{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:14:22Z","timestamp":1763018062631,"version":"3.37.3"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T00:00:00Z","timestamp":1567641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CDC Foundation","award":["971-17"],"award-info":[{"award-number":["971-17"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pneumococcus is a leading cause of pneumonia and meningitis. Zambia introduced a 10-valent pneumococcal conjugate vaccine (PCV10) in July 2013 using a 3-dose primary series at ages 6, 10, and 14 weeks with no booster. We evaluated the impact of PCV10 on meningitis and pneumonia hospitalizations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using hospitalization data from first-level care hospitals, available at the Ministry of Health, and from the largest pediatric referral hospital in Lusaka, we identified children aged &lt;5 years who were hospitalized with pneumonia or meningitis from January 2010\u2013December 2016. We used time-series analyses to measure the effect of PCV10 on monthly case counts by outcome and age group (&lt;1 year, 1\u20134 years), accounting for seasonality. We defined the pre- and post-PCV10 periods as January 2010\u2013June 2013 and July 2014\u2013December 2016, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At first-level care hospitals, pneumonia and meningitis hospitalizations among children aged &lt;5 years accounted for 108 884 and 1742 admissions in the 42 months pre-PCV10, respectively, and 44 715 and 646 admissions in the 30 months post-PCV10, respectively. Pneumonia hospitalizations declined by 37.8% (95% confidence interval [CI] 21.4\u201350.3%) and 28.8% (95% CI 17.7\u201338.7%) among children aged &lt;1 year and 1\u20134 years, respectively, while meningitis hospitalizations declined by 72.1% (95% CI 63.2\u201379.0%) and 61.6% (95% CI 50.4\u201370.8%), respectively, in these age groups. In contrast, at the referral hospital, pneumonia hospitalizations remained stable and a smaller but significant decline in meningitis was observed among children aged 1\u20134 years (39.3%, 95% CI 16.2\u201357.5%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PCV10 introduction was associated with declines in meningitis and pneumonia hospitalizations in Zambia, especially in first-level care hospitals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz456","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T07:09:28Z","timestamp":1559286568000},"page":"S58-S65","source":"Crossref","is-referenced-by-count":10,"title":["Declines in Pneumonia and Meningitis Hospitalizations in Children Under 5 Years of Age After Introduction of 10-Valent Pneumococcal Conjugate Vaccine in Zambia, 2010\u20132016"],"prefix":"10.1093","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3193-8750","authenticated-orcid":false,"given":"Evans M","family":"Mpabalwani","sequence":"first","affiliation":[{"name":"University of Zambia, School of Medicine, Department of Pediatrics & Child Health Unit, Ministry of Health, Ndeke House, Lusaka, Zambia"},{"name":"Lusaka Children\u2019s Hospital Unit, Ministry of Health, Ndeke House, Lusaka, Zambia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chileshe","family":"Lukwesa-Musyani","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory Unit, Ministry of Health, Ndeke House, Lusaka, Zambia; University Teaching Hospitals"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akakambama","family":"Imamba","sequence":"additional","affiliation":[{"name":"Lusaka Children\u2019s Hospital Unit, Ministry of Health, Ndeke House, Lusaka, Zambia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Nakazwe","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory Unit, Ministry of Health, Ndeke House, Lusaka, Zambia; University Teaching Hospitals"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belem","family":"Matapo","sequence":"additional","affiliation":[{"name":"World Health Organization Zambia Unit, Ministry of Health, Ndeke House, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chilweza M","family":"Muzongwe","sequence":"additional","affiliation":[{"name":"Department of Monitoring and Evaluation, Public Health & Research, Health Management Information System Unit, Ministry of Health, Ndeke House, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trust","family":"Mufune","sequence":"additional","affiliation":[{"name":"Department of Monitoring and Evaluation, Public Health & Research, Health Management Information System Unit, Ministry of Health, Ndeke House, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Soda","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M","family":"Mwenda","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea S","family":"Lutz","sequence":"additional","affiliation":[{"name":"Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, Georgia"},{"name":"Oak Ridge Institute for Science and Education, United States Department of Energy, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Pondo","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda C","family":"Lessa","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,9,5]]},"reference":[{"key":"2019092600314529000_CIT0001","first-page":"525","article-title":"Pneumococcal infections","volume-title":"Red book: 2006 report of the Committee on Infectious Diseases","author":"American Academy of Pediatrics","year":"2006","edition":"27th ed"},{"volume-title":"Estimated Hib and pneumococcal deaths for children under 5 years of age, 2008","author":"World Health 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