Evidence map›Paper›PMID 36520841›Full record

ArticlePloS one2022

Effectiveness of 13-valent pneumococcal conjugate vaccine on radiological primary end-point pneumonia among cases of severe community acquired pneumonia in children: A prospective multi-site hospital-based test-negative study in Northern India.

Shally Awasthi, Neera Kohli, Monika Agarwal, Chandra Mani Pandey, Tuhina Rastogi, Anuj Kumar Pandey, Chittaranjan Roy, Kripanath Mishra, Neelam Verma, Chandra Bhushan Kumar and 6 more

Abstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Shally AwasthiDepartment of Pediatrics, King George's Medical University, Lucknow, India.ORCID 0000-0003-1254-9802
Neera KohliDepartment of Radio-diagnosis, King George's Medical University, Lucknow, India.
Monika AgarwalDepartment of Community Medicine, King George's Medical University, Lucknow, India.
Chandra Mani PandeyDepartment of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Tuhina RastogiDepartment of Pediatrics, King George's Medical University, Lucknow, India.
Anuj Kumar PandeyDepartment of Pediatrics, King George's Medical University, Lucknow, India.
Chittaranjan RoyDepartment of Community Medicine, Darbhanga Medical College and Hospital, Darbhanga, India.
Kripanath MishraDepartment of Pediatrics, Darbhanga Medical College and Hospital, Darbhanga, India.
Neelam VermaDepartment of Pediatrics, Patna Medical College and Hospital, Patna, India.
Chandra Bhushan KumarDepartment of Pediatrics, Patna Medical College and Hospital, Patna, India.
Pankaj Kumar JainDepartment of Community Medicine, Uttar Pradesh University of Medical Sciences, Etawah, India.
Rajesh YadavDepartment of Pediatrics, Uttar Pradesh University of Medical Sciences, Etawah, India.
Puneet DhasmanaDepartment of Pediatrics, King George's Medical University, Lucknow, India.
Abhishek ChauhanDepartment of Radio-diagnosis, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.
Namita MohindraDepartment of Radio-diagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Ram Chandra ShuklaDepartment of Radio-diagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCommunity acquired pneumonia (CAP) is a leading cause of under-five mortality in India and Streptococcus pneumoniae is the main bacterial pathogen for it. Pneumococcal Conjugate Vaccine 13 (PCV13) has been introduced in a phased manner, in the national immunization program of India since 2017/2018. The primary objective of this study was to evaluate the effectiveness of PCV13 on chest radiograph (CXR)-confirmed pneumonia, in children hospitalized with WHO-defined severe CAP.

methodsThis prospective, multi-site test-negative study was conducted in a hospital-network situated in three districts of Northern India where PCV13 had been introduced. Children aged 2-23 months, hospitalized with severe CAP and with interpretable CXR were included after parental consent. Clinical data was extracted from hospital records. CXRs were interpreted by a panel of three independent blinded trained radiologists. Exposure to PCV13 was defined as ≥2 doses of PCV13 in children aged ≤ 12 months and ≥ 1 dose(s) in children > 12 months of age. Our outcome measures were CXR finding of primary endpoint pneumonia with or without other infiltrates (PEP±OI); vaccine effectiveness (VE) and hospital mortality.

resultsFrom 1st June 2017-30th April 2021, among 2711 children included, 678 (25.0%) were exposed to PCV1. CXR positive for PEP±OI on CXR was found in 579 (21.4%), of which 103 (17.8%) were exposed to PCV. Adjusted odds ratio (AOR) for PEP±OI among the exposed group was 0.69 (95% CI, 0.54-0.89, p = 0.004). Adjusted VE was 31.0% (95% CI: 11.0-44.0) for PEP±OI. AOR for hospital mortality with PEP±OI was 2.65 (95% CI: 1.27-5.53, p = 0.01).

conclusionIn severe CAP, children exposed to PCV13 had significantly reduced odds of having PEP±OI. Since PEP±OI had increased odds of hospital mortality due to CAP, countrywide coverage with PCV13 is an essential priority.

Indexed as

Community-Acquired InfectionsPneumococcal InfectionsPneumonia, PneumococcalChildHospital MortalityHospitalsHumansPneumococcal VaccinesProspective StudiesVaccines, ConjugatePneumococcal VaccinesVaccines, Conjugate

Identifiers

PMID36520841
PMCPMC9754232

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.