Pneumococcal carriage among children under five in Accra, Ghana, five years after the introduction of pneumococcal conjugate vaccine

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dc.contributor.authorDayie, N.T.K.D.
dc.contributor.authorTettey, E.Y.
dc.contributor.authorNewman, M.J.
dc.contributor.authorBannerman, E.
dc.contributor.authorDonkor, E.S.
dc.contributor.authorAppiah-Korang, L.
dc.contributor.authorHans-Christian, S.
dc.date.accessioned2019-11-29T08:54:16Z
dc.date.available2019-11-29T08:54:16Z
dc.date.issued2019-09-05
dc.descriptionResearch Articleen_US
dc.description.abstractBackground: The study objective was to determine the carriage and serotype distribution of Streptococcus pneumoniae among children in Accra, Ghana, five years after the introduction of the pneumococcal conjugate vaccine (PCV-13) in 2012. Methods: Nasopharyngeal swab samples were collected from 410 children below 5 years of age in Accra, Ghana, from September to December, 2016. Pneumococcal isolates were identified by optochin sensitivity and bile solubility. Serotyping was performed using the latex agglutination kit and Quellung reaction. The isolates were furthermore tested for antimicrobial susceptibility for different antimicrobials, including penicillin (PEN). Twelve isolates including seven non-typeable (NT) isolates were characterized using whole-genome sequencing analysis (WGS). Results: The overall carriage prevalence was found to be 54% (95% CI, 49–59%), and 20% (95% CI, 49–59%) of the children were carrying PCV-13 included serotypes, while 37% (95% CI, 33–42%) of the children were carrying non- PCV-13 serotypes. Based on the serotype distribution, 33% of all observed serotypes were included in PCV-13 while 66% were non-PCV-13 serotypes. The dominating non-PCV-13 serotypes were 23B, 16F, and 11A followed by PCV- 13 serotypes 23F and 19F. The PCV-13 covers the majority of resistant isolates in Accra. A proportion of 22.3% of the isolates showed intermediate resistance to penicillin G, while only one isolate showed full resistance. Forty-five isolates (20.5%) were defined as multidrug-resistant (MDR) as they were intermediate/resistant to three or more classes of antimicrobials. Of the seven NT isolates characterized by WGS, four showed highest match to genotype 38, while the remaining three showed highest match to genotype 14. Four MDR serotype 19A isolates were found to be MLST 320. Conclusion: PCV-13 introduced in Ghana did not eliminate PCV-13 covered serotypes, and the carriage rate of 54% in this study is similar to carriage studies from pre PCV-13 period. However, the penicillin non-susceptible isolates have been reduced from 45% of carriage isolates before PCV-13 introduction to 22.3% of the isolates in this study. Continuous monitoring of serotype distribution is important, and in addition, an evaluation of an alternative vaccination schedule from 3 + 0 to 2 + 1 will be important to consideren_US
dc.description.sponsorshipthe Office of Research, Innovation and Development of the University of Ghana (Grant no. URF/9/ILG-068/2015–2016) for this study is gratefully acknowledged. We also wish to thank the Torben and Alice Frimodts Foundationen_US
dc.identifier.otherhttps://doi.org/10.1186/s12887-019-1690-5
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/33913
dc.language.isoenen_US
dc.publisherBMC Pediatricsen_US
dc.relation.ispartofseries19;316
dc.subjectStreptococcus pneumoniaeen_US
dc.subjectGhanaen_US
dc.subjectCarriageen_US
dc.subjectSerotypeen_US
dc.subjectPCV-13en_US
dc.titlePneumococcal carriage among children under five in Accra, Ghana, five years after the introduction of pneumococcal conjugate vaccineen_US
dc.typeArticleen_US

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