Beissegulova Gulzhan, Ramazanova Bakyt, Mustafina Kamilya, Begadilova Tolkyn, Koloskova Yekaterina, Seitkhanova Bibigul, Mamatova Aliya, Iskakova Ulzhan, Sailaubekuly Ratbek, Seiitbay Zhaksylyk
Department of Microbiology and Virology, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
Department of Microbiology, Virology and Immunology, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
PLoS One. 2024 Dec 18;19(12):e0315461. doi: 10.1371/journal.pone.0315461. eCollection 2024.
This study aims to examine the prevalence of nasopharyngeal Streptococcus pneumoniae carriage (NSPC) in infants during their first two years of life and to compare the carriage rates among different vaccine groups and country income-levels. This will be achieved through a systematic review of the published literature, specifically focusing on data from cohort studies and randomized controlled trials. A comprehensive search was conducted in four electronic databases: PubMed, Web of Science, ScienceDirect, and Scopus, using a predefined search strategy. Forty-nine articles met the inclusion criteria for this systematic review. According to the results obtained from the random effects model, the pooled mean prevalence of NSPC was 1.68% at birth (95% CI [0.50; 5.47]), 24.38% at 1 to 4 months (95% CI [19.06; 30.62]), 48.38% at 4 to 6 months (95% CI [41.68; 55.13]), 59.14% at 7 to 9 months (95% CI [50.88; 66.91]), 48.41% at 10 to 12 months (95% CI [41.54; 55.35]), 42.00% at 13 to 18 months (95% CI [37.01; 47.16]), and 48.34% at 19 to 24 months (95% CI [38.50; 58.31]). The highest NSPC rates were observed among children aged 4 to 6 months and 7 to 9 months across all vaccine groups. Low-income countries consistently demonstrated the highest NSPC rates across all age categories studied. This systematic review and meta-analysis provide robust evidence of the high prevalence of NSPC in infants aged 4 to 6 months and 7 to 9 months in all vaccine groups, with persistent regional disparities, especially among low-income countries. The study highlights the need for continuous monitoring of NSPC trends, particularly the emergence of non-vaccine serotypes. Policymakers and healthcare providers should leverage these findings to enhance vaccination strategies, aiming to minimize the overall burden of pneumococcal diseases in infants.
本研究旨在调查婴儿出生后头两年鼻咽部肺炎链球菌携带（NSPC）的流行情况，并比较不同疫苗组和国家收入水平之间的携带率。这将通过对已发表文献进行系统综述来实现，特别关注队列研究和随机对照试验的数据。使用预定义的搜索策略，在四个电子数据库（PubMed、科学网、ScienceDirect和Scopus）中进行了全面搜索。49篇文章符合本系统综述的纳入标准。根据随机效应模型得出的结果，NSPC的合并平均流行率在出生时为1.68%（95%CI[0.50；5.47]），1至4个月时为24.38%（95%CI[19.06；30.62]），4至6个月时为48.38%（95%CI[41.68；55.13]），7至9个月时为59.14%（95%CI[50.88；66.91]），10至12个月时为48.41%（95%CI[41.54；55.35]），13至18个月时为42.00%（95%CI[37.01；47.16]），19至24个月时为48.34%（95%CI[38.50；58.31]）。在所有疫苗组中，4至6个月和7至9个月大的儿童中观察到的NSPC率最高。在所有研究年龄组中，低收入国家的NSPC率始终最高。本系统综述和荟萃分析提供了有力证据，表明在所有疫苗组中，4至6个月和7至9个月大的婴儿中NSPC的流行率很高，且存在持续的地区差异，尤其是在低收入国家。该研究强调需要持续监测NSPC趋势，特别是非疫苗血清型的出现。政策制定者和医疗服务提供者应利用这些发现来加强疫苗接种策略，以尽量减少婴儿肺炎球菌疾病的总体负担。
