Background The 10-valent conjugate vaccine (PCV10) was introduced into the Extended Program on Immunization in Madagascar. We assessed the impact of PCV10 on the targeted pneumococcal serotypes among children < 5 years of age at Centre Hospitalier Universitaire Mère Enfant Tsaralalàna. Method Between 2012 and December 2018, cerebrospinal fluid (CSF) samples were collected and tested for S. pneumoniae by culture, and antigen tests. The Sentinel Site Laboratory (SSL) referred available CSF samples to the Regional Reference Laboratory (RRL) for real-time polymerase chain reaction confirmatory testing and serotyping. Results In total, 3616 CSF specimens were collected. The SSL referred 2716 to the RRL; 125 were positive for S. pneumoniae. At the RRL, 115 samples that tested positive for S. pneumoniae were serotyped; PCV10 serotypes accounted for 20%. Compared to the pre-PCV period, the proportion of S. pneumoniae detected declined from 22% to 6.6%, (P < .05), the proportion of PCV10 serotypes as the cause of pneumococcal meningitis cases declined by 26% following vaccine introduction. Conclusions In our findings, PCV10 introduction resulted in a decline of meningitis caused by S. pneumoniae and PCV10 vaccine serotypes.

中文翻译：

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在马达加斯加引入肺炎球菌结合疫苗后，疫苗型肺炎链球菌血清型下降

背景 10 价结合疫苗 (PCV10) 被引入马达加斯加的免疫扩展计划。我们评估了 PCV10 对儿童中目标肺炎球菌血清型的影响 < 5 岁在 Center Hospitalier Universitaire Mère Enfant Tsaralalàna。方法 2012 年至 2018 年 12 月，收集脑脊液 (CSF) 样本，通过培养和抗原检测检测肺炎链球菌。Sentinel Site Laboratory (SSL) 将可用的 CSF 样本提交给区域参考实验室 (RRL) 进行实时聚合酶链反应确认测试和血清分型。结果共采集脑脊液标本3616份。SSL 将 2716 提交给 RRL；125 例肺炎链球菌呈阳性。在 RRL，对 115 个肺炎链球菌检测呈阳性的样本进行了血清分型；PCV10血清型占20%。与 PCV 之前相比，检测到的肺炎链球菌比例从 22% 下降到 6.6%（P < .05），疫苗引入后导致肺炎球菌脑膜炎病例的 PCV10 血清型比例下降了 26% . 结论 在我们的研究结果中，PCV10 的引入导致由肺炎链球菌和 PCV10 疫苗血清型引起的脑膜炎减少。