776. Effectiveness of pneumococcal conjugate vaccine -PCV10- in a city of the Colombian Caribbean: case-control study nested in a cohort.
Session: Poster Abstract Session: Vaccines: Pneumococcal
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDWeek. Poster Efectividad2.pdf (826.8 kB)
  • Background: Acute otitis media (AOM) is a common infection in childhood and one of the leading causes of morbidity. The role of pneumococcal conjugate vaccines (PCV) has been extensively studied in cases of invasive disease, but its role in non-invasive diseases such as OMA remains to be demonstrated.

    Aim: to evaluate the effectiveness of PCV against 10 serotypes to prevent cases of AOM in Cartagena, Colombia.

    Methods In a cohort of 876 patients followed prospectively from birth to 15 months of age the effectiveness of PCV-10 valent pneumococcal AOM was estimated using a nested case study in a cohort controls. Events with AOM were selected as cases and health infants were selected as control in the cohort follow-up, matched by age at diagnosis.

    Results: 100% of cases and controls were affiliated to the subsidized regime. Median of breastfeeding was 3.0 [IQR 2.0; 5.0] in both group. The bottle was used by 68.2% (CI 95% 52.4-81.4) of cases and 70.5% (CI 95% 54.8-83.2) of controls. Median time of weaning was 3.0 [IQR 2; 4] for cases and 6.0 [IQR 4.0-6.0] for controls (p 0.64). No infants in the control group used pacifier, while it was used in one case (P 0.31). There were not significant difference between cases and control in exposure to cigarette smoke and biomass (p 0.5), siblings with history of AOM (p 0.1). 61.4% of cases and 70.5% of controls had on timely vaccination schedule (p 0.36). Attendance at day care was a risk factor with AOM (P 0.03). OR of having AOM in infants was 0.66 [95% CI 0.27-1.61] and a vaccine effectiveness of 33.3% [95% CI -61 to 73]. Haemophilus influenzae was isolated in 20% all reported by National Health Institute as nontypeable negative B-lactamase. Pneumococcus was isolated in 15%, only one was serotyping as 6C. S. pyogenes and S. aureus were isolated each in 10% of cases.

    Conclusion: PCV-10 was not effective in preventing AOM. Attendance at day care was the only risk factor associated with OMA (p 0.03). The use of pacifier, baby bottle and breastfeeding were not significant.

    Wilfrido Coronell-Rodríguez, PhD (C) Tropical Medicine1, Cindy Arteta-Acosta, Student Master of Epidemiology1, Steven Osorio-Anaya, Resident of Otolaryngology2, Saabad Mejia-Bermudez, Student Medicine3, Fernando De La Hoz, PhD4 and Nelson Alvis-Guzman, PhD5, (1)Faculty of Medicine, Universidad de Cartagena, Cartagena, Colombia, (2)Universidad de Cartagena, Zaragocilla, Cartagena, Colombia, (3)Universidad del Sinu, Cartagena, Colombia, (4)Universidad Nacional, Bogota, Colombia, (5)Universidad de Cartagena, Cartagena, Colombia

    Disclosures:

    W. Coronell-Rodríguez, COLCIENCIAS: Administrative Department of Science, Technology and Innovation in Colombia , Research grant and Research support

    C. Arteta-Acosta, COLCIENCIAS: Administrative Department of Science, Technology and Innovation in Colombia , Research grant and Research support

    S. Osorio-Anaya, COLCIENCIAS: Administrative Department of Science, Technology and Innovation in Colombia , Research grant and Research support

    S. Mejia-Bermudez, None

    F. De La Hoz, COLCIENCIAS: Administrative Department of Science, Technology and Innovation in Colombia , Research grant and Research support

    N. Alvis-Guzman, COLCIENCIAS: Administrative Department of Science, Technology and Innovation in Colombia , Research grant and Research support

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.