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Distribution de l'échantillon  

Distribution de l'échantillon  

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Technical Report
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Robert E., Swennen B. Enquête de couverture vaccinale en Fédération Wallonie-Bruxelles, Bruxelles excepté, Bruxelles, ULB-Provac – 2015

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... The seven-valent vaccine (PCV7) was replaced by the thirteen valent (PCV13) in 2011, which was in turn replaced by the ten-valent vaccine (PCV10) in 2015-2016 [9]. The programme rapidly achieved high three dose coverage in children (2008)(2009): >80%; 2015-2016: >94%) [10][11][12][13]. ...
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Background Changes in serotype distribution have been described after the switch from the 13-valent pneumococcal conjugate vaccine (PCV13) to the 10-valent pneumococcal conjugate vaccine (PCV10) in Belgium. Aim To describe serotype’s invasive disease potential and the detailed evolution of serotype distribution and antimicrobial susceptibility of pneumococcal isolates (carriage and IPD) in children up to 30 months of age over a period during and after the vaccine switch (2015–2018). Methods S. pneumoniae strains isolated from the nasopharynx of healthy children attending day-care centres (DCCs) and strains from normally sterile sites of children with IPD were serotyped (Quellung-reaction) and antimicrobial susceptibility testing was performed. Invasive disease potential was defined as the serotype-specific odds ratio (OR). Results The highly invasive (OR > 1) serotypes 12F, 1, 3, 24A/B/F, 33F, 19A, and 9N were not frequently carried (<7.5% of carriage strains). Different serotypes dominated in carriage (23B, 23A, 11A, 15B) versus IPD (12F, 19A, 10A, 33F). PCV13 vaccine serotypes increased in carriage (5.4% (25/463) in period 1 vs 10.3% (69/668) in period 3) and in IPD (7.3% (8/110 in period 1 vs 23.9% (34/142) in period 3) due to an increase (p < 0.01) in serotype 19A. The penicillin non-susceptibility of 19A was lower (p = 0.02) in carriage (6.8%) than in IPD (23.5%). Erythromycin and tetracycline non-susceptibility were more frequent (p < 0.01) in IPD (26.0%; 23.0%) compared to carriage strains (18.2%; 14.5%) and penicillin non-susceptibility increased over the three year study period (carriage: 13.4%, 19.8%, 18.5%, p = 0.05; IPD: 11.8%, 15.0%, 20.4%, p = 0.02). Conclusion Only some of the serotypes with high invasive disease potential (serotype 1, 3, 19A) in Belgium are included in PCV10 and/or PCV13. This reinforces the need for continuous monitoring, both in healthy children as in children with IPD, to better understand the dynamics of pneumococcal disease, to optimise the composition and implementation of PCVs.
... In the Brussels (Capital) region either the Flemish or the Walloon programme was followed, depending on the consulting physician. The pneumococcal vaccination programme rapidly achieved high three-dose coverage in children (coverage in Belgium; > 80% in all regions in 2008-2009 vs > 94% in all regions in 2015-2016 [23][24][25][26]) and the overall incidence of IPD in Belgium significantly decreased after implementation of the vaccination programme; post-PCV7 period (2007-2010) vs pre-PCV7 period (pre 2007): decrease of 35%; post-PCV13 (2015) vs PCV7-era (2007)(2008)(2009)(2010): decrease of 42% [22]. ...
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Background The current carriage study was set up to reinforce surveillance during/after the PCV13-to-PCVC10 switch in Belgium.AimThis observational study monitored carriage of Streptococcus pneumoniae (Sp) serotypes, particularly those no longer covered (3, 6A, 19A), as well as Haemophilus influenzae (Hi), because PCV10 contains the non-typeable Hi protein D.MethodsA total of 2,615 nasopharyngeal swabs from children (6-30 months old) attending day care were collected in three periods over 2016-2018. Children's demographic and clinical characteristics and vaccination status were obtained through a questionnaire. Sp and Hi were identified by culture and PCR. Pneumococcal strains were tested for antimicrobial (non-)susceptibility by disc diffusion and serotyped by Quellung-reaction (Quellung-reaction and PCR for serotypes 3, 6A, 19A).ResultsThe carriage prevalence of Sp (> 75%) remained stable over the successive periods but that of Hi increased (87.4%, 664 Hi-carriers/760 in 2016 vs 93.9%, 895/953 in 2017-2018). The proportion of non-PCV13 vaccine serotypes decreased (94.6%, 438 isolates/463 in 2016 vs 89.7%, 599/668 in 2017-2018) while that of PCV13-non-PCV10 vaccine serotypes (3 + 6A + 19A) increased (0.9%, 4 isolates/463 in 2016 vs 7.8%, 52/668 in 2017-2018), with serotype 19A most frequently identified (87.9%, 58/66 isolates). Non-susceptibility of pneumococci against any of the tested antibiotics was stable over the study period (> 44%).Conclusions During and after the PCV13-to-PCV10 vaccine switch, the proportion of non-PCV13 serotypes decreased, mainly due to a serotype 19A carriage prevalence increase. These results complement invasive pneumococcal disease surveillance data, providing further basis for pneumococcal vaccination programme policy making.
... Each year, one million children under the age of five die from pneumococcal disease worldwide [6]. The introduction of pneumococcal conjugate vaccines (PCVs) has impacted upon pneumococcal disease and carriage [1,2,[7][8][9][10][11] The Belgian infant pneumococcal vaccination programme reached high coverage in 2015-2016 (Wallonia: 96.9% [12], Flanders: 94.9% [13], Brussels: 90.1% [14]) and is characterised by a unique sequence of conjugated vaccine introductions over time: from a 7-valent vaccine in 2007 (PCV7, comprising serotypes 4, 6B, 9V, 14, 18C, 19F and 23F) to a 13-valent PCV in 2011 (PCV13, comprising the PCV7 serotypes plus 1, 5, 7F, 3, 6A, 19A) and to a 10-valent vaccine in 2015-2016 (PCV10, comprising the PCV7 serotypes plus 1, 5, 7F). PCV10 was introduced at different time points in the three Belgian regions (Flanders: 1 July 2015, Wallonia: 1 May 2016; Brussels: Flemish or Walloon programme, depending on the consulted physician). ...
Article
Background: A three year pneumococcal carriage study was set up in Belgium when the vaccination programme switched from a 13-valent (PCV13) to a 10-valent (PCV10) vaccine. We compared the first follow-up period (October 2016 - June 2017, year 2, Y2) for nasopharyngeal carriage, serotype distribution and antimicrobial susceptibility of S. pneumoniae with the baseline (January-July 2016, year 1, Y1). Materials/methods: A single nasopharyngeal swab was taken in children (6-30 months), either attending one of the 112 day-care centres (DCCs), or visiting one of the 21 physicians for an acute otitis media (AOM). S. pneumoniae were cultured, screened for antimicrobial susceptibility, and serotyped. Results: In Y2, 1218 samples were collected. The majority of the Y2-children (>85%) was vaccinated appropriately for their age. Children in Y2 received either PCV13 only (DCC: 23.5%; AOM: 24.6%), PCV10 only (DCC: 29.8%; AOM: 37.7%), or a mix of both vaccines (DCC: 31.9%; AOM: 25.4%). Pneumococcal carriage rates were high (Y2, DCC: 68.2%; AOM: 64.8%). Among carriers, prevalence of PCV13 serotypes was low (Y2 vs Y1, DCC: 3.5% vs 5.4%; AOM: 7.6% vs 7.7%). Although prevalence of PCV13-non-PCV10 serotypes did not increase significantly compared to Y1 (Y2 vs Y1, DCC: 1.6% vs 0.9%; Y2 vs Y1, AOM: 5.1% vs 0.0%), the proportion of serotypes 3, 6A, 19A among PCV13 serotype carriers in DCC was significantly higher in Y2 (46.2% vs Y1: 16.0%, p-value = 0.034). Serotypes 23B and 15B were the predominant non-vaccine serotypes (Y2). Among detected strains, non-susceptibility to at least one of five antibiotics tested (penicillin, tetracycline, erythromycin, levofloxacin, cotrimoxazole) was comparable to Y1 (Y2 vs Y1, DCC: 41.3% vs 42.4%; AOM: 49.4% vs 48.1%). Conclusion: After completion of the PCV13-to-PCV10 vaccine switch in Belgium, the proportion of PCV13-non-PCV10 serotypes (mainly 19A) significantly increased among PCV13 serotype carriers in DCC, stressing the need for strengthened surveillance as the PCV10-vaccinated population grows.
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... In Belgium, the measles vaccine was available on the market in 1974 [12]. Vaccination with measles-mumps-rubella (MMR) combined vaccine was introduced free of charge in the routine vaccination programme in Belgium in 1985 (one dose) and 1995 (two doses [13][14][15]. In 2012, coverage for the second dose of MMR was 92.5% in Flanders [15]. ...
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