{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:05:53Z","timestamp":1789239953365,"version":"build-2803163510"},"update-to":[{"DOI":"10.12688\/f1000research.25227.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T00:00:00Z","timestamp":1604880000000}}],"reference-count":42,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T00:00:00Z","timestamp":1604880000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background<\/ns3:bold>\n                    : This study aimed to summarise the evidence on the impact of routine administration of 10-valent and 13-valent pneumococcal conjugate vaccines on pneumonia in children under five years of age in sub-Saharan Africa.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods:<\/ns3:bold>\n                    A systematic search of the literature was conducted including primary research reporting on the impact of 10- or 13-valent pneumococcal vaccines on childhood pneumonia in a sub-Saharan African country. Case-control, cohort, pre-post and time-series study designs were eligible for inclusion. Thematic narrative synthesis was carried out to summarise the findings.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results:<\/ns3:bold>\n                    Eight records were included in the final analysis, 6 records were pre-post or time-series studies, 1 was a case-control study and 1 report combined pre-post and case-control studies. Vaccine impact on clinical pneumonia measured as percentage reduction in risk (%RR) was mostly non-significant. The reduction in risk was more consistent in radiological and pneumococcal pneumonia.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions:<\/ns3:bold>\n                    Evidence of the positive impact of routine infant pneumococcal vaccination on clinical pneumonia incidence in sub-Saharan Africa is inconclusive. Ongoing surveillance and further research is required to establish the long term trend in pneumonia epidemiology and aetiology after PCV introduction.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>PROSPERO registration<\/ns3:bold>\n                    :\n                    <ns3:ext-link xmlns:ns4=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" ns4:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42019142369\">CRD42019142369<\/ns3:ext-link>\n                    30\/09\/19\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.25227.2","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T10:50:17Z","timestamp":1604919017000},"page":"765","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Estimating the impact of pneumococcal conjugate vaccines on childhood pneumonia in sub-Saharan Africa: A systematic review"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0017-8429","authenticated-orcid":false,"given":"Chukwuemeka","family":"Onwuchekwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassey","family":"Edem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Oga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2020,11,9]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"2226-34","DOI":"10.1016\/S0140-6736(03)13779-8","article-title":"Where and why are 10 million children dying every year?","volume":"361","author":"R Black","year":"2003","journal-title":"Lancet."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"e4-e5","DOI":"10.1016\/S2214-109X(18)30446-7","article-title":"Global childhood pneumonia: the good news, the bad news, and the way ahead.","volume":"7","author":"S Howie","year":"2019","journal-title":"Lancet Glob Health."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"1380-1390","DOI":"10.1016\/S0140-6736(12)61901-1","article-title":"Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: A systematic analysis.","volume":"381","author":"H Nair","year":"2013","journal-title":"Lancet."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"e47-e57","DOI":"10.1016\/S2214-109X(18)30408-X","article-title":"Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis.","volume":"7","author":"D McAllister","year":"2019","journal-title":"Lancet Glob Heal."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"5886-5892","DOI":"10.1016\/j.vaccine.2012.03.054","article-title":"Population-based surveillance for invasive pneumococcal disease and pneumonia in infants and young children in Bogot\u00e1, Colombia.","volume":"30","author":"J Benavides","year":"2012","journal-title":"Vaccine."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"1901-9","DOI":"10.1016\/j.vaccine.2011.12.012","article-title":"Population-based surveillance for invasive pneumococcal disease and pneumonia in infants and young children in Goi\u00e2nia, Brazil.","volume":"30","author":"A Andrade","year":"2012","journal-title":"Vaccine."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"2342-8","DOI":"10.1016\/j.vaccine.2012.01.047","article-title":"Prospective epidemiologic surveillance of invasive pneumococcal disease and pneumonia in children in San Jos\u00e9, Costa Rica.","volume":"30","author":"A Arguedas","year":"2012","journal-title":"Vaccine."},{"key":"ref-8","first-page":"463-7","article-title":"Pneumococcal conjugate vaccine - 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Dataset."},{"key":"ref-19","article-title":"Data extraction form.xlsx.","author":"C Onwuchekwa","year":"2020","journal-title":"figshare. 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An update and perspective.","volume":"13","author":"A Berical","year":"2016","journal-title":"Ann Am Thorac Soc."},{"key":"ref-36","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1186\/s12879-015-1198-z","article-title":"Assessing the impact of pneumococcal conjugate vaccines on invasive pneumococcal disease using polymerase chain reaction-based surveillance: An experience from South Africa.","volume":"15","author":"S Tempia","year":"2015","journal-title":"BMC Infect Dis."},{"key":"ref-37","doi-asserted-by":"publisher","first-page":"5776-5785","DOI":"10.1016\/j.vaccine.2017.09.005","article-title":"The impact of 10-valent and 13-valent pneumococcal conjugate vaccines on hospitalization for pneumonia in children: A systematic review and meta-analysis.","volume":"35","author":"C Alicino","year":"2017","journal-title":"Vaccine."},{"key":"ref-38","first-page":"353-9","article-title":"Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies.","volume":"83","author":"T Cherian","year":"2005","journal-title":"Bull World Health Organ."},{"key":"ref-39","doi-asserted-by":"publisher","first-page":"348-355","DOI":"10.1093\/ije\/dyw098","article-title":"Interrupted time series regression for the evaluation of public health interventions: A tutorial.","volume":"46","author":"J Bernal","year":"2017","journal-title":"Int J Epidemiol."},{"key":"ref-40","doi-asserted-by":"publisher","first-page":"597-600","DOI":"10.1136\/bmj.333.7568.597","article-title":"The case of the misleading funnel plot.","volume":"333","author":"J Lau","year":"2006","journal-title":"BMJ."},{"key":"ref-41","article-title":"PRISMA checklist.","author":"C Onwuchekwa","year":"2020","journal-title":"figshare."},{"key":"ref-42","doi-asserted-by":"publisher","DOI":"10.1101\/865154","article-title":"Estimating the impact of pneumococcal conjugate vaccines on childhood pneumonia in sub-Saharan Africa: A systematic review.","author":"O Chukwuemeka","year":"2019","journal-title":"bioRxiv."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/9-765\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-765\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-765\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T06:06:07Z","timestamp":1606802767000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/9-765\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,9]]},"references-count":42,"URL":"https:\/\/doi.org\/10.12688\/f1000research.25227.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.30623.r74452","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.30623.r74452","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,9]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/9-765\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.27840.r67910, Blandina Theophil Mmbaga, Kilimanjaro Christian Medical Center, Kilimanjaro Clinical Research Institute, Moshi, Tanzania, 06 Oct 2020, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/9-765\/v1#referee-response-67910","order":0,"name":"referee-response-67910","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>chukwuemeka Onwuchekwa<\/b>; \n<i>Posted: 06 Oct 2020<\/i>; Thank you for the favourable review.","URL":"https:\/\/f1000research.com\/articles\/9-765\/v2#referee-comment-6008","order":1,"name":"referee-comment-6008","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.30623.r74452, Dodi Safari, Molecular Bacteriology Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia, 01 Dec 2020, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/9-765\/v2#referee-response-74452","order":2,"name":"referee-response-74452","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}