Impact Assessment of the Io-Valent Pneumococcal Conjugate Vaccine in Prevention Of Pneumonia Among Children Under Five Years in Kijabe Mission Hospital, Kiambu County

Abstract

This study assessed the impact of the 10 valent pneumococcal conjugate vaccine on pneumonia prevention by determining annual trends of pneumonia, recurrent pneumonia levels as well as establishing the association of other factors, PCV-lO a.nd pneumonia. Using retrospective unmatched case control study design, the study enrolled a total of 190 participants with 130 in the first stratum (0-2~ years old) and 60 from the second stratum (Above 2~ years old). The total number' of cases was 49 and non cases were 141. The first stratum had 37 case patients (28.46%) and 9:3 (71.54%) control patients. Male gender was represented by a total of 119 patients with 27 case patients (22.69%) and 92 (77.31%) controls. The conduct of this study was necessitated by there being no other impact studies since peV-IO introduction as well as challenges of serotype replacement witnessed with previous PCVs that is likely to affect the effeetiveness of peV-IO. In addition, pneumonia causation is diverse hence its occurrence cannot be stopped by use of only peV-IO which is effective against 10 of the over 90 serotypes of pneumococcus. Furthermore: the findings of the KEMRl study in Kilifi showed that the nasopharyngeal carriage of common serotypes declined with age while the carriage for uncommon serot.ypes did not decline. peV-I0 is effective against ten common serotypes thus increasing the chances of the uncommon serotypes ca.using pneumococcal disease. Data was obtained using interviewer-administered questionnaires: The study findings were that 81.6% of the children had received PCV-lO out of whom 78.1% had received 3 doses within 14 weeks after birth. In spite of these coverage, the proportion of younger children «2 ~ years) was higher in the cases (75.5%) as compared to the controls (66.0%). However, a.ge was not a significant predictor of pneumonia (p=O.21S) as well as gender (p=O.206). Most importantly, PCV-I0 was shown to protect against pneumonia, odds ratio 0.683 (p=0.032). This association is supported by the reduction in annual incidences of pneumonia since 2012 by 48.05% to 2013 a.nd 43.75% from 2013 to 2014. Environmental factors were however, significantly associated with pneumonia to include taking the children to events and transmission of colds to children from other family members