Pneumococcal conjugate vaccines (PCV) to reduce fatalities due to pneumonia caused by Streptococcus pneumoniae among children introduced in India in the year 2017 in a phased manner. Monitoring impact of PCV in the reduction of pneumococcal disease is crucial. The objective of this study was to evaluate hospitalisation rate of clinical pneumococcal disease among children under five years of age in Haryana, India.
A longitudinal bidirectional hospital-based surveillance was purposively established in pediatrics department five health facilities that admitted sick children, aged above six weeks and less than five years, and residents of Haryana, India, from 2015 to 2020. Under-five-children admitted with clinically suspected pneumococcal disease were enrolled. Pretested data extraction forms were used to record information on demographic data, household information, medical history. Clinical and laboratory information were retrieved from case files during retrospective period. In prospective period, samples including blood, nasopharyngeal swabs, and cerebrospinal fluid, for culture, and urine samples for antigen testing were collected.
A total of 2817 children, 67.5% males and 67.2% children aged less than one year were hospitalised. Clinical pneumonia hospitalisations decreased from 32.1%(2015) to 22.6%(2019) but increased slightly to 23.6% during the COVID-19 pandemic. In the prospective period, the S. pneumoniae positivity rate was 4.6% among pneumonia cases, 6% among meningitis cases, and 4.3% among sepsis cases in urine samples. The nasopharyngeal carriage rate was 0.9% among pneumonia cases, primarily serotype 19F.
There was an overall decrease in pneumonia-related hospitalisations which could be attributed to the synergistic effects of multiple childhood vaccinations.