Abstract:
Background: Pneumococcal vaccine immunizations may be responsible for alterations in serotype epidemiology
within a region. This study investigated the pneumococcal carriage prevalence and the impact of the 13-valent
pneumococcal conjugate vaccine (PCV-13) on circulating serotypes among healthy children in Northern Ghana.
Methods: This was a cross sectional study conducted in the Kassena-Nankana districts of Northern Ghana from
November to December during the dry season of 2018. Nasopharyngeal swabs collected from 193 participants
were cultured per standard microbiological protocols and pneumococcal isolates were serotyped using the latex
agglutination technique and the capsular Quellung reaction test. We examined for any association between the
demographic characteristics of study participants and pneumococcal carriage using chi-square test and logistic
regression.
Results: Of the 193 participants that were enrolled the mean age was 8.6 years and 54.4% were females. The
carriage rate among the participants was 32.6% (63/193), and twenty different serotypes were identified. These
included both vaccine serotypes (VT), 35% (7/20) and non-vaccine serotypes (NVT), 65% (13/20). The predominant
serotypes (34 and 11A), both of which were NVT, accounted for a prevalence of 12.8%. PCV-13 covered only 35% of
serotypes identified whiles 40% of serotypes are covered by PPV 23.
Conclusion: Post-vaccination carriage of S. pneumoniae is high and is dominated by non-vaccine serotypes. There
is therefore a need for the conduct of invasive pneumococcal disease surveillance (IPD) to find out if the high nonvaccine
serotype carriage translates to disease. And in addition, a review of the currently used PCV-13 vaccine in
the country would be considered relevant.
