{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:49:17Z","timestamp":1765961357947,"version":"3.37.3"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite the availability of vaccines, invasive bacterial diseases remain a public health concern and cause childhood morbidity and mortality. We investigated the characteristics of etiological agents causing bacterial meningitis in children &amp;lt;5 years in the years pre- (2010\u20132012) and post- (2014\u20132019) 10-valent pneumococcal conjugate vaccine (PCV10) introduction in Zambia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hi), and Neisseria meningitidis (Nm) from cerebrospinal fluid (CSF) were identified by microbiological culture and\/or real-time polymerase chain reaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the surveillance period, a total of 3811 children were admitted with suspected meningitis, 16% (598 of 3811) of which were probable cases. Bacterial meningitis was confirmed in 37% (221 of 598) of the probable cases. Spn pneumoniae, Hi, and Nm accounted for 67% (148 of 221), 14% (31 of 221), and 19% (42 of 221) of confirmed cases, respectively. Thirty-six percent of pneumococcal meningitis was caused by 10-valent pneumococcal conjugate vaccine (PCV10) serotypes, 16% 13-valent pneumococcal conjugate vaccine and 39% by nonvaccine serotype (NVS). There was an association between the introduction of PCV10 vaccination and a decrease in both Spn meningitis and the proportion of PVC10 serotypes in the postvaccination period. Antimicrobial susceptibility of 47 Spn isolates revealed 34% (16 of 47) penicillin resistance. The 31 serotyped Hi accounted for 74% type b (Hib) and 10% type a (Hia). All 42 serogrouped Nm belonged to serogroup W.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There was a decline in pneumococcal meningitis and proportion of PCV10 serotypes in the postvaccination period. However, the serotype replacement with non-PCV10 serotypes and penicillin resistance warrant continued surveillance to inform policy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab193","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T19:10:50Z","timestamp":1617649850000},"page":"S275-S284","source":"Crossref","is-referenced-by-count":8,"title":["The Burden of Invasive Bacterial Disease and the Impact of 10-Valent Pneumococcal Conjugate Vaccine in Children &amp;lt;5 years hospitalized for Meningitis in Lusaka, Zambia, 2010\u20132019"],"prefix":"10.1093","volume":"224","author":[{"given":"Kaunda","family":"Yamba","sequence":"first","affiliation":[{"name":"University Teaching Hospitals, Pathology & Microbiology Laboratory, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evans","family":"Mpabalwani","sequence":"additional","affiliation":[{"name":"University of Zambia, School of Medicine, Department of Paediatrics & Child Health, Lusaka, Zambia"},{"name":"University Teaching Hospitals, Children\u2019s Hospital, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Nakazwe","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals, Pathology & Microbiology Laboratory, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evans","family":"Mulendele","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals, Children\u2019s Hospital, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goitom","family":"Weldegebriel","sequence":"additional","affiliation":[{"name":"World Health Organisation, Regional Office for Africa, Brazzaville, Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M","family":"Mwenda","sequence":"additional","affiliation":[{"name":"World Health Organisation, Regional Office for Africa, Brazzaville, Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reggis","family":"Katsande","sequence":"additional","affiliation":[{"name":"World Health Organisation, Regional Office for Africa, Brazzaville, Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"de Gouveia","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Chizema-Kawesha","sequence":"additional","affiliation":[{"name":"Ministry of Health, Directorate of Public Health, Disease Surveillance and Research, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Chanda","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals, Pathology & Microbiology Laboratory, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belem","family":"Matapo","sequence":"additional","affiliation":[{"name":"World Health Organisation, Regional Office for Africa, Brazzaville, Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C L","family":"Mwansa","sequence":"additional","affiliation":[{"name":"Lusaka Apex Medical University, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chileshe","family":"Lukwesa-Musyani","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals, Pathology & Microbiology Laboratory, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"2021090116304195600_CIT0001","article-title":"Levels & Trends in Child Mortality 2019","volume":"52","author":"UNICEF: WHO: World Bank: UN DESA.","year":"2019","journal-title":"UN IGME Rep"},{"key":"2021090116304195600_CIT0002","doi-asserted-by":"crossref","first-page":"419","DOI":"10.2471\/BLT.07.047159","article-title":"Childhood vaccination in Africa and Asia: the effects of parents\u2019 knowledge and attitudes","volume":"86","author":"Jheeta","year":"2008","journal-title":"Bull World Health Organ"},{"author":"UNICEF","key":"2021090116304195600_CIT0003"},{"key":"2021090116304195600_CIT0004","doi-asserted-by":"crossref","first-page":"e0198772","DOI":"10.1371\/journal.pone.0198772","article-title":"Global etiology of bacterial meningitis: a systematic review and meta-analysis","volume":"13","author":"Oordt-Speets","year":"2018","journal-title":"PLoS One"},{"key":"2021090116304195600_CIT0005","doi-asserted-by":"crossref","first-page":"e735","DOI":"10.1016\/S2214-109X(19)30081-6","article-title":"National, regional, and state-level burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in India: modelled estimates for 2000\u201315","volume":"7","author":"Wahl","year":"2019","journal-title":"Lancet Glob Heal"},{"key":"2021090116304195600_CIT0006","doi-asserted-by":"crossref","first-page":"e229","DOI":"10.1016\/j.ijid.2012.05.838","article-title":"Aetiological agents of meningitis in Zambia: is there a need for a pneumococcal vaccine?","volume":"16","author":"Lukwesa","year":"2012","journal-title":"Int J Infect Dis"},{"key":"2021090116304195600_CIT0007","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12866-016-0747-y","article-title":"Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae in children with acute bacterial meningitis in Mozambique: implications for a national immunization strategy","volume":"16","author":"Nhantumbo","year":"2016","journal-title":"BMC Microbiol"},{"key":"2021090116304195600_CIT0008","doi-asserted-by":"crossref","first-page":"S58","DOI":"10.1093\/cid\/ciz456","article-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","volume":"69","author":"Mpabalwani","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2021090116304195600_CIT0009","first-page":"49","article-title":"Clinical infectious diseases","volume":"2019","author":"Mwenda","year":"2019","journal-title":"Meningitis Surveill Africa"},{"key":"2021090116304195600_CIT0010","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S1473-3099(05)70083-9","article-title":"Epidemiological differences among pneumococcal serotypes","volume":"5","author":"Hausdorff","year":"2005","journal-title":"Lancet Infect Dis"},{"key":"2021090116304195600_CIT0011","first-page":"e735","volume-title":"The Lancet Global Health","author":"Wahl","year":"2019"},{"key":"2021090116304195600_CIT0012","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S1473-3099(10)70048-7","article-title":"Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis","volume":"10","author":"Edmond","year":"2010","journal-title":"Lancet Infect Dis"},{"key":"2021090116304195600_CIT0013","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1080\/14760584.2020.1825948","article-title":"Haemophilus influenzae type b disease in the era of conjugate vaccines: critical factors for successful eradication","volume":"19","author":"Slack","year":"2020","journal-title":"Expert Rev. Vaccines [Internet]"},{"key":"2021090116304195600_CIT0014","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0140-6736(09)61203-4","article-title":"Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates","volume":"374","author":"Watt","year":"2009","journal-title":"Lancet"},{"key":"2021090116304195600_CIT0015","first-page":"E116","article-title":"Epidemiology of Neisseria meningitidis infections: case distribution by age and relevance of carriage","volume":"56","author":"Gabutti","year":"2015","journal-title":"J Prev Med Hyg"},{"key":"2021090116304195600_CIT0016","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1080\/21645515.2018.1451287","article-title":"Vaccination strategies for the prevention of meningococcal disease","volume":"14","author":"Vuocolo","year":"2018","journal-title":"Hum Vaccines Immunother"},{"key":"2021090116304195600_CIT0017","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1080\/21645515.2018.1454570","article-title":"Impact of meningococcal vaccination on carriage