scholarly journals Epidemiology of Streptococcus pneumoniae serotypes in children before and after pneumococcal vaccination

2021 ◽  
Vol 6 (4) ◽  
pp. 54-66
Author(s):  
I. N. Protasova ◽  
S. V. Sidorenko ◽  
I. V. Feldblum ◽  
N. V. Bakhareva
Keyword(s):  
Streptococcus Pneumoniae ◽  
Age Groups ◽  
Pneumococcal Vaccination ◽  
Healthy Children ◽  
Pneumococcal Serotypes ◽  
Older Children ◽  
Pneumococcal Carriage ◽  
Serotype Replacement ◽  
High Prevalence ◽  
Before And After

Aim. To investigate how the pneumococcal vaccination affects the distribution of Streptococcus pneumoniae serotypes.Materials and Methods. In 2011-2019, 1,852 healthy children (1,354 aged ≤ 5 years and 480 aged from 6 to 17 years) were examined for the nasopharyngeal pneumococcal carriage. Of them, 539 children were tested before the start of pneumococcal vaccination (2011-2014), while 1,313 were tested during the vaccine campaign (2015-2019). Pneumococcal strains were serotyped using multiplex polymerase chain reaction.Results. Streptococcus pneumoniae serotype distribution considerably differed between children ≤ 5 and 6-17 years of age. Serotypes 23F, 19F, 19A, 6AB, and 15BC were prevalent in children ≤ 5 years of age while the older children were characterised by a high prevalence of capsular serotypes (3 and 33AF/37), serogroup 9 (9AV and 9LN), non-typeable streptococci, as well as 19F, 6AB and 6CD serotypes. Vaccination was associated with a significantly decreased prevalence of Streptococcus pneumoniae carriage (from 41.5% to 19.2%) among children ≤ 5 years of age, while this reduction was less pronounced (from 13.5 to 9.0%) in older children. Vaccination led to the shift in the distribution of pneumococcal serotypes towards an increased prevalence of non-vaccine serotypes that was particularly prominent in children ≤ 5 years of age. In particular, vaccination reduced the prevalence of 23F and 19A pneumococcal serotypes but heightened prevalence of 11AD serotype and to the appearance of previously undetected serotypes such as 8, 10A, 17F, 22F, 24ABF, 34, and 39.Conclusion. Pneumococcal vaccination decreased prevalence of pneumococcal carriage, yet causing a serotype replacement effect requiring improved microbiological monitoring in children of all age groups.

scholarly journals Evaluating post-vaccine expansion patterns of pneumococcal serotypes

2020 ◽  
Author(s):  
Maile T. Phillips ◽  
Joshua L. Warren ◽  
Noga Givon-Lavi ◽  
Adrienn Tothpal ◽  
Gili Regev-Yochay ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Invasive Pneumococcal Disease ◽  
Jewish Population ◽  
Pneumococcal Disease ◽  
Pneumococcal Serotypes ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Vaccine Serotypes ◽  
Serotype Replacement ◽  
Disease Understanding

ABSTRACTStreptococcus pneumoniae remains a leading cause of morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) are effective but target only a fraction of the more than 90 pneumococcal serotypes. As a result, the introduction of PCVs has been followed by the emergence of non-vaccine serotypes. With higher-valency PCVs currently under development, there is a need to understand and predict patterns of serotype replacement to anticipate future changes. In this study, we evaluated patterns of change in serotype prevalence post-PCV introduction in Israel. We found that the assumption that non-vaccine serotypes increase by the same proportion overestimates changes in serotype prevalence in Jewish and Bedouin children. Furthermore, pre-vaccine prevalence was positively associated with increases in prevalence over the study period. From our analyses, serotypes 12F, 8, 16F, 33F, 9N, 7B, 10A, 22F, 24F, and 17F were estimated to have gained the most cases of invasive pneumococcal disease through serotype replacement in the Jewish population. However, this model also failed to quantify some additional cases gained, suggesting that changes in carriage in children alone may be insufficient to explain serotype replacement in disease. Understanding of serotype replacement is important as higher-valency vaccines are introduced.

scholarly journals Leisure Activities of Healthy Children and Adolescents

2019 ◽  
Vol 16 (12) ◽  
pp. 2078 ◽  
Author(s):  
Lea Auhuber ◽  
Mandy Vogel ◽  
Nico Grafe ◽  
Wieland Kiess ◽  
Tanja Poulain
Keyword(s):  
Physical Activity ◽  
Social Life ◽  
Economic Status ◽  
Leisure Activities ◽  
Age Groups ◽  
Healthy Children ◽  
Older Children ◽  
Physically Active ◽  
Mobile Phone Use ◽  
Study Participants

