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Phongsamart W, Allen KE, Vandepitte WP, Techasaensiri C, Kosalaraksa P, Laoprasopwattana K, Khantee P, Udompornwattana S, Suwanpakdee D, Sudjaritruk T, Puthanakit T, Anugulruengkitt S, Southern J, Fletcher MA, Dunne EM, Thamaree R, Morales G, Chokephaibulkit K, Chotpitayasunondh T. Outcomes among Thai children with risk conditions hospitalized for pneumococcal disease (invasive or non-bacteraemic pneumonia): A multi-centre, observational study. IJID REGIONS 2023; 8:49-57. [PMID: 37415954 PMCID: PMC10319896 DOI: 10.1016/j.ijregi.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 07/08/2023]
Abstract
Objective To describe the risk condition status and clinical outcomes among Thai children hospitalized with pneumococcal disease. Methods In this retrospective analysis, children with invasive pneumococcal disease (IPD) or x-ray-confirmed non-bacteraemic pneumococcal pneumonia (NBPP) were identified from nine hospitals in Thailand between 2010 and 2019. Data on risk factors and outcomes were extracted from medical records. Results In total, 413 cases were identified: 319 IPD and 94 NBPP. Overall, 133 (32.2%) patients were admitted to intensive care units and 11/406 (2.7%) died. Twenty-seven percent of IPD cases had at-risk conditions and 15% had high-risk conditions. Most IPD cases (32.9%) occurred in children aged 2-4 years, and most NBPP cases (28.7%) occurred in infants aged 0-11 months. Of 51 Streptococcus pneumoniae isolates collected, 41 (80%) were pneumococcal 13-valent conjugate vaccine serotypes. Only 5.1% of children had received a pneumococcal vaccine. Conclusions Most children with IPD and NBPP did not have high-risk or at-risk conditions, while 42% had at-risk or high-risk conditions for pneumococcal disease. Very few children in the cohort had received any type of pneumococcal vaccine. Increasing the availability of pneumococcal conjugate vaccines should be considered to reduce the burden of pneumococcal disease among children in Thailand.
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Affiliation(s)
- Wanatpreeya Phongsamart
- Department of Paediatrics, Division of Infectious Diseases, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Chonnamet Techasaensiri
- Division of Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pope Kosalaraksa
- Division of Infectious Disease, Department of Paediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Puttichart Khantee
- Department of Paediatrics, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand
| | | | | | - Tavitiya Sudjaritruk
- Department of Paediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thanyawee Puthanakit
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Suvaporn Anugulruengkitt
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jo Southern
- Pfizer Biopharma Group, Collegeville, PA, USA
| | - Mark A. Fletcher
- Pfizer Biopharma Emerging Markets Medical Affairs, Vaccines, Paris, France
| | | | | | | | - Kulkanya Chokephaibulkit
- Department of Paediatrics, Division of Infectious Diseases, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Ngamprasertchai T, Kositamongkol C, Lawpoolsri S, Rattanaumpawan P, Luvira V, Chongtrakool P, Kaewkungwal J, Chokephaibulkit K, Phisalprapa P. A cost-effectiveness analysis of the 13-valent pneumococcal conjugated vaccine and the 23-valent pneumococcal polysaccharide vaccine among Thai older adult. Front Public Health 2023; 11:1071117. [PMID: 37457251 PMCID: PMC10339832 DOI: 10.3389/fpubh.2023.1071117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction This study aims to assess the economic impact of introducing the 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) to Thai older adult aged ≥ 65 years who are healthy or with chronic health conditions and immunocompromised conditions from a societal perspective in order to introduce the vaccine to Thailand's National Immunization Program for the older adult. Methods A Markov model was adopted to simulate the natural history and economic outcomes of invasive pneumococcal diseases using updated published sources and Thai databases. We reported analyses as incremental cost-effectiveness ratios (ICER) in USD per quality-adjusted life year (QALY) gained. In addition, sensitivity analyses and budget impact analyses were conducted. Results The base-case analysis of all interventions (no vaccinations [current standard of care in Thailand], PPSV23, and PCV13) showed that PPSV23 was extendedly dominated by PCV13. Among healthy individuals or those with chronic health conditions, ICER for PCV13 was 233.63 USD/QALY; meanwhile, among individuals with immunocompromised conditions, ICER for PCV13 was 627.24 USD/QALY. PCV13 are economical vaccine for all older adult Thai individuals when compared to all interventions. Conclusions In the context of Thailand, PCV13 is recommended as the best buy and should be primarily prioritized when both costs and benefits are considered. Also, this model will be beneficial to the two-next generation pneumococcal vaccines implementation in Thailand.
