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As a result, their increasing prevalence in pneumococcal diseases following the introduction of PCVs poses a significant public health concern. This study provides a global summary of the epidemiology of non\u2010typeable pneumococcal diseases by estimating their prevalence and antimicrobial resistance rates, and identifying the circulating sequence types. An extensive search was conducted in PubMed, Scopus and Web of Science for studies reporting pneumococcal diseases caused by non\u2010typeable\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    . A meta\u2010analysis was performed to estimate the pooled prevalence of non\u2010typeable\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    in pneumococcal diseases. Thirty\u2010four studies conducted in 25 countries spanning four continents were included in the analysis. The pooled prevalence of non\u2010typeable\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    in pneumococcal diseases was 8.7% (95% CI [4.6; 13.9]). The pooled prevalence of non\u2010typeable\n                    <jats:italic>S. pneumoniae<\/jats:italic>\n                    was highest in conjunctivitis at 37.6% (95% CI [14.4; 64.4]), followed by meningitis at 5.8% (95% CI [2.7; 9.8]), pneumonia at 5.3% (95% CI [1.8; 10.4]), and otitis media at 0.9% (95% CI [0.2; 2.1]). The pooled prevalence of non\u2010typeable\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    in pre\u2010vaccination studies and post\u2010vaccination studies was 5.2% (95% CI [1.7; 10.2]) and 10.9% (95% CI [4.5; 19.6]), respectively. More than 25% of non\u2010typeable pneumococcal isolates were multidrug\u2010resistant. This study presents the first comprehensive global estimate demonstrating a substantial prevalence of non\u2010typeable pneumococcal diseases. Continuous surveillance is essential to monitor trends in non\u2010typeable pneumococcal diseases, informing decisions on disease control and vaccine development.\n                  <\/jats:p>","DOI":"10.1111\/tmi.70067","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:01:45Z","timestamp":1774422105000},"page":"822-831","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Non\u2010Typeable\n                    <scp>\n                      <i>Streptococcus pneumoniae<\/i>\n                    <\/scp>\n                    and Pneumococcal Diseases: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9791-1848","authenticated-orcid":false,"given":"Onyansaniba K.","family":"Ntim","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology University of Ghana Medical School  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Kungu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology University of Ghana Medical School  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah K.","family":"Narwortey","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology University of Ghana Medical School  Accra Ghana"},{"name":"Navrongo Health Research Centre, Ghana Health Services Biomedical Department  Navrongo Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Donkor","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology University of Ghana Medical School  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2014.11.007"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-018-0001-8"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0103293"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1202938"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.06.028"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.47470-0"},{"key":"e_1_2_11_8_1","first-page":"816","article-title":"Use of 13\u2010Valent Pneumococcal Conjugate Vaccine and 23\u2010Valent Pneumococcal Polysaccharide Vaccine for Adults With Immunocompromising Conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR. 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