ArticlePloS one2016
HIV Infection and the Epidemiology of Invasive Pneumococcal Disease (IPD) in South African Adults and Older Children Prior to the Introduction of a Pneumococcal Conjugate Vaccine (PCV).
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Upper airways colonisation of Streptococcus pneumoniae in adults aged 60 years and older: A systematic review of prevalence and individual participant data meta-analysis of risk factors.The Journal of infection · 2020Pooled it
- Optimizing pneumococcal prevention in South African older adults: Cost-effectiveness of PCV20 versus PPSV23 in the context of HIV-associated risk.Human vaccines & immunotherapeutics · 2026Article
- Pneumococcal population structure influences the effects of air pollution on invasive disease risk in South Africa.Nature microbiology · 2026Article
- Adult vaccination in people living with HIV attending a tertiary centre infectious diseases clinic.Southern African journal of HIV medicine · 2026Article
- Risk conditions for invasive pneumococcal disease in adults: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Pneumococcal disease burden in high-risk older adults: Exploring impact of comorbidities, long-term care facilities, antibiotic resistance, and immunization policies through a narrative literature review.Human vaccines & immunotherapeutics · 2024Review
- Nanofluidic qPCR unable to detect and serotype Streptococcus pneumoniae in urine samples of hospitalized South African patients with community-acquired pneumonia.Scientific reports · 2023Article
- Cost-Effectiveness Analysis of the South African Infant National Immunization Program for the Prevention of Pneumococcal Disease.Infectious diseases and therapy · 2023Article
- A comprehensive overview of pneumococcal vaccination recommendations for adults in South Africa, 2022.Journal of thoracic disease · 2022Review
- Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV.PloS one · 2022Article
- Cytokine response in cerebrospinal fluid of meningitis patients and outcome associated with pneumococcal serotype.Scientific reports · 2021Article
- Treponema pallidum Macrolide Resistance and Molecular Epidemiology in Southern Africa, 2008 to 2018.Journal of clinical microbiology · 2021Article
- Impact and effectiveness of 13-valent pneumococcal conjugate vaccine on population incidence of vaccine and non-vaccine serotype invasive pneumococcal disease in Blantyre, Malawi, 2006-18: prospective observational time-series and case-control studies.The Lancet. Global health · 2021Observational
- Global genomic pathogen surveillance to inform vaccine strategies: a decade-long expedition in pneumococcal genomics.Genome medicine · 2021Review
- Promoting Healthy Ageing in South Africa Through Vaccination of the Elderly.Frontiers in public health · 2021Review
- 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
- Presentation and outcome of suspected sepsis in a high-HIV burden, high antiretroviral coverage setting.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2020Article
- Article
- 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
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionStreptococcus pneumoniae is the commonest cause of bacteremic pneumonia among HIV-infected persons. As more countries with high HIV prevalence are implementing infant pneumococcal conjugate vaccine (PCV) programs, we aimed to describe the baseline clinical characteristics of adult invasive pneumococcal disease (IPD) in the pre-PCV era in South Africa in order to interpret potential indirect effects following vaccine use.
methodsNational, active, laboratory-based surveillance for IPD was conducted in South Africa from 1 January 2003 through 31 December 2008. At 25 enhanced surveillance (ES) hospital sites, clinical data, including HIV serostatus, were collected from IPD patients ≥ 5 years of age. We compared the clinical characteristics of individuals with IPD in those HIV-infected and -uninfected using multivariable analysis. PCV was introduced into the routine South African Expanded Program on Immunization (EPI) in 2009.
resultsIn South Africa, from 2003-2008, 17 604 cases of IPD occurred amongst persons ≥ 5 years of age, with an average incidence of 7 cases per 100 000 person-years. Against a national HIV-prevalence of 18%, 89% (4190/4734) of IPD patients from ES sites were HIV-infected. IPD incidence in HIV-infected individuals is 43 times higher than in HIV-uninfected persons (52 per 100 000 vs. 1.2 per 100 000), with a peak in the HIV-infected elderly population of 237 per 100 000 persons. Most HIV-infected individuals presented with bacteremia (74%, 3 091/4 190). HIV-uninfected individuals were older; and had more chronic conditions (excluding HIV) than HIV-infected persons (39% (210/544) vs. 19% (790/4190), p<0.001). During the pre-PCV immunization era in South Africa, 71% of serotypes amongst HIV-infected persons were covered by PCV13 vs. 73% amongst HIV-uninfected persons, p = 0.4, OR 0.9 (CI 0.7-1.1).
conclusionSeventy to eighty-five percent of adult IPD in the pre-PCV era were vaccine serotypes and 93% of cases had recognized risk factors (including HIV-infection) for pneumococcal vaccination. These data describe the epidemiology of IPD amongst HIV-infected and -uninfected adults during the pre-PCV era and provide a robust baseline to calculate the indirect effect of PCV in future studies.
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