Authors: Kaunda, Yamba (UTH), Evans Mpabalwani (UTH), Ruth Nakazwe (UTH), Evans Mulendele (UTH) Goitom Weldegebriel (WHO), Jason M Mwenda (WHO), Reggis Katsande (WHO), Linda de Gouveia (NICD), Elizabeth Chizema-Kawesha (MOH), Raphael Chanda (UTH), Belem Matapo (MOH), James C L Mwansa (Apex University), Chileshe Lukwesa-Musyani (UTH).
Citation Style For This Article: Yamba K, Mpabalwani E, Nakazwe R, et al. Title: Impact of PCV10 in Children <5 years hospitalized for Bacterial Meningitis at the Children’s Hospital, Lusaka, Zambia, 2010-2019. Health Press Zambia Bull. 2020; 4(4); pp 24
Background
Invasive Bacterial Diseases (IBDs) are still a public health concern in Africa, causing childhood morbidity and mortality despite the availability of vaccines. We investigated the characteristics of aetiological agents causing IBDs in children ≤5 years in the pre-and post-vaccination period in Zambia.
Method
Identification of Streptococcus pneumonia (Spn), Haemophilus influenza (Hi), and Neisseria meningitides (Nm) from cerebrospinal fluid (CSF) was achieved by microscopy, culture, antigen detection, and chemical analysis. Real-time polymerase chain reaction (RT-PCR) was performed on positive samples for the detection/confirmation of Spn, Hi, and Nm with serotyping (Spn, Hi) and serogrouping (Nm).
Results
During the period of review (2010-2019), 3810 suspected, 658 probable and 231 confirmed bacterial meningitis cases were reported. Spn, Nm, and Hi accounted for 65% (151/231), 20% (45/231) and 15% (35/231) respectively. Pneumococcal serotypes included PCV10 serotypes 52% and non-PCV10 serotypes 48% of which 14% were PCV13 serotypes and 34% non-vaccine serotypes (NVS). Of note is the 20% reduction in confirmed S. pneumonia 60% (90/151) in the pre-vaccination period (2010-2014) to 40% (61/151) in the post-vaccination period (2014-2019) and a decrease in PCV10 serotypes from 77% (36/47) to 23% (11/47). All serotyped Nm and Hi belonged to serogroup W and H. influenza type b respectively. Reduced pneumococcal susceptibility to penicillin 67% and ceftriaxone 98% was observed.
Conclusion/Recommendations
There was a decrease in the frequency of pneumococcal bacterial meningitis and PCV10 serotypes in the post-vaccination period. However, the Spn and Nm serotype/serogroup replacement and the increased penicillin resistance warrants for continued surveillance to inform and guide treatment and vaccination policies, the introduction of PCV13 in our setting, and strengthening vaccination programs.