# name
Burden of invasive pneumococcal disease among children in rural
                Mozambique: 2001-2012

# metadata.dc.description.abstract[].value
BACKGROUND: Invasive pneumococcal disease (IPD) is a major cause
                of illness and death among children worldwide. 10-valent
                pneumococcal conjugate vaccine (PCV10) was introduced as part of
                the Mozambican routine immunization program in April 2013. We
                characterized the IPD burden in a rural area of Mozambique
                before PCV introduction and estimated the potential impact of
                this intervention. METHODS: We conducted population-based
                surveillance for IPD, defined as S. pneumoniae isolated from
                blood or cerebrospinal fluid, among children <5 years old
                admitted to Manhica District Hospital, a referral hospital in a
                rural area with high prevalence of human immunodiciency virus
                infection. S. pneumoniae was identified using standard
                microbiologic methods and serotyped using sequential multiplex
                PCR or Quellung. IPD incidence was calculated among cases from a
                defined catchment area. RESULTS: From January 2001 through
                December 2012, we isolated 768 cases of IPD, 498 (65%) of which
                were bacteraemic pneumonia episodes. A total of 391 (51%) were
                from the catchment area, yielding IPD incidence rates of 479,
                390 and 107 episodes per 100,000 children-years at risk among
                children <12, 12-23 and 24-<60 months old, respectively.
                The overall IPD incidence fluctuated and showed a downward trend
                over time. In these same age groups, in-hospital death occurred
                in 48 (17%), 26 (12%), and 21 (13%) of all IPD cases,
                respectively. Overall 90% (543/603) of IPD isolates were
                available for serotyping; of those, 65% were covered by PCV10
                and 83% by PCV13. Among 77 hospital deaths associated with
                serotyped IPD, 49% and 69% were caused by isolates included in
                the PCV10 and PCV13, respectively. CONCLUSIONS: We describe very
                high rates of IPD among children in rural Mozambique that were
                declining before PCV introduction. Children <1 year old have
                the greatest incidence and case fatality; although the rates
                remain high among older groups as well. Most IPD episodes and
                many deaths among children <5 years old will likely be
                prevented through PCV10 introduction in Mozambique.

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.1371/journal.pone.0190687

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Burden of invasive pneumococcal disease among children in rural
                Mozambique: 2001-2012