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Affiliation(s)
- Thundon Ngamprasertchai
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chayanis Kositamongkol
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pinyo Rattanaumpawan
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Viravarn Luvira
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Piriyaporn Chongtrakool
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jaranit Kaewkungwal
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kulkanya Chokephaibulkit
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pochamana Phisalprapa
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Pichichero M, Malley R, Kaur R, Zagursky R, Anderson P. Acute otitis media pneumococcal disease burden and nasopharyngeal colonization in children due to serotypes included and not included in current and new pneumococcal conjugate vaccines. Expert Rev Vaccines 2023; 22:118-138. [PMID: 36565291 DOI: 10.1080/14760584.2023.2162506] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Despite the introduction of effective pneumococcal conjugate vaccines (PCV), Streptococcus pneumoniae remains a major cause of acute otitis media (AOM) worldwide. New, higher valency vaccines that offer broader serotype coverage have been recently developed and others are in development. However, given the capsular serotypes expressed by pneumococci causing AOM, it is unclear to what extent differing or higher valency PCVs will provide additional protection. AREAS COVERED We conducted a systematic literature search of the MEDLINE database to identify articles published from January 2016 to September 2021 in 4 low and middle income and 10 high-income countries. We searched PubMed with terms: (Streptococcus pneumoniae) OR pneumococcal AND serotype AND (conjugate vaccine). We evaluated serotype distribution and the actual or projected coverage of pneumococcal serotypes by PCV10 (GlaxoSmithKline), PCV13 (Pfizer), PCV10SII (Serum Institute of India) PCV15 (Merck) and PCV20 (Pfizer). EXPERT OPINION Our review highlights the important epidemiological differences in serotype distribution and coverage by existing and higher valency vaccines to protect against AOM in children. These data provide support for further evaluation of serotype-independent vaccines for optimal control of pneumococcal AOM disease worldwide.
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Affiliation(s)
- Michael Pichichero
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Richard Malley
- Boston Children's Hospital, Division of Infectious Diseases, Boston Massachusetts, USA
| | - Ravinder Kaur
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Robert Zagursky
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Porter Anderson
- Boston Children's Hospital, Division of Infectious Diseases, Boston Massachusetts, USA
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Saiphoklang N, Phadungwatthanachai J. Factors influencing acceptance of influenza and pneumococcal vaccinations for patients with chronic obstructive pulmonary disease. Hum Vaccin Immunother 2022; 18:2102840. [PMID: 35943223 DOI: 10.1080/21645515.2022.2102840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD), often complicated by influenza or pneumococcus, is a leading cause of mortality worldwide. Vaccinations against influenza and pneumococcus are, but vaccination coverage in Thailand has not been ascertained. This study aimed to determine the determinants of influenza and pneumococcal vaccination acceptance in COPD patients. A cross-sectional study of 210 COPD patients was conducted. Demographics, vaccinations, clinical outcomes (exacerbations and hospitalizations), and pulmonary functions were collected. A total of 134 COPD patients (91.0%male) were eligible for final analysis. Of these, 102 (76.1%) and 59 (44.0%) were vaccinated against influenza and pneumococcus, respectively. The influenza-vaccinated group had a higher rate of pneumococcal vaccination than the influenza-unvaccinated group (57.8% vs 0%, P < .001). Rates of influenza and pneumococcal vaccinations were higher in the pulmonologist group than in the non-pulmonologist group (71.6% vs 31.3%, P < .001 and 91.5% vs 38.7%, P < .001, respectively). By multivariable logistic regression analysis, influenza vaccination coverage was significantly higher among patients with bronchodilator response on pulmonary function testing. Pneumococcal vaccination coverage was significantly higher among patients who were seeing pulmonologists. Reasons for not getting influenza vaccination or pneumococcal vaccination were lack of recommendation, lack of knowledge, and misunderstanding, and in the case of pneumococcal vaccine, the expense. In conclusion, the influenza vaccination coverage in our COPD patients was considered high while the pneumococcal vaccination coverage was considered low. Physicians are advised to recommend and promote pneumococcal vaccination.