and disease transmission: a review of the literature","volume":"14","author":"Balmer","year":"2018","journal-title":"Hum Vaccines Immunother"},{"year":"2015","author":"WHO.","key":"2021090116304195600_CIT0018"},{"key":"2021090116304195600_CIT0019","first-page":"S21","article-title":"The effect of Haemophilus influenzae type B and pneumococcal conjugate vaccines on childhood meningitis mortality: a systematic review","volume-title":"BMC Public Health [Internet]","author":"Davis","year":"2013"},{"year":"2020","author":"World Health Organization.","key":"2021090116304195600_CIT0020"},{"year":"2020","author":"World Health Organization.","key":"2021090116304195600_CIT0021"},{"author":"World Health Organization","key":"2021090116304195600_CIT0022"},{"key":"2021090116304195600_CIT0023","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1128\/JCM.06087-11","article-title":"Clinical validation of multiplex real-time PCR assays for detection of bacterial meningitis pathogens","volume":"50","author":"Wang","year":"2012","journal-title":"J Clin Microbiol"},{"key":"2021090116304195600_CIT0024","doi-asserted-by":"crossref","first-page":"3271","DOI":"10.1128\/JCM.01061-14","article-title":"Challenges of using molecular serotyping for surveillance of pneumococcal disease","volume":"52","author":"Magomani","year":"2014","journal-title":"J Clin Microbiol"},{"key":"2021090116304195600_CIT0025","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1128\/JCM.02927-12","article-title":"Sequential triplex real-time PCR assay for detecting 21 pneumococcal capsular serotypes that account for a high global disease burden","volume":"51","author":"Pimenta","year":"2013","journal-title":"J Clin Microbiol"},{"key":"2021090116304195600_CIT0026","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1128\/JCM.06087-11","article-title":"Clinical validation of multiplex real-time PCR assays for detection of bacterial meningitis pathogens","volume":"50","author":"Wang","year":"2012","journal-title":"J Clin Microbiol"},{"key":"2021090116304195600_CIT0027","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1128\/JCM.00102-07","article-title":"Real-time PCR for determining capsular serotypes of Haemophilus influenzae","volume":"45","author":"Maaroufi","year":"2007","journal-title":"J Clin Microbiol"},{"author":"CLSI","key":"2021090116304195600_CIT0028"},{"key":"2021090116304195600_CIT0029","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0197390","article-title":"Characterization of strains of Neisseria meningitidis causing meningococcal meningitis in Mozambique, 2014: implications for vaccination against meningococcal meningitis","author":"Munguambe","year":"2018","journal-title":"PLoS One"},{"key":"2021090116304195600_CIT0030","doi-asserted-by":"crossref","first-page":"e0179905","DOI":"10.1371\/journal.pone.0179905","article-title":"Estimated severe pneumococcal disease cases and deaths before and after pneumococcal conjugate vaccine introduction in children younger than 5 years of age in South Africa","volume":"12","author":"von Mollendorf","year":"2017","journal-title":"PLoS One"},{"key":"2021090116304195600_CIT0031","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0198772","article-title":"Global etiology of bacterial meningitis: a systematic review and meta-analysis","author":"Oordt-Speets","year":"2018","journal-title":"PLoS One"},{"key":"2021090116304195600_CIT0032","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.3201\/eid\/1706.101404","article-title":"Invasive Streptococcus pneumoniae in children, Malawi, 2004\u20132006","volume":"17","author":"Cornick","year":"2011","journal-title":"Emerg Infect Dis"},{"key":"2021090116304195600_CIT0033","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1128\/CMR.00018-12","article-title":"Pediatric invasive pneumococcal disease in the United States in the era of pneumococcal conjugate vaccines","volume":"25","author":"Tan","year":"2012","journal-title":"Clin Microbiol Rev"},{"key":"2021090116304195600_CIT0034","doi-asserted-by":"crossref","first-page":"S81","DOI":"10.1093\/cid\/ciz474","article-title":"Pediatric Bacterial Meningitis Surveillance in Nigeria from 2010 to 2016, Prior to and during the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine","volume":"69","author":"Tagbo","year":"2019","journal-title":"Clin. Infect. Dis"},{"key":"2021090116304195600_CIT0035","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0177746","article-title":"Surveillance of impact of PCV-10 vaccine on pneumococcal meningitis in Mozambique, 2013 - 2015","author":"Nhantumbo","year":"2017","journal-title":"PLoS