TY - JOUR
T1 - Factors associated with pneumococcal carriage and density in children and adults in Fiji, using four cross-sectional surveys
AU - Neal, Eleanor F.G.
AU - Nguyen, Cattram D.
AU - Ratu, Felista T.
AU - Dunne, Eileen M.
AU - Kama, Mike
AU - Ortika, Belinda D.
AU - Boelsen, Laura K.
AU - Kado, Joseph
AU - Tikoduadua, Lisi
AU - Devi, Rachel
AU - Tuivaga, Evelyn
AU - Reyburn, Rita C.
AU - Satzke, Catherine
AU - Rafai, Eric
AU - Mulholland, E. Kim
AU - Russell, Fiona M.
PY - 2020/4
Y1 - 2020/4
N2 - This study describes predictors of pneumococcal nasopharyngeal carriage and density in Fiji. We used data from four annual (2012–2015) cross-sectional surveys, pre- and post-introduction of ten-valent pneumococcal conjugate vaccine (PCV10) in October 2012. Infants (5–8 weeks), toddlers (12–23 months), children (2–6 years), and their caregivers participated. Pneumococci were detected and quantified using lytA qPCR, with molecular serotyping by microarray. Logistic and quantile regression were used to determine predictors of pneumococcal carriage and density, respectively. There were 8,109 participants. Pneumococcal carriage was negatively associated with years post-PCV10 introduction (global P0.001), and positively associated with indigenous iTaukei ethnicity (aOR 2.74 [95% CI 2.17–3.45] P0.001); young age (infant, toddler, and child compared with caregiver participant groups) (global P0.001); urban residence (aOR 1.45 [95% CI 1.30–2.57] P0.001); living with 2 children 5 years of age (aOR 1.42 [95% CI 1.27–1.59] P0.001); low family income (aOR 1.44 [95% CI 1.28–1.62] P0.001); and upper respiratory tract infection (URTI) symptoms (aOR 1.77 [95% CI 1.57–2.01] P0.001). Predictors were similar for PCV10 and non-PCV10 carriage, except PCV10 carriage was negatively associated with PCV10 vaccination (0.58 [95% CI 0.41–0.82] P = 0.002) and positively associated with exposure to household cigarette smoke (aOR 1.21 [95% CI 1.02–1.43] P = 0.031), while there was no association between years post-PCV10 introduction and non-PCV10 carriage. Pneumococcal density was positively associated with URTI symptoms (adjusted median difference 0.28 [95% CI 0.16, 0.40] P0.001) and toddler and child, compared with caregiver, participant groups (global P = 0.008). Predictors were similar for PCV10 and non-PCV10 density, except infant, toddler, and child participant groups were not associated with PCV10 density. PCV10 introduction was associated with reduced the odds of overall and PCV10 pneumococcal carriage in Fiji. However, after adjustment iTaukei ethnicity was positively associated with pneumococcal carriage compared with Fijians of Indian Descent, despite similar PCV10 coverage rates.
AB - This study describes predictors of pneumococcal nasopharyngeal carriage and density in Fiji. We used data from four annual (2012–2015) cross-sectional surveys, pre- and post-introduction of ten-valent pneumococcal conjugate vaccine (PCV10) in October 2012. Infants (5–8 weeks), toddlers (12–23 months), children (2–6 years), and their caregivers participated. Pneumococci were detected and quantified using lytA qPCR, with molecular serotyping by microarray. Logistic and quantile regression were used to determine predictors of pneumococcal carriage and density, respectively. There were 8,109 participants. Pneumococcal carriage was negatively associated with years post-PCV10 introduction (global P0.001), and positively associated with indigenous iTaukei ethnicity (aOR 2.74 [95% CI 2.17–3.45] P0.001); young age (infant, toddler, and child compared with caregiver participant groups) (global P0.001); urban residence (aOR 1.45 [95% CI 1.30–2.57] P0.001); living with 2 children 5 years of age (aOR 1.42 [95% CI 1.27–1.59] P0.001); low family income (aOR 1.44 [95% CI 1.28–1.62] P0.001); and upper respiratory tract infection (URTI) symptoms (aOR 1.77 [95% CI 1.57–2.01] P0.001). Predictors were similar for PCV10 and non-PCV10 carriage, except PCV10 carriage was negatively associated with PCV10 vaccination (0.58 [95% CI 0.41–0.82] P = 0.002) and positively associated with exposure to household cigarette smoke (aOR 1.21 [95% CI 1.02–1.43] P = 0.031), while there was no association between years post-PCV10 introduction and non-PCV10 carriage. Pneumococcal density was positively associated with URTI symptoms (adjusted median difference 0.28 [95% CI 0.16, 0.40] P0.001) and toddler and child, compared with caregiver, participant groups (global P = 0.008). Predictors were similar for PCV10 and non-PCV10 density, except infant, toddler, and child participant groups were not associated with PCV10 density. PCV10 introduction was associated with reduced the odds of overall and PCV10 pneumococcal carriage in Fiji. However, after adjustment iTaukei ethnicity was positively associated with pneumococcal carriage compared with Fijians of Indian Descent, despite similar PCV10 coverage rates.
UR - http://www.scopus.com/inward/record.url?scp=85082790797&partnerID=8YFLogxK
U2 - 10.1371/JOURNAL.PONE.0231041
DO - 10.1371/JOURNAL.PONE.0231041
M3 - Article
C2 - 32236150
AN - SCOPUS:85082790797
SN - 1932-6203
VL - 15
JO - PLoS One
JF - PLoS One
IS - 4
M1 - e0231041
ER -