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Affiliation(s)
- Narongkorn Saiphoklang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Thailand
| | - Jiranan Phadungwatthanachai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Thailand
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Uttajug A, Ueda K, Seposo XT, Honda A, Takano H. Effect of a vegetation fire event ban on hospital visits for respiratory diseases in Upper Northern Thailand. Int J Epidemiol 2022; 51:514-524. [PMID: 35134940 DOI: 10.1093/ije/dyac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Upper Northern Thailand (UNT) has been episodically affected by air pollution from vegetation burning, which causes adverse respiratory health effects. However, no study has evaluated the effect of regulatory actions to prohibit vegetation burning on respiratory morbidity. We examined the effect of a burning ban enforced in May 2016 on hospital visits for respiratory diseases in UNT. METHODS This study used data from eight provinces in UNT. Analyses were conducted for January to April of 2014-2016 (before ban enforcement) and January to April of 2017-2018 (after ban enforcement). Particulate matter of 10 microns in diameter or smaller (PM10) concentrations, numbers of satellite fire hotspots and age-standardized rates of hospital visits for respiratory diseases before and after ban enforcement were compared. The effect of the ban on hospital visits for respiratory diseases was evaluated using an interrupted time-series analysis controlled for season-specific temporal trends, day of week, public holiday, temperature, relative humidity, number of hospitals and offset population, with gastrointestinal diseases as a negative control. A meta-analysis was performed to pool province-specific effect estimates. RESULTS The daily average PM10 concentration and the number of fire hotspots decreased after ban enforcement in all provinces in UNT, with percent changes ranging from 5.3 to 34.3% and 14.3 to 81.5%, respectively. The adjusted pooled effect estimates of hospital visits for respiratory diseases decreased by 9.1% (95% CI: 5.1, 12.9), whereas a null association was observed for gastrointestinal diseases. CONCLUSION The burning ban had a positive impact on both air pollution levels and rates of hospital visits for respiratory diseases in UNT.
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Affiliation(s)
- Athicha Uttajug
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan.,Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Xerxes Tesoro Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Akiko Honda
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan.,Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan.,Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan
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Lagousi T, Papadatou I, Strempas P, Chatzikalil E, Spoulou V. Pneumococcal Immunization Strategies for High-Risk Pediatric Populations Worldwide: One Size Does Not Fit All. Vaccines (Basel) 2021; 9:vaccines9121390. [PMID: 34960136 PMCID: PMC8704627 DOI: 10.3390/vaccines9121390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 10/25/2022] Open
Abstract
Despite the significant reduction in pneumococcal disease due to pneumococcal vaccines, protection of vulnerable high-risk individuals, especially pediatric populations, remains a great challenge. In an effort to maximize the protection of high-risk children against pneumococcal disease, a combined schedule that includes both conjugate and polysaccharide vaccines is recommended by several countries in the developed world. On the other hand, middle- and low-income countries do not have in place established policies for pneumococcal immunization of children at risk. Pneumococcal conjugate vaccines, despite their benefits, have several limitations, mainly associated with serotype replacement and the wide range of serotype coverage worldwide. In addition, PPV23-impaired immunogenicity and the hyporesponsiveness effect among populations at risk have been well-documented. Therefore, the added value of continuing to include PPV23 in vaccination schedules for high-risk individuals in the years to come remains to be determined by monitoring whether the replacing/remaining serotypes causing IPD are covered by PPV23 to determine whether its benefits outweigh its limitations. In this review, we aim to describe serotype distribution and vaccine efficacy data on pneumococcal disease in the pre- and post-PCV implementation era among high-risk children in both developed and developing countries, assessing the optimization of current recommendations for their vaccination against pneumococcal disease.
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Affiliation(s)
- Theano Lagousi
- Immunobiology Research Laboratory and Infectious Diseases Department “MAKKA”, First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, Athens Medical School, 11527 Athens, Greece; (I.P.); (V.S.)
- Athens Medical School, University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-746-7620
| | - Ioanna Papadatou
- Immunobiology Research Laboratory and Infectious Diseases Department “MAKKA”, First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, Athens Medical School, 11527 Athens, Greece; (I.P.); (V.S.)
- Athens Medical School, University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros Strempas
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, Athens Medical School, 11527 Athens, Greece; (P.S.); (E.C.)
| | - Elena Chatzikalil
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, Athens Medical School, 11527 Athens, Greece; (P.S.); (E.C.)
| | - Vana Spoulou
- Immunobiology Research Laboratory and Infectious Diseases Department “MAKKA”, First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, Athens Medical School, 11527 Athens, Greece; (I.P.); (V.S.)
- Athens Medical School, University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
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