The burden of pneumococcal disease among Latin American and Caribbean children: review of the evidence La carga de enfermedad neumocócica en niños de América Latina y el Caribe: revisión de la información científica

• Main Authors: Maria Teresa Valenzuela, Rosalyn O'Loughlin, Fernando De La Hoz, Elizabeth Gomez, Dagna Constenla, Anushua Sinha, Juan Esteban Valencia, Brendan Flannery, Ciro A. De Quadros
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2009
• Subjects: Streptococcus pneumoniae; vacunas neumocócicas; revisión; América Latina; región del Caribe; pneumococcal vaccines; review literature; Latin America and the Caribbean; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Meier
• Online Access: https://doaj.org/article/0dc21ac7c6ef4d1cb533be78a51f7b44

OBJECTIVE: To conduct a comprehensive review of data on pneumococcal disease incidence in Latin America and the Caribbean and project the annual number of pneumococcal disease episodes and deaths among children < 5 years of age in the region. METHODS: We carried out a systematic review (1990 to 2006) on the burden of pneumococcal disease in children < 5 years of age in the region. We summarized annual incidence rates and case fatality ratios using medians and interquartile ranges for invasive pneumococcal disease (IPD) (including all-IPD and separately abstracting pneumococcal meningitis, pneumonia, bacteremia, and sepsis data), pneumonia (all cause and radiologically confirmed), and acute otitis media by age group: < 1 year, < 2 years, and < 5 years. We modeled age-specific cumulative incidence of disease obtained from standard Kaplan-Meier analysis and projected data to obtain regional estimates of disease burden. We adjusted burden estimates by serotype coverage, vaccination coverage, and vaccine efficacy to estimate the number of cases and deaths averted. RESULTS: Of 5 998 citations identified, 26 papers from 10 countries were included. The estimated annual burden of pneumonia, meningitis, and acute otitis media caused by pneumococcus in children < 5 years of age ranged from 980 000 to 1 500 000, 2 600 to 6 800, and 980 000 to 1 500 000, respectively. An estimated 12 000 to 28 000 deaths due to pneumococcal disease occur in the region annually. Pneumococcal conjugate vaccine could save 1 life per 1 100 and prevent 1 case per 13 children vaccinated. CONCLUSION: A substantial burden of pneumococcal disease in the region is potentially preventable with pneumococcal conjugate vaccines and should be considered in regional vaccine decision making. Results are limited by the very few studies, conducted in selected settings, included in this review. OBJETIVO: Realizar una revisión amplia de los datos sobre la incidencia de la enfermedad neumocócica en América Latina y el Caribe y proyectar el ...