The objective of the present study was to give a detailed overview on the leisure behavior of adolescents (frequency, differences between gender, age groups and social class, time trends, and inter-relations). In total, 1449 10- to 18-year-old German adolescents were included in the study. Participants answered questionnaires about their media use, physical activity, outdoor time, engagement in choir/orchestra and theater/dancing, social life and socio-economic status (SES). The results revealed that girls, children with lower SES as well as older children reported to use screen-based media more often and that girls, older children and children with lower SES were less physically active. In addition, boys and children with lower SES engaged less frequently in choir/orchestra and theater/dancing, while children with higher SES met their friends more often. The time trend analysis showed that mobile phone use increased drastically from 2011 to 2017, while engagement in choir/orchestra and theater/dancing decreased. Regarding the inter-relation between leisure activities, high screen times were significantly associated with less physical activity and less outdoor time. Physical activity, in contrast, was significantly related to better social life and more outdoor time. These findings highlight the growing importance of electronic media in adolescents’ lives and their tendency to displace other leisure activities.

scholarly journals Estimating the contribution of HIV-infected adults to household pneumococcal transmission in South Africa, 2016–2018: A hidden Markov modelling study

2021 ◽  
Vol 17 (12) ◽  
pp. e1009680
Author(s):  
Deus Thindwa ◽  
Nicole Wolter ◽  
Amy Pinsent ◽  
Maimuna Carrim ◽  
John Ojal ◽  
...  
Keyword(s):  
South African ◽  
Hidden Markov ◽  
Age Groups ◽  
Hiv Status ◽  
Older Children ◽  
Markov Modelling ◽  
Household Transmission ◽  
Pneumococcal Carriage ◽  
Immunodeficiency Virus ◽  
Infected Adult

Human immunodeficiency virus (HIV) infected adults are at a higher risk of pneumococcal colonisation and disease, even while receiving antiretroviral therapy (ART). To help evaluate potential indirect effects of vaccination of HIV-infected adults, we assessed whether HIV-infected adults disproportionately contribute to household transmission of pneumococci. We constructed a hidden Markov model to capture the dynamics of pneumococcal carriage acquisition and clearance observed during a longitudinal household-based nasopharyngeal swabbing study, while accounting for sample misclassifications. Households were followed-up twice weekly for approximately 10 months each year during a three-year study period for nasopharyngeal carriage detection via real-time PCR. We estimated the effect of participant’s age, HIV status, presence of a HIV-infected adult within the household and other covariates on pneumococcal acquisition and clearance probabilities. Of 1,684 individuals enrolled, 279 (16.6%) were younger children (<5 years-old) of whom 4 (1.5%) were HIV-infected and 726 (43.1%) were adults (≥18 years-old) of whom 214 (30.4%) were HIV-infected, most (173, 81.2%) with high CD4+ count. The observed range of pneumococcal carriage prevalence across visits was substantially higher in younger children (56.9–80.5%) than older children (5–17 years-old) (31.7–50.0%) or adults (11.5–23.5%). We estimate that 14.4% (95% Confidence Interval [CI]: 13.7–15.0) of pneumococcal-negative swabs were false negatives. Daily carriage acquisition probabilities among HIV-uninfected younger children were similar in households with and without HIV-infected adults (hazard ratio: 0.95, 95%CI: 0.91–1.01). Longer average carriage duration (11.4 days, 95%CI: 10.2–12.8 vs 6.0 days, 95%CI: 5.6–6.3) and higher median carriage density (622 genome equivalents per millilitre, 95%CI: 507–714 vs 389, 95%CI: 311.1–435.5) were estimated in HIV-infected vs HIV-uninfected adults. The use of ART and antibiotics substantially reduced carriage duration in all age groups, and acquisition rates increased with household size. Although South African HIV-infected adults on ART have longer carriage duration and density than their HIV-uninfected counterparts, they show similar patterns of pneumococcal acquisition and onward transmission.

scholarly journals Can children swallow tablets? Outcome data from a feasibility study to assess the acceptability of different-sized placebo tablets in children (creating acceptable tablets (CAT))

