TY - JOUR
T1 - National, regional, and provincial disease burden attributed to Streptococcus pneumoniae and Haemophilus influenzae type b in children in China
T2 - Modelled estimates for 2010–17
AU - Lai, Xiaozhen
AU - Wahl, Brian
AU - Yu, Wenzhou
AU - Xu, Tingting
AU - Zhang, Haijun
AU - Garcia, Cristina
AU - Qin, Ying
AU - Guo, Yan
AU - Yin, Zundong
AU - Knoll, Maria Deloria
AU - Fang, Hai
N1 - Funding Information:
HF reports grants from the Bill & Melinda Gates Foundation and Sanofi Pasteur. BW reports grants from the Bill & Melinda Gates Foundation. MDK reports grants from the Bill & Melinda Gates Foundation, Pfizer and Gavi Alliance, and personal fees from Merck. CG reports grants from the Bill & Melinda Gates Foundation and Pfizer, and personal fees from Merck. All other authors declare no competing interests.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/5
Y1 - 2022/5
N2 - Background: Vaccination against Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) is not included in China's national immunization programme. To inform China's immunization polices, we estimated annual national, regional, and provincial childhood mortality and morbidity attributable to pneumococcus and Hib in 2010–17. Methods: We estimated proportions of pneumonia and meningitis deaths and cases attributable to pneumococcus and Hib using evidence from vaccine clinical trials and surveillance studies of bacterial meningitis and pathogen-specific case fatality ratios (CFR). Then we applied the proportions to model provincial-level pneumonia cases and deaths, meningitis deaths and meningitis CFR in children aged 1–59 months, accounting for vaccine coverage. Non-pneumonia, non-meningitis (NPNM) invasive disease cases were derived by applying NPNM meningitis ratios to meningitis estimates. Findings: In 2010–17, annual pneumococcal deaths fell by 49% from 15 600 (uncertainty range: 10 800–17 300) to 8 000 (5 500–8 900), and Hib deaths fell by 56% from 6 500 (4 500–8 800) to 2 900 (2 000–3 900). Severe pneumococcal and Hib cases decreased by 16% to 218 200 (161 500–252 200) in 2017 and 29% to 49 900 (29 000–99 100). Estimated 2017 national three-dose coverage in private market was 1·3% for PCV and 33·4% for Hib vaccine among children aged 1–59 months. Provinces in the west region had the highest disease burden. Interpretation: Childhood mortality and morbidity attributable to pneumococcal and Hib has decreased in China, but still substantially varied by region and province. Higher vaccine coverage could further reduce disease burden. Funding: Bill & Melinda Gates Foundation.
AB - Background: Vaccination against Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) is not included in China's national immunization programme. To inform China's immunization polices, we estimated annual national, regional, and provincial childhood mortality and morbidity attributable to pneumococcus and Hib in 2010–17. Methods: We estimated proportions of pneumonia and meningitis deaths and cases attributable to pneumococcus and Hib using evidence from vaccine clinical trials and surveillance studies of bacterial meningitis and pathogen-specific case fatality ratios (CFR). Then we applied the proportions to model provincial-level pneumonia cases and deaths, meningitis deaths and meningitis CFR in children aged 1–59 months, accounting for vaccine coverage. Non-pneumonia, non-meningitis (NPNM) invasive disease cases were derived by applying NPNM meningitis ratios to meningitis estimates. Findings: In 2010–17, annual pneumococcal deaths fell by 49% from 15 600 (uncertainty range: 10 800–17 300) to 8 000 (5 500–8 900), and Hib deaths fell by 56% from 6 500 (4 500–8 800) to 2 900 (2 000–3 900). Severe pneumococcal and Hib cases decreased by 16% to 218 200 (161 500–252 200) in 2017 and 29% to 49 900 (29 000–99 100). Estimated 2017 national three-dose coverage in private market was 1·3% for PCV and 33·4% for Hib vaccine among children aged 1–59 months. Provinces in the west region had the highest disease burden. Interpretation: Childhood mortality and morbidity attributable to pneumococcal and Hib has decreased in China, but still substantially varied by region and province. Higher vaccine coverage could further reduce disease burden. Funding: Bill & Melinda Gates Foundation.
KW - China
KW - Haemophilus influenzae type b
KW - Immunization
KW - Streptococcus pneumoniae
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U2 - 10.1016/j.lanwpc.2022.100430
DO - 10.1016/j.lanwpc.2022.100430
M3 - Article
C2 - 35308577
AN - SCOPUS:85126361101
SN - 2666-6065
VL - 22
JO - The Lancet Regional Health - Western Pacific
JF - The Lancet Regional Health - Western Pacific
M1 - 100430
ER -