New Malawi PCV13 Pneumonia Study Shows Substantial Impact and Uses New Measures

A new study of PCV13 impact on pneumonia in children under 5 years has just been published from Malawi.  This time series analysis of routinely collected data from all health system levels includes rarely studied rural community hospitals, health centers, and lay community health workers. Between 2012-2014, following PCV13 introduction in 2011, McCollum, Colbourn and colleagues, documented substantial reductions in the case burden and incidence of severe clinical pneumonia, pneumonia with hypoxemia, and hospital pneumonia mortality.

The authors conducted active surveillance of routine care by public-sector healthcare providers in two central region districts.  The analysis employed pre-post comparisons and multivariable time series regression over a two and half year period.  In addition to being one of the first studies to report the impact of PCV13 routine programmatic use on pneumonia in a low-income setting, this study is notable for being conducted in an HIV-endemic sub-Saharan African country, and for being one of the first to use a surveillance case definition that includes low oxygen saturation measurements, a measure of disease severity, to monitor PCV impact.  This research adds to the expanding body of regional and global evidence that PCV is highly effective at preventing life-threatening pneumonia in children. Other African sites that have reported PCV impact on pneumonia include the Gambia, Kenya, Rwanda, and South Africa with ongoing pneumonia impact studies in Mozambique and Togo.