Determinants of pneumococcal carriage by age in Africa (2000-2021): a systematic analysis
Abstract
Background: Streptococcus pneumoniae (S. pneumoniae) is one of the major pathogenic bacteria involved in pneumonia, with pneumococcal pneumonia often preceded by nasopharyngeal carriage of S. pneumoniae. The burden of pneumococcal pneumonia is highest in low-and middle-income countries, particularly in Africa. This systematic review examined the determinants of pneumococcal carriage across different age groups in Africa by analysing studies conducted between 2000 and 2021.
Methods: Our search strategy and inclusion criteria focused on studies describing pneumococcal carriage in Africa, from which we extracted data on group size, pneumococcal carriage, identification methods, vaccination status, respiratory tract infections, and underlying diseases.
Results: Our findings indicate the highest pneumococcal carriage rates in children under 5 years, while data on carriage in the elderly (60 years and above) remains limited. HIV/AIDS, as an underlying disease, was associated with increased pneumococcal carriage. Carriage of serotypes included in the pneumococcal vaccines was decreased in those vaccinated compared to non-vaccinated. However, we did not observe an effect of pneumococcal vaccination on total carriage, suggesting replacement of vaccine-type serotypes by non-vaccine serotypes.
Discussion: This indicates the need for further research to understand the impact of pneumococcal vaccination among all age groups in diverse geographical locations. Special emphasis should be…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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