E.W. "Al" Thrasher
Status: Funded - Closed
Effectiveness of PCV-10 to reduce severe viral acute lower respiratory infection in Bangladesh
Megan Reller, M.D., Ph.D., MPH, DTM&H
BACKGROUND: Pneumonia and other acute lower respiratory infections (ALRI) are the leading cause of death in children worldwide (1.5 million per year in resource-limited countries) and viruses, with or without bacterial co-infection, cause at least 50% of these infections. A 10-valent pneumococcal conjugate vaccine (PCV-10) will soon be introduced into the national infant immunization program in Bangladesh with catch-up (for those <23 months residing in the study areas).
GAP: PCV-10 may decrease mortality by reducing severe disease related to respiratory virus-Streptococcus pneumoniae co-infections; in a trial in South Africa, a 9-valent PCV significantly reduced viral ALRI: influenza A (45%), parainfluenza 1-3 (44%), respiratory syncytial virus (22%), and human metapneumovirus (45%). The effectiveness of 10-valent PCV-10 on severe viral ALRI in children 2-23 months of age is unstudied.
HYPOTHESIS: We hypothesize that PCV-10 will effectively decrease severe viral ALRI in children 2-23 months of age in Bangladesh.
METHODS: We will study children under surveillance for invasive pneumococcal disease (IPD) in a well-established rural field site (Sylhet-district, population ~770,000) in Bangladesh.
We will evaluate PCV-10’s impact by assessing any PCV-10 vaccine vs. none among cases (patients with laboratory-confirmed severe viral ALRI) vs. controls (2 hospital-based, age- and sex-matched without ALRI).
IMPACT: The stronger the evidence for the beneficial impact of PCV-10 on reducing ALRI and IPD, the more likely resource-poor countries are to invest limited resources in this intervention; further, this work has other potential implications for prevention and treatment, such as routine vaccination for influenza and/or use of anti-viral medications in patients with severe ALRI who are at greatest risk for death.
Virus, Pneumococcus, Vaccine, Respiratory, Case Control, Treatment, Human
Johns Hopkins University School of Medicine
United States, Bangladesh