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Project Details

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

Summary

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).

RESULTS: Pending

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.

Keywords:
Virus, Pneumococcus, Vaccine, Respiratory, Case Control, Treatment, Human










Supervising Institution:
Johns Hopkins University School of Medicine

Project Location:
United States, Bangladesh

Award Amount:
$499,003

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