{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T06:55:24Z","timestamp":1782543324518,"version":"3.54.5"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,4,8]],"date-time":"2019-04-08T00:00:00Z","timestamp":1554681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"US Agency for International Development","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Kenya introduced 10-valent pneumococcal conjugate vaccine (PCV10) among children &amp;lt;1 year in 2011 with catch-up vaccination among children 1\u20134 years in some areas. We assessed changes in pneumococcal carriage and antibiotic susceptibility patterns in children &amp;lt;5 years and adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>During 2009\u20132013, we performed annual cross-sectional pneumococcal carriage surveys in 2 sites: Kibera (children &amp;lt;5 years) and Lwak (children &amp;lt;5 years, adults). Only Lwak had catch-up vaccination. Nasopharyngeal and oropharyngeal (adults only) swabs underwent culture for pneumococci; isolates were serotyped. Antibiotic susceptibility testing was performed on isolates from 2009 and 2013; penicillin nonsusceptible pneumococci (PNSP) was defined as penicillin-intermediate or -resistant. Changes in pneumococcal carriage by age (&amp;lt;1 year, 1\u20134 years, adults), site, and human immunodeficiency virus (HIV) status (adults only) were calculated using modified Poisson regression, with 2009\u20132010 as baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 2962 children (2073 in Kibera, 889 in Lwak) and 2590 adults (2028 HIV+, 562 HIV\u2212). In 2013, PCV10-type carriage was 10.3% (Lwak) to 14.6% (Kibera) in children &amp;lt;1 year and 13.8% (Lwak) to 18.7% (Kibera) in children 1\u20134 years. This represents reductions of 60% and 63% among children &amp;lt;1 year and 52% and 60% among children 1\u20134 years in Kibera and Lwak, respectively. In adults, PCV10-type carriage decreased from 12.9% to 2.8% (HIV+) and from 11.8% to 0.7% (HIV\u2212). Approximately 80% of isolates were PNSP, both in 2009 and 2013.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PCV10-type carriage declined in children &amp;lt;5 years and adults post\u2013PCV10 introduction. However, PCV10-type and PNSP carriage persisted in children regardless of catch-up vaccination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz285","type":"journal-article","created":{"date-parts":[[2019,4,3]],"date-time":"2019-04-03T22:23:22Z","timestamp":1554330202000},"page":"814-826","source":"Crossref","is-referenced-by-count":16,"title":["Impact of 10-Valent Pneumococcal Conjugate Vaccine Introduction on Pneumococcal Carriage and Antibiotic Susceptibility Patterns Among Children Aged &amp;lt;5 Years and Adults With Human Immunodeficiency Virus Infection: Kenya, 2009\u20132013"],"prefix":"10.1093","volume":"70","author":[{"given":"Miwako","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfrey","family":"Bigogo","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute , Kisumu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Kim","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"},{"name":"US Public Health Service , Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ondari D","family":"Mogeni","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research , Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M","family":"Conklin","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Odoyo","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute , Kisumu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herine","family":"Odiembo","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute , Kisumu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Ouma","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research , Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M","family":"Harris","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennedy","family":"Odero","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research , Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Milucky","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Ouma","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research , Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Aol","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute , Kisumu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Audi","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute , Kisumu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton","family":"Onyango","sequence":"additional","affiliation":[{"name":"Global Disease Detection Division, Centers for Disease Control and Prevention , Nairobi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Cosmas","sequence":"additional","affiliation":[{"name":"Global Disease Detection Division, Centers for Disease Control and Prevention , Nairobi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geofrey","family":"Jagero","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research, Kenya Medical Research Institute , Kisumu"},{"name":"University of Maryland School of Medicine, Center for International Health, Education, and Biosecurity Kenya Programs , Nairobi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Farrar","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"da Gloria Carvalho","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia G","family":"Whitney","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F","family":"Breiman","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research , Nairobi, Kenya"},{"name":"Emory Global Health Institute , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda C","family":"Lessa","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,9]]},"reference":[{"key":"2024111411410443100_CIT0001","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/S1473-3099(17)30396-1","article-title":"GBD 2015 LRI Collaborators. 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No 8"},{"key":"2024111411410443100_CIT0024","unstructured":"Swarthout\n              TD\n            , LourencoJ, FronterreC, et al\n          Limited vaccine-induced control of pneumococcal carriage amongst children six years post-introduction of 13-valent pneumococcal conjugate vaccine in Malawi: impact of force-of-infection and natural immunity. In: 11th International Symposium on Pneumocicci and Pneumococcal Diseases (Melbourne, Australia), 2018. Abstract No. ISPPD-0228.Available at: https:\/\/isppd.kenes.com\/2018\/Documents\/ISPPD-11%20Abstract% 20Book.pdf"},{"key":"2024111411410443100_CIT0025","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/cid\/ciw720","article-title":"Long-term impact of a \u201c3 + 0\u201d schedule for 7- and 13-valent pneumococcal conjugate vaccines on invasive pneumococcal disease in Australia, 2002\u20132014","volume":"64","author":"Jayasinghe","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2024111411410443100_CIT0026","unstructured":"Otiti\n              M\n            , AkechD, SimiyuS, et al\n          Residual nasopharyngeal carriage of vaccine type pneumococci in a mature PCV10 immunisation programme in Kenya. In: 11th International Symposium on Pneumococci and Pneumococcal Diseases (Melbourne, Australia), 2018. Abstract No. ISPPD-0590. Available at: https:\/\/isppd.kenes.com\/2018\/Documents\/ISPPD-11%20Abstract%20Book.pdf"},{"key":"2024111411410443100_CIT0027","first-page":"369876","article-title":"Impact of 10-valent pneumococcal conjugate vaccine on invasive pne","author":"Hammitt","year":"2018"},{"key":"2024111411410443100_CIT0028","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1471-2431-10-4","article-title":"Do pneumococcal conjugate vaccines provide any cross-protection against serotype 19A?","volume":"10","author":"Hausdorff","year":"2010","journal-title":"BMC Pediatr"},{"key":"2024111411410443100_CIT0029","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1086\/648593","article-title":"Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine","volume":"201","author":"Pilishvili","year":"2010","journal-title":"J Infect 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conjugate vaccine on adult carriage of Streptococcus pneumoniae: an explanation of trends in invasive pneumococcal disease","volume":"193","author":"Hammitt","year":"2006","journal-title":"J Infect Dis"},{"key":"2024111411410443100_CIT0036","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1093\/infdis\/jir755","article-title":"Prevention of antibiotic-nonsusceptible Streptococcus pneumoniae with conjugate vaccines","volume":"205","author":"Hampton","year":"2012","journal-title":"J Infect Dis"},{"key":"2024111411410443100_CIT0037","first-page":"822","article-title":"Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged \u226565 years: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"63","author":"Tomczyk","year":"2014","journal-title":"MMWR Morb Mortal Wkly 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