ArticlePloS one2011
Ten years of surveillance for invasive Streptococcus pneumoniae during the era of antiretroviral scale-up and cotrimoxazole prophylaxis in Malawi.
Article in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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Who cites it
45 citing papers in PubMed, 74 citations in OpenAlex.
- Trial-of-antibiotics to assist tuberculosis diagnosis in symptomatic adults in Malawi (ACT-TB study): a randomised controlled trial.The Lancet. Global health · 2023Trial
- Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine in HIV-infected individuals naive to pneumococcal vaccination.AIDS (London, England) · 2015Trial
- Invasiveness potential of pneumococcal serotypes in children after introduction of PCV13 in Blantyre, Malawi.BMC infectious diseases · 2023Article
- Article
- Estimating the contribution of HIV-infected adults to household pneumococcal transmission in South Africa, 2016-2018: A hidden Markov modelling study.PLoS computational biology · 2021Article
- Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease.BMC infectious diseases · 2021Article
- Vaccine strategies to reduce the burden of pneumococcal disease in HIV-infected adults in Africa.Expert review of vaccines · 2020Review
- Influenza-like illness is associated with high pneumococcal carriage density in Malawian children.The Journal of infection · 2020Article
- Accuracy and consequences of usingBMJ open · 2020Article
- Early Signals of Vaccine-driven Perturbation Seen in Pneumococcal Carriage Population Genomic Data.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Genomic Characteristics of InvasiveBioinformatics and biology insights · 2020Article
- Distinct climate influences on the risk of typhoid compared to invasive non-typhoid Salmonella disease in Blantyre, Malawi.Scientific reports · 2019Article
- Indirect Effects of 10-Valent Pneumococcal Conjugate Vaccine Against Adult Pneumococcal Pneumonia in Rural Western Kenya.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Pneumococcal Conjugate Vaccine Impact on Meningitis and Pneumonia Among Children Aged <5 Years-Zimbabwe, 2010-2016.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Etiology and Risk Factors for Mortality in an Adult Community-acquired Pneumonia Cohort in Malawi.American journal of respiratory and critical care medicine · 2019Observational
- Effect of the duration of antimicrobial exposure on the development of antimicrobial resistance (AMR) for macrolide antibiotics: protocol for a systematic review with a network meta-analysis.Systematic reviews · 2018Article
- Burden of invasive pneumococcal disease among children in rural Mozambique: 2001-2012.PloS one · 2018Article
- Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998-2016): a surveillance study.The Lancet. Infectious diseases · 2017Article
- Article
- Genomic landscape of extended-spectrum β-lactamase resistance in Escherichia coli from an urban African setting.The Journal of antimicrobial chemotherapy · 2017Article
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveTo document trends in invasive pneumococcal disease (IPD) in a central hospital in Malawi during the period of national scale-up of antiretroviral therapy (ART) and cotrimoxazole prophylaxis.
methodsBetween 1 January 2000 and 31 December 2009 almost 100,000 blood cultures and 40,000 cerebrospinal fluid (CSF) cultures were obtained from adults and children admitted to the Queen Elizabeth Central Hospital, Blantyre, Malawi with suspected severe bacterial infection.
results4,445 pneumococcal isolates were obtained over the 10 year period. 1,837 were from children: 885 (19.9%) from blood and 952 (21.4%) from CSF. 2,608 were from adults: 1,813 (40.8%) from blood and 795 (17.9%) from CSF. At the start of the surveillance period cotrimoxazole resistance was 73.8% and at the end was 92.6%. Multidrug resistance (MDR) was present in almost one third of isolates and was constant over time. Free ART was introduced in Malawi in 2004. From 2005 onwards there was a decline in invasive pneumococcal infections with a negative correlation between ART scale-up and the decline in IPD (Pearson's correlation r = -0.91; p<0.001).
conclusionDuring 2004-2009, national ART scale-up in Malawi was associated with a downward trend in IPD at QECH. The introduction of cotrimoxazole prophylaxis in HIV-infected groups has not coincided with a further increase in pneumococcal cotrimoxazole or multidrug resistance. These data highlight the importance of surveillance for high disease burden infections such as IPD in the region, which will be vital for monitoring pneumococcal conjugate vaccine introduction into national immunisation programmes.
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