Ikiriza Antony*, John Rubaihayo, Innocent Atuhe, Alphonsina Mujawimana, David Ndungutse
Background: Pneumococcal disease is a leading preventable cause of childhood diseases and deaths globally with many of the deaths occurring in low and middle-income countries. In Uganda, Pneumococcal Conjugate Vaccine 13 vaccination campaign was rolled out in 2014 yet data on vaccination coverage, prevalence of pneumococcal disease in children <5 years are scarce. This study therefore evaluated the pneumococcal disease burden following pneumococcal conjugate vaccination campaign in Uganda.
Methods: This was an eight year retrospective analysis of pneumococcal surveillance data recorded from 3 regions of Uganda (namely Kigezi region in South Western Uganda, Busoga region in Eastern Uganda and Tooro region in Mid-western Uganda) during January 2012-December 2020. Demographic and clinical diagnosis data were abstracted from medical records at three regional referral hospitals representing the 3 regions to assess disease burden before and after introduction of the Pneumococcal conjugate vaccine (PVC 13) in Uganda. Data were summarized by demographic characteristics and geographical location of study subjects.
Results: Pre-vaccination period had a prevalence of 59.4% of the cases while the post-vaccination period had 40.6% prevalence rate. By region, prevalence was highest in Kigezi (52.1%) followed by Tooro (32.6%) and lowest in Busoga at (15.3%).
In these settings, immunological serotyping was never done and data on most risk factors were missing. The prevalence of pediatric pneumococcal infections remains high even after vaccination campaign calling for a review of the vaccination strategy.
Conclusion and recommendations: Pneumococcal disease burden was still high (40.6%) despite pneumococcal vaccination roll out. The highest prevalence of pneumococcal disease was in children under 24 months old. However, local surveillance capacity needs to be strengthened to capture data on pneumococcal serotypes and pneumococcal disease risk