One"},{"key":"2021090116304195600_CIT0036","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.jpeds.2019.07.057","article-title":"Diversity of serotype replacement after pneumococcal conjugate vaccine implementation in Europe","volume":"213","author":"Levy","year":"2019","journal-title":"J Pediatr"},{"key":"2021090116304195600_CIT0037","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1080\/21645515.2015.1084450","article-title":"The potential impact of pneumococcal conjugate vaccine in Africa: considerations and early lessons learned from the South African experience","volume":"12","author":"Madhi","year":"2016","journal-title":"Hum Vaccin Immunother"},{"key":"2021090116304195600_CIT0038","doi-asserted-by":"crossref","first-page":"18977","DOI":"10.1038\/s41598-020-75691-5","article-title":"Divergent serotype replacement trends and increasing diversity in pneumococcal disease in high income settings reduce the benefit of expanding vaccine valency","volume":"10","author":"L\u00f8chen","year":"2020","journal-title":"Sci Rep"},{"year":"2020","author":"World Health Organization (WHO).","key":"2021090116304195600_CIT0039"},{"key":"2021090116304195600_CIT0040","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1093\/cid\/ciz505","article-title":"Declining trends of pneumococcal meningitis in Gambian children after the introduction of pneumococcal conjugate vaccines","volume":"69","author":"Sanneh","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2021090116304195600_CIT0041","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/S1473-3099(16)30253-5","article-title":"Emergence of epidemic Neisseria meningitidis serogroup C in Niger, 2015: an analysis of national surveillance data","volume":"16","author":"Sidikou","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"2021090116304195600_CIT0042","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1086\/525260","article-title":"Emergence of endemic serogroup W135 meningococcal disease associated with a high mortality rate in South Africa","volume":"46","author":"von Gottberg","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2021090116304195600_CIT0043","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijid.2016.12.001","article-title":"Resurgence of Neisseria meningitidis serogroup W ST-11 (cc11) in Madagascar, 2015\u20132016","volume":"55","author":"Rasoanandrasana","year":"2017","journal-title":"Int J Infect Dis"},{"key":"2021090116304195600_CIT0044","doi-asserted-by":"crossref","first-page":"e19717","DOI":"10.1371\/journal.pone.0019717","article-title":"Epidemiology, molecular characterization and antibiotic resistance of Neisseria meningitidis from patients \u226415 years in Manhi\u00e7a, rural Mozambique","volume":"6","author":"Ibarz-Pav\u00f3n","year":"2011","journal-title":"PLoS One"},{"key":"2021090116304195600_CIT0045","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.15585\/mmwr.mm6649a3","article-title":"Large outbreak of Neisseria meningitidis Serogroup C \u2014 Nigeria, December 2016\u2013June 2017","volume":"66","author":"Nnadi","year":"2017","journal-title":"Morb Mortal Wkly Rep"},{"key":"2021090116304195600_CIT0046","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/infdis\/jiz336","article-title":"Status of the rollout of the meningococcal serogroup A conjugate vaccine in African meningitis belt countries in 2018","volume":"220","author":"Bwaka","year":"2019","journal-title":"J Infect Dis"},{"key":"2021090116304195600_CIT0047","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1016\/j.vaccine.2017.02.045","article-title":"Childhood pneumococcal disease in Africa - A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility","volume":"35","author":"Iroh Tam","year":"2017","journal-title":"Vaccine"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/224\/Supplement_3\/S275\/40211117\/jiab193.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/224\/Supplement_3\/S275\/40211117\/jiab193.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T16:35:41Z","timestamp":1630514141000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/224\/Supplement_3\/S275\/6361064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,1]]},"references-count":47,"journal-issue":{"issue":"Supplement_3","published-online":{"date-parts":[[2021,9,1]]},"published-print":{"date-parts":[[2021,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiab193","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"type":"print","value":"0022-1899"},{"type":"electronic","value":"1537-6613"}],"subject":[],"published-other":{"date-parts":[[2021,9,1]]},"published":{"date-parts":[[2021,9,1]]}}}