, and acute otitis media caused by pneumococcus in children < 5 years of age ranged from 980000 to 1500000, 2600 to 6800, and 980000 to 1500000, respectively. An estimated 12000 to 28000 deaths due to pneumococcal disease occur in the region annually. Pneumococcal conjugate vaccine could save 1 life per 1 100 and prevent 1 case per 13 children vaccinated. Conclusion. A substantial burden of pneumococcal disease in the region is potentially preventable with pneumococcal conjugate vaccines and should be considered in regional vaccine decision making. Results are limited by the very few studies, conducted in selected settings, included in this review.
AB - Objective. To conduct a comprehensive review of data on pneumococcal disease incidence in Latin America and the Caribbean and project the annual number of pneumococcal disease episodes and deaths among children < 5 years of age in the region. Methods. We carried out a systematic review (1990 to 2006) on the burden of pneumococcal disease in children < 5 years of age in the region. We summarized annual incidence rates and case fatality ratios using medians and interquartile ranges for invasive pneumococcal disease (IPD) (including all-IPD and separately abstracting pneumococcal meningitis, pneumonia, bacteremia, and sepsis data), pneumonia (all cause and radiologically confirmed), and acute otitis media by age group: < 1 year, < 2 years, and < 5 years. We modeled age-specific cumulative incidence of disease obtained from standard Kaplan-Meier analysis and projected data to obtain regional estimates of disease burden. We adjusted burden estimates by serotype coverage, vaccination coverage, and vaccine efficacy to estimate the number of cases and deaths averted. Results. Of 5998 citations identified, 26 papers from 10 countries were included. The estimated annual burden of pneumonia, meningitis, and acute otitis media caused by pneumococcus in children < 5 years of age ranged from 980000 to 1500000, 2600 to 6800, and 980000 to 1500000, respectively. An estimated 12000 to 28000 deaths due to pneumococcal disease occur in the region annually. Pneumococcal conjugate vaccine could save 1 life per 1 100 and prevent 1 case per 13 children vaccinated. Conclusion. A substantial burden of pneumococcal disease in the region is potentially preventable with pneumococcal conjugate vaccines and should be considered in regional vaccine decision making. Results are limited by the very few studies, conducted in selected settings, included in this review.
KW - Latin America and the Caribbean
KW - Pneumococcal vaccines
KW - Review literature
KW - Streptococcus pneumoniae
UR - http://www.scopus.com/inward/record.url?scp=67651108585&partnerID=8YFLogxK
U2 - 10.1590/S1020-49892009000300011
DO - 10.1590/S1020-49892009000300011
M3 - Article
C2 - 19454155
AN - SCOPUS:67651108585
SN - 1020-4989
VL - 25
SP - 270
EP - 279
JO - Revista Panamericana de Salud Publica/Pan American Journal of Public Health
JF - Revista Panamericana de Salud Publica/Pan American Journal of Public Health
IS - 3
ER -