• 1.

    Lodha R, Kabra SK, Pandey RM, 2013. Antibiotics for community-acquired pneumonia in children. Cochrane Database Syst Rev 6: CD004874.

  • 2.

    Fischer Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O'Brien KL, Campbell H, Black RE, 2013. Global burden of childhood pneumonia and diarrhoea. Lancet 381: 14051416.

    • Search Google Scholar
    • Export Citation
  • 3.

    Oishi K, Tamura K, Akeda Y, 2014. Global control of pneumococcal infections by pneumococcal vaccines. Trop Med Health 42: 8386.

  • 4.

    Ruuskanen O, Lahti E, Jennings LC, Murdoch DR, 2011. Viral pneumonia. Lancet 377: 12641275.

  • 5.

    Scott JAG, Brooks WA, Peiris JSM, Holtzman D, Mulholland EK, 2008. Pneumonia research to reduce childhood mortality in the developing world. J Clin Invest 118: 12911300.

    • Search Google Scholar
    • Export Citation
  • 6.

    Grijalva CG, Nuorti JP, Arbogast PG, Martin SW, Edwards KM, Griffin MR, 2007. Decline in pneumonia admissions after routine childhood immunisation with pneumococcal conjugate vaccine in the USA: a time-series analysis. Lancet 369: 11791186.

    • Search Google Scholar
    • Export Citation
  • 7.

    Pírez MC, Algorta G, Cedrés A, Sobrero H, Varela A, Giachetto G, Montano A, 2011. Impact of universal pneumococcal vaccination on hospitalizations for pneumonia and meningitis in children in Montevideo, Uruguay. Pediatr Infect Dis J 30: 669674.

    • Search Google Scholar
    • Export Citation
  • 8.

    Ministry of Health of Rwanda, National Institute of Statistics of Rwanda, Kigali, Rwanda and ICF Macro, Calverton, Maryland, USA, 2009. Rwanda DHS, 2007-2008 - Rwanda Interim Demographic and Health Survey, FR215. Available at: http://dhsprogram.com/publications/index.cfm.

    • Search Google Scholar
    • Export Citation
  • 9.

    MOH, 2011. Expanded program on immunization, Comprehensive multi-year plan 2011–2015. Available at: http://www.gavi.org/country/rwanda/documents/#cmyp.

    • Search Google Scholar
    • Export Citation
  • 10.

    Patrzalek M, Gorynski P, Albrecht P, 2012. Indirect population impact of universal PCV7 vaccination of children in a 2 + 1 schedule on the incidence of pneumonia morbidity in Kielce, Poland. Eur J Clin Microbiol Infect Dis 31: 30233028.

    • Search Google Scholar
    • Export Citation
  • 11.

    Gray D, Zar HJ, 2009. Management of community-acquired pneumonia in HIV-infected children. Expert Rev Anti Infect Ther 7: 437451.

  • 12.

    Gray DM, Zar HJ, 2010. Community-acquired pneumonia in HIV-infected children: a global perspective. Curr Opin Pulm Med 16: 208216.

  • 13.

    Zar HJ, 2004. Pneumonia in HIV-infected and HIV-uninfected children in developing countries: epidemiology, clinical features, and management. Curr Opin Pulm Med 10: 176182.

    • Search Google Scholar
    • Export Citation
  • 14.

    Victora CG, Kirkwood BR, Ashworth A, Black RE, Rogers S, Sazawal S, Campbell H, Gove S, 1999. Potential interventions for the prevention of childhood pneumonia in developing countries: improving nutrition. Am J Clin Nutr 70: 309320.

    • Search Google Scholar
    • Export Citation
  • 15.

    WHO/UNICEF, 2014. Rwanda: WHO and UNICEF Estimates of Immunization Coverage: 2014 Revision, 123. Available at: http://data.unicef.org/child-health/immunization.html.

    • Search Google Scholar
    • Export Citation
  • 16.

