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The effect of Haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence, severe morbidity and mortality.
Int J Epidemiol. 2010 Apr; 39 Suppl 1:i172-85.IJ

Abstract

BACKGROUND

With the aim of populating the Lives Saved Tool (LiST) with parameters of effectiveness of existing interventions, we conducted a systematic review of the literature assessing the effect of Haemophilus influenzae type b (Hib) and pneumococcal (PC) conjugate vaccines on incidence, severe morbidity and mortality from childhood pneumonia.

METHODS

We summarized cluster randomized controlled trials (cRCTs) and case-control studies of Hib conjugate vaccines and RCTs of 9- and 11-valent PC conjugate vaccines conducted in developing countries across outcome measures using standard meta-analysis methods. We used a set of standardized rules developed for the purpose of populating the LiST tool with required parameters to promote comparability across reviews of interventions against the major causes of childhood mortality. The estimates could be adjusted further to account for factors such as PC vaccine serotype content, PC serotype distribution and human immunodeficiency virus prevalence but this was not included as part of the LiST model approach.

RESULTS

The available evidence from published data points to a summary effect of the Hib conjugate vaccine on clinical pneumonia of 4%, on clinical severe pneumonia of 6% and on radiologically confirmed pneumonia of 18%. Respective effectiveness estimates for PC vaccines (all valent) on clinical pneumonia is 7%, clinical severe pneumonia is 7% and radiologically confirmed pneumonia is 26%.

CONCLUSIONS

The findings indicated that radiologically confirmed pneumonia, as a severe morbidity proxy for mortality, provided better estimates for the LiST model of effect of interventions on mortality reduction than did other outcomes evaluated. The LiST model will use this to estimate the pneumonia mortality reduction which might be observed when scaling up Hib and PC conjugate vaccination in the context of an overall package of child health interventions.

Authors+Show Affiliations

Public Health Sciences, University of Edinburgh, Edinburgh, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

20348119

Citation

Theodoratou, Evropi, et al. "The Effect of Haemophilus Influenzae Type B and Pneumococcal Conjugate Vaccines On Childhood Pneumonia Incidence, Severe Morbidity and Mortality." International Journal of Epidemiology, vol. 39 Suppl 1, 2010, pp. i172-85.
Theodoratou E, Johnson S, Jhass A, et al. The effect of Haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence, severe morbidity and mortality. Int J Epidemiol. 2010;39 Suppl 1:i172-85.
Theodoratou, E., Johnson, S., Jhass, A., Madhi, S. A., Clark, A., Boschi-Pinto, C., Bhopal, S., Rudan, I., & Campbell, H. (2010). The effect of Haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence, severe morbidity and mortality. International Journal of Epidemiology, 39 Suppl 1, i172-85. https://doi.org/10.1093/ije/dyq033
Theodoratou E, et al. The Effect of Haemophilus Influenzae Type B and Pneumococcal Conjugate Vaccines On Childhood Pneumonia Incidence, Severe Morbidity and Mortality. Int J Epidemiol. 2010;39 Suppl 1:i172-85. PubMed PMID: 20348119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of Haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence, severe morbidity and mortality. AU - Theodoratou,Evropi, AU - Johnson,Sue, AU - Jhass,Arnoupe, AU - Madhi,Shabir A, AU - Clark,Andrew, AU - Boschi-Pinto,Cynthia, AU - Bhopal,Sunil, AU - Rudan,Igor, AU - Campbell,Harry, PY - 2010/3/30/entrez PY - 2010/4/2/pubmed PY - 2010/4/28/medline SP - i172 EP - 85 JF - International journal of epidemiology JO - Int J Epidemiol VL - 39 Suppl 1 N2 - BACKGROUND: With the aim of populating the Lives Saved Tool (LiST) with parameters of effectiveness of existing interventions, we conducted a systematic review of the literature assessing the effect of Haemophilus influenzae type b (Hib) and pneumococcal (PC) conjugate vaccines on incidence, severe morbidity and mortality from childhood pneumonia. METHODS: We summarized cluster randomized controlled trials (cRCTs) and case-control studies of Hib conjugate vaccines and RCTs of 9- and 11-valent PC conjugate vaccines conducted in developing countries across outcome measures using standard meta-analysis methods. We used a set of standardized rules developed for the purpose of populating the LiST tool with required parameters to promote comparability across reviews of interventions against the major causes of childhood mortality. The estimates could be adjusted further to account for factors such as PC vaccine serotype content, PC serotype distribution and human immunodeficiency virus prevalence but this was not included as part of the LiST model approach. RESULTS: The available evidence from published data points to a summary effect of the Hib conjugate vaccine on clinical pneumonia of 4%, on clinical severe pneumonia of 6% and on radiologically confirmed pneumonia of 18%. Respective effectiveness estimates for PC vaccines (all valent) on clinical pneumonia is 7%, clinical severe pneumonia is 7% and radiologically confirmed pneumonia is 26%. CONCLUSIONS: The findings indicated that radiologically confirmed pneumonia, as a severe morbidity proxy for mortality, provided better estimates for the LiST model of effect of interventions on mortality reduction than did other outcomes evaluated. The LiST model will use this to estimate the pneumonia mortality reduction which might be observed when scaling up Hib and PC conjugate vaccination in the context of an overall package of child health interventions. SN - 1464-3685 UR - https://www.unboundmedicine.com/medline/citation/20348119/The_effect_of_Haemophilus_influenzae_type_b_and_pneumococcal_conjugate_vaccines_on_childhood_pneumonia_incidence_severe_morbidity_and_mortality_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyq033 DB - PRIME DP - Unbound Medicine ER -