In:
PLOS Medicine, Public Library of Science (PLoS), Vol. 19, No. 5 ( 2022-5-31), p. e1004016-
Abstract:
Infants are at highest risk of pneumococcal disease. Their added protection through herd effects is a key part in the considerations on optimal pneumococcal vaccination strategies. Yet, little is currently known about the main transmission pathways to this vulnerable age group. Hence, this study investigates pneumococcal transmission routes to infants in the coastal city of Nha Trang, Vietnam. Methods and findings In October 2018, we conducted a nested cross-sectional contact and pneumococcal carriage survey in randomly selected 4- to 11-month-old infants across all 27 communes of Nha Trang. Bayesian logistic regression models were used to estimate age specific carriage prevalence in the population, a proxy for the probability that a contact of a given age could lead to pneumococcal exposure for the infant. We used another Bayesian logistic regression model to estimate the correlation between infant carriage and the probability that at least one of their reported contacts carried pneumococci, controlling for age and locality. In total, 1,583 infants between 4 and 13 months old participated, with 7,428 contacts reported. Few infants (5%, or 86 infants) attended day care, and carriage prevalence was 22% (353 infants). Most infants (61%, or 966 infants) had less than a 25% probability to have had close contact with a pneumococcal carrier on the surveyed day. Pneumococcal infection risk and contact behaviour were highly correlated: If adjusted for age and locality, the odds of an infant’s carriage increased by 22% (95% confidence interval (CI): 15 to 29) per 10 percentage points increase in the probability to have had close contact with at least 1 pneumococcal carrier. Moreover, 2- to 6-year-old children contributed 51% (95% CI: 39 to 63) to the total direct pneumococcal exposure risks to infants in this setting. The main limitation of this study is that exposure risk was assessed indirectly by the age-dependent propensity for carriage of a contact and not by assessing carriage of such contacts directly. Conclusions In this study, we observed that cross-sectional contact and infection studies could help identify pneumococcal transmission routes and that preschool-age children may be the largest reservoir for pneumococcal transmission to infants in Nha Trang, Vietnam.
Type of Medium:
Online Resource
ISSN:
1549-1676
DOI:
10.1371/journal.pmed.1004016
DOI:
10.1371/journal.pmed.1004016.g001
DOI:
10.1371/journal.pmed.1004016.g002
DOI:
10.1371/journal.pmed.1004016.g003
DOI:
10.1371/journal.pmed.1004016.t001
DOI:
10.1371/journal.pmed.1004016.t002
DOI:
10.1371/journal.pmed.1004016.s001
DOI:
10.1371/journal.pmed.1004016.s002
DOI:
10.1371/journal.pmed.1004016.s003
DOI:
10.1371/journal.pmed.1004016.s004
DOI:
10.1371/journal.pmed.1004016.s005
DOI:
10.1371/journal.pmed.1004016.s006
DOI:
10.1371/journal.pmed.1004016.s007
DOI:
10.1371/journal.pmed.1004016.r001
DOI:
10.1371/journal.pmed.1004016.r002
DOI:
10.1371/journal.pmed.1004016.r003
DOI:
10.1371/journal.pmed.1004016.r004
DOI:
10.1371/journal.pmed.1004016.r005
DOI:
10.1371/journal.pmed.1004016.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2164823-2
Bookmarklink