    Cohen C, von Mollendorf C, de Gouveia L, Naidoo N, Meiring S, Quan V, Nokeri V, Fortuin-de Smit M, Malope-Kgokong B, Moore D, Reubenson G, Moshe M, Madhi SA, Eley B, Hallbauer U, Kularatne R, Conklin L, O'Brien KL, Zell ER, Klugman K, Whitney CG, von Gottberg A, for the South African Invasive Pneumococcal Disease Case-Control Study Group, 2014. Effectiveness of seven-valent pneumococcal conjugate vaccine (PCV-7) against invasive pneumococcal disease in HIV-infected and -uninfected children in South Africa: a matched case-control study. Clin Infect Dis 59: 808818.

    • Search Google Scholar
    • Export Citation
  • 17.

    Binagwaho A, Pegurri E, Drobac PC, Mugwaneza P, Stulac SN, Wagner CM, Karema C, Tsague L, 2013. Prevention of mother-to-child transmission of HIV: cost-effectiveness of antiretroviral regimens and feeding options in Rwanda. PLoS One 8: e54180.

    • Search Google Scholar
    • Export Citation
  • 18.

    Tornheim JA, Manya AS, Oyando N, Kabaka S, Breiman RF, Feikin DR, 2007. The epidemiology of hospitalized pneumonia in rural Kenya: the potential of surveillance data in setting public health priorities. Int J Infect Dis 11: 536543.

    • Search Google Scholar
    • Export Citation
  • 19.

    Thanee C, Pancharoen C, Likitnukul S, Luangwedchakarn V, Umrod P, Phasomsap C, Apornpong T, Chuanchareon T, Butterworth O, Puthanakit T, 2011. The immunogenicity and safety of pneumococcal conjugate vaccine in human immunodeficiency virus-infected Thai children. Vaccine 29: 58865891.

    • Search Google Scholar
    • Export Citation
  • 20.

    Abzug MJ, Pelton SI, Song LY, Fenton T, Levin MJ, Nachman SA, Borkowsky W, Rosenblatt HM, Marcinak JF, Dieudonne A, Abrams EJ, Pathak I, Pediatric AIDS Clinical Trials Group P1024 Protocol Team, 2006. Immunogenicity, safety, and predictors of response after a pneumococcal conjugate and pneumococcal polysaccharide vaccine series in human immunodeficiency virus-infected children receiving highly active antiretroviral therapy. Pediatr Infect Dis J 25: 920929.

    • Search Google Scholar
    • Export Citation
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Decline in Child Hospitalization and Mortality After the Introduction of the 7-Valent Pneumococcal Conjugative Vaccine in Rwanda

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  • 1 Department of Biology, College of Science and Technology, University of Rwanda, Kigali, Rwanda.
  • | 2 Department of Biomedical Laboratory Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
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Pneumonia is a public health problem in the tropics, and the 7-valent pneumococcal conjugative vaccine (PCV-7) has been introduced in an effort to prevent the disease and therefore reduce childhood mortality. In Rwanda, PCV-7 was introduced in 2009, and we aimed to determine its impact on the rate of child hospitalization/mortality due to pneumonia. A retrospective survey was conducted on hospitalization rates and pediatric deaths between two periods, that is, before the introduction of PCV-7 (2007–2009) and after the introduction of PCV-7 (2010–2013) in Kabutare District Hospital. There was a 53% reduction in hospitalization, with a significant decline in in-hospital deaths between the two periods. There was also a significant correlation between vaccination coverage and decline in hospitalization rates between 2009 and 2013. We conclude that PCV-7 vaccine is associated with significant reduction in the rate of child hospitalization and mortality but more mechanistic studies are warranted to determine the immunological impact, especially in the context of coinfections and malnutrition.

Author Notes

* Address correspondence to Nadine Rujeni, Department of Biomedical laboratory Sciences, College of Medicine and Health Sciences, University of Rwanda, Avenue de l'armee, P.O. Box 3286, Kigali, Rwanda. E-mail: nrujeni@gmail.com

Financial support: The Rwanda Educational Board provided a scholarship to Janvier Rurangwa.

Authors' addresses: Janvier Rurangwa, Department of Biology, College of Science and Technology, University of Rwanda, Kigali, Rwanda, E-mail: jr.herve002@gmail.com. Nadine Rujeni, Department of Biomedical laboratory Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda, E-mail: nrujeni@gmail.com.

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