{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T07:28:17Z","timestamp":1774682897936,"version":"3.50.1"},"reference-count":42,"publisher":"BMJ","issue":"5","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"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,4,25]]},"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pneumococcal conjugate vaccines (PCVs) prevent disease through both direct protection of vaccinated individuals and indirect protection of unvaccinated individuals by reducing nasopharyngeal (NP) carriage and transmission of vaccine-type (VT) pneumococci. While the indirect effects of PCV vaccination are well described, the PCV coverage required to achieve the indirect effects is unknown. We will investigate the relationship between PCV coverage and VT carriage among undervaccinated children using hospital-based NP pneumococcal carriage surveillance at three sites in Asia and the Pacific.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      We are recruiting cases, defined as children aged 2\u201359 months admitted to participating hospitals with acute respiratory infection in Lao People\u2019s Democratic Republic, Mongolia and Papua New Guinea. Thirteen-valent PCV status is obtained from written records. NP swabs are collected according to standard methods, screened using\n                      <jats:italic>lytA<\/jats:italic>\n                      qPCR and serotyped by microarray. Village-level vaccination coverage, for the resident communities of the recruited cases, is determined using administrative data or community survey. Our analysis will investigate the relationship between VT carriage among undervaccinated cases (indirect effects) and vaccine coverage using generalised estimating equations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval has been obtained from the relevant ethics committees at participating sites. The results are intended for publication in open-access peer-reviewed journals and will demonstrate methods suitable for low- and middle-income countries to monitor vaccine impact and inform vaccine policy makers about the PCV coverage required to achieve indirect protection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-021512","type":"journal-article","created":{"date-parts":[[2018,5,18]],"date-time":"2018-05-18T05:50:26Z","timestamp":1526622626000},"page":"e021512","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries: a protocol for a prospective observational 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Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen M","family":"Dunne","sequence":"additional","affiliation":[{"name":"Pneumococcal Research Group, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross","family":"Andrews","sequence":"additional","affiliation":[{"name":"Global & Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia"},{"name":"National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher C","family":"Blyth","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Western Australia, Perth, Australia"},{"name":"Department of Infectious Diseases, Princess Margaret 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