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036508 ◽  
Author(s):  
Louise Bracken ◽  
Emma McDonough ◽  
Samantha Ashleigh ◽  
Fiona Wilson ◽  
Joanne Shakeshaft ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Age Groups ◽  
District General Hospital ◽  
Outcome Data ◽  
Recruitment Rate ◽  
Healthy Children ◽  
Older Children ◽  
Paediatric Hospital ◽  
Overall Acceptability ◽  
Research Facilities

ObjectiveFeasibility study to investigate the acceptability of different-sized placebo tablets in children aged 4–12 years.Design and settingClinical Research Facilities, inpatient wards and outpatient clinics within a Regional Paediatric Hospital and/or District General Hospital. Healthy children and National Health Service (NHS) patients were asked to swallow three placebo tablets: 6 mm, 8 mm and 10 mm, smallest to largest. The researcher observed children’s facial expressions and behaviours on swallowing and measured the volume of water consumed. Participants completed a questionnaire about the overall acceptability; including swallowability, taste and volume of water consumed. For analysis, participants were stratified by age: 4–8 years and 9–12 years.ResultsThe feasibility study led to an estimated recruitment rate of 0.8% for NHS inpatients and 211 healthy children over a 1-year period. In total, 55 participants were recruited, 30 to the younger group, of which 77% had never taken a tablet before. 84% of the 25 older children had previously taken a tablet. All participants attempted to swallow the smallest sized tablet. The children aged 4–8 years found the larger tablets easier to swallow, however the older children found little difference between the tablet sizes. The younger children required more water to swallow each tablet size compared with the older children where an increasing volume of water was consumed as tablet size increased. Taste was rated highly for both age groups. The 8 mm tablets were deemed the most acceptable tablet size by all participants.ConclusionTablets are potentially an acceptable formulation for children aged 4–12 years. Most children aged 4–8 years who attempted to swallow tablets successfully did so. Recruitment of NHS inpatients to medicine acceptability studies is challenging, however, recruitment of children of staff proved an effective strategy. Valuable lessons have been learnt from this feasibility study which will inform the design of a larger definitive trial.

scholarly journals 2210. Nasopharyngeal Detection of Streptococcus pneumoniae and Clinical Disease Severity in Children with Community-Acquired Pneumonia (CAP)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S753-S753
Author(s):  
Ki Wook Yun ◽  
Alexis Juergensen ◽  
Rebecca Wallihan ◽  
Ankita P Desai ◽  
Sherman J Alter ◽  
...  
Keyword(s):  
Immune Response ◽  
Streptococcus Pneumoniae ◽  
Disease Severity ◽  
Host Immune Response ◽  
Advisory Board ◽  
Diagnostic Methods ◽  
Clinical Disease ◽  
Healthy Children ◽  
Pneumococcal Carriage ◽  
Research Grant

Abstract Background Streptococcus pneumoniae is the most common pyogenic bacteria associated with CAP in children, but the proportion of cases might be underestimated because of the low sensitivity of current standard diagnostic methods. Nasopharyngeal (NP) carriage of pneumococcus commonly precedes the development of pneumococcal pneumonia, and facilitates pneumococcus interactions with other respiratory pathogens and the host immune response. This study investigated the relationship between pneumococcal carriage and the severity of CAP in children. Methods We conducted a prospective, multicenter, observational study for CAP among previously healthy children aged 2 months through 18 years in six children’s hospitals in Ohio. Blood, pleural fluid, and NP swabs were collected for pathogen detection by culture and/or polymerase chain reaction (PCR). S. pneumoniae was quantified in NP swabs by real-time PCR. Patient management followed the standard of care in each study site. Results Among 441 children with radiologically confirmed CAP, 156 (35.4%) had no bacterial or viral pathogens identified as etiologic agents. NP pneumococcal carriage rate in this group was 34.6%. Children with CAP and pneumococcal carriage (53/156) were younger (5.9 vs. 9.6 years, P < 0.001) than those with no carriage (103/156). Median neutrophil counts and median procalcitonin concentrations were significantly higher in the pneumococcal carriage group (12,030 vs. 8,370 cells/mm3 and 1.0 vs. 0.5 mg/dl, respectively; P < 0.05 for both) than in the non-carriage group. Children with documented pneumococcal carriage received respiratory support more frequently (50.0% vs. 28.2%, p = 0.012) and had a longer duration of hospitalization (3.5 ± 3.8 vs. 2.1 ± 2.0 days, P = 0.026) than those without pneumococcal carriage. Age was not associated with any of the variables used to assess clinical disease severity. Conclusion Pneumococcal carriage was associated with higher inflammatory markers and greater clinical disease severity in children with CAP in whom no pathogens were identified by standard diagnostics. This suggests that NP carriage of pneumococcus in children with CAP may modulate the host immune response and possibly influence clinical disease severity. Disclosures Octavio Ramilo, MD, Bill & Melinda Gates Foundation: Research Grant; Janssen: Research Grant; Merck: Advisory Board; NIH: Research Grant; Ohio Children’s Hospital Association (OCHA): Research Grant; Pfizer: Advisory Board, Consultant, Lectures; Sanofi/Medimmune: Advisory Board.

Urinary Excretion of Calcium Following an Oral Calcium Loading Test in Healthy Children

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 594-597
Author(s):  
F. Bruder Stapleton ◽  
H. Norman Noe ◽  
Gerald Jerkins ◽  
Shane Roy
Keyword(s):  
Age Groups ◽  
Dietary Calcium ◽  
Urinary Calcium ◽  
Dietary Calcium Intake ◽  
Healthy Children ◽  
Loading Test ◽  
Calcium Loading ◽  
Before And After ◽  
Calcium Load

The ratio of urinary calcium (UCa)/urinary creatinine (UCr) concentrations (mg/mg) during calcium loading has been used to diagnose hypercalciuric states in adults. The UCa/UCr ratios have been examined before and after an oral dose of calcium in 48 healthy children following five days of abstinence from dietary milk products. No differences in UCa/UCr ratios were observed between sexes, races, or age groups. UCa/UCr ratio before the calcium dose was 0.09 ± 0.12 (mean ± 2 SD) and increased to 0.12 ± 0.15 in urine samples collected for four hours after the calcium load. A direct relationship between UCa/UCr ratio and urinary sodium (UNa)/UCr ratio was observed (r = .57, P &lt; .01). In six children, calcium loading studies were repeated without prior restriction of dietary calcium. Dietary calcium intake before the calcium loading had little effect upon UCa/UCr ratio before the calcium dose in these six children (0.068 vs 0.08); however, UCa/UCr values after the calcium load were significantly lower (0.08 vs 0.15) when no dietary calcium restriction preceded the calcium-loading study. These data may allow characterization of renal hypercalciuria and gastrointestinal hyperabsorption of calcium in children with urolithiasis.

scholarly journals Estimating the contribution of HIV-infected adults to household pneumococcal transmission in South Africa, 2016-2018: A hidden Markov modelling study.

2021 ◽  
Author(s):  
Deus Thindwa ◽  
Nicole Wolter ◽  
Amy Pinsent ◽  
Maimuna Carrim ◽  
John Ojal ◽  
...  
Keyword(s):  
South African ◽  
Hidden Markov ◽  
Age Groups ◽  
Hiv Status ◽  
Older Children ◽  
Markov Modelling ◽  
Household Transmission ◽  
Pneumococcal Carriage ◽  
Immunodeficiency Virus ◽  
Infected Adult

Human immunodeficiency virus (HIV) infected adults are at a higher risk of pneumococcal colonisation and disease, even while receiving antiretroviral therapy (ART). To help evaluate potential indirect effects of vaccination of HIV-infected adults, we assessed whether HIV-infected adults disproportionately contribute to household transmission of pneumococci. We constructed a hidden Markov model to capture the dynamics of pneumococcal carriage acquisition and clearance observed during a longitudinal household-based nasopharyngeal swabbing study, while accounting for sample misclassifications. Households were followed-up twice weekly for 10 months for nasopharyngeal carriage detection via real-time PCR. We estimated the effect of participant age, HIV status, presence of a HIV-infected adult within the household and other covariates on pneumococcal acquisition and clearance probabilities. Of 1,684 individuals enrolled, 279 (16.6%) were younger children (<5 years-old) of whom 4 (1.5%) were HIV-infected and 726 (43.1%) were adults (>=18 years-old) of whom 214 (30.4%) were HIV-infected, most (173, 81.2%) with high CD4+ count. The observed range of pneumococcal carriage prevalence across visits was substantially higher in younger children (56.9-80.5%) than older children (5-17 years-old) (31.7-50.0%) or adults (11.5-23.5%). We estimate that 14.4% (95% Confidence Interval [CI]: 13.7-15.0) of pneumococcal-negative swabs were false negatives. Daily carriage acquisition probabilities among HIV-uninfected younger children were similar in households with and without HIV-infected adults (hazard ratio: 0.95, 95%CI: 0.91-1.01). Longer average carriage duration (11.4 days, 95%CI: 10.2-12.8 vs 6.0 days, 95%CI: 5.6 - 6.3) and higher median carriage density (622 genome equivalents per millilitre, 95%CI: 507-714 vs 389, 95%CI: 311.1-435.5) were estimated in HIV-infected vs HIV-uninfected adults. The use of ART and antibiotics substantially reduced carriage duration in all age groups, and acquisition rates increased with household size. Although South African HIV-infected adults on ART have longer carriage duration and density than their HIV-uninfected counterparts, they show similar patterns of pneumococcal acquisition and onward transmission.

scholarly journals Impact of infant pneumococcal vaccination on invasive pneumococcal diseases in France, 2001-2006

2008 ◽  
Vol 13 (35) ◽  
Author(s):  
A Lepoutre ◽  
E Varon ◽  
S Georges ◽  
L Gutmann ◽  
D Lévy-Bruhl
Keyword(s):  
Pneumococcal Meningitis ◽  
Age Groups ◽  
Pneumococcal Vaccination ◽  
Early Observation ◽  
Older Children ◽  
Vaccine Serotypes ◽  
Time Period ◽  
Laboratory Surveillance ◽  
Pneumococcal Bacteraemia ◽  
The Impact

Vaccination with the 7-valent pneumococcal conjugate vaccine (PCV) has been recommended in France since 2003 for children under the age of two years who are at risk due to medical or living conditions. From 2006, the recommendation has been extended to all children under two years. The impact of PCV introduction on the incidence of pneumococcal meningitis and bacteraemia and on the serotype distribution in French children and other age-groups was assessed using laboratory surveillance data. The coverage with three doses of PCV was 44% in children aged 6-12 months in 2006. From 2001/2002 to 2006, the incidence of pneumococcal meningitis decreased from 8.0 to 6.0 cases per 100,000, and the incidence of pneumococcal bacteraemia decreased from 21.8 to 17.5 cases per 100,000 in children under the age of two years. For the vaccine strains, the incidence of pneumococcal meningitis and bacteraemia decreased from 20,4 to 6.0 cases per 100,000, while the incidence of pneumococcal meningitis and bacteraemia due to non-vaccine strains increased from 9.4 to 17.5 cases per 100,000 in this time period. The incidence in older children and adults did not decrease. Further expansion of PCV coverage is expected to increase the impact of the vaccination in both children and adults. However, the fact that cases caused by vaccine serotypes have been partially substituted by cases of non-vaccine serotypes is likely to reduce the overall benefit of PCV in France, should this early observation be confirmed in the future.

scholarly journals Accommodative Amplitude in School-Age Children

2017 ◽  
Vol 71 (5) ◽  
pp. 387-391
Author(s):  
Gatis Ikaunieks ◽  
Karola Panke ◽  
Madara Segliņa ◽  
Aiga Švede ◽  
Gunta Krūmiņa
Keyword(s):  
Visual Acuity ◽  
Age Groups ◽  
School Age Children ◽  
School Age ◽  
Older Children ◽  
Good Visual Acuity ◽  
Before And After ◽  
Near Work ◽  
Anatomical Parameters ◽  
Accommodative Amplitude

Abstract In children, intensive near-work affects the accommodation system of the eye. Younger children, due to anatomical parameters, read at smaller distance than older children and we can expect that the accommodation system of younger can be affected more than that of older children. We wanted to test this hypothesis. Some authors showed that the norms of amplitude of accommodation (AA) developed by Hofstetter (1950) not always could be applied for children. We also wanted to verify these results. A total of 106 (age 7-15) children participated in the study. Distance visual acuity was measured for all children and only data of children with good visual acuity 1.0 or more (dec. units) were analysed (73 children). Accommodative amplitude was measured before and after lessons using subjective push-up technique (with RAF Near Point Ruler). The results showed that the amplitude of accommodation reduced significantly (p < 0.05) during the day and decrease of AA was similar in different age groups (about ~0.70 D). Additional measurements are needed to verify that the observed changes in AA were associated with fatigue effect. The results showed lower accommodation values compared to average values calculated according to the Hofstetter equation (p < 0.05).

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