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Dynamics of pneumococcal transmission in vaccine-naive children and their HIV-infected or HIV-uninfected mothers during the first 2 years of life
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Shiri, Tinevimbo, Auranen, Kari, Nunes, Marta C., Adrian, Peter V., van Niekerk, Nadia, de Gouveia, Linda, von Gottberg, Anne, Klugman, Keith P. and Madhi, Shabir A. (2013) Dynamics of pneumococcal transmission in vaccine-naive children and their HIV-infected or HIV-uninfected mothers during the first 2 years of life. American Journal of Epidemiology, 178 (11). pp. 1629-1637. doi:10.1093/aje/kwt200 ISSN 0002-9262.
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Official URL: http://dx.doi.org/10.1093/aje/kwt200
Abstract
Pneumococcal vaccine-naïve mother-child dyads in South Africa had nasopharyngeal swabs taken 9 times within the first 2 years of the children's lives between January 2007 and May 2009. To quantify the strength of the association of serotype-specific carriage in mother-child dyads, a stochastic transmission model was fitted to the data. Children were more susceptible to individual serotypes included in the 7-valent pneumococcal conjugate vaccine (PCV7) transmitted by their mothers than vice versa; however, children infected their mothers with these serotypes more frequently than mothers infected children. The child-to-mother steady-state forces of pneumococcal acquisition were between 0.36 and 3.29 (per 1,000 days) compared with 0.06-0.51 for mother-to-child transmission. Although children of mothers infected with human immunodeficiency virus were more often exposed to PCV7 serotypes by their mothers, their risk of acquisition remained low compared with the risk of child-to-mother transmission. Mothers acquired pneumococci at lower rates (per 1,000 days) from unmeasured exposure within families and in the wider community (range, 0.12-1.69 per 1,000 days) than did children (range, 1.10-5.21 per 1,000 days). Pneumococcal immunization of young children is expected to have an indirect effect of reducing PCV7 serotype maternal colonization and possibly disease even in settings such as ours, in which there is a high prevalence of human immunodeficiency virus-infected mothers.
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | American Journal of Epidemiology | ||||||||
Publisher: | Oxford University Press | ||||||||
ISSN: | 0002-9262 | ||||||||
Official Date: | 3 October 2013 | ||||||||
Dates: |
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Volume: | 178 | ||||||||
Number: | 11 | ||||||||
Page Range: | pp. 1629-1637 | ||||||||
DOI: | 10.1093/aje/kwt200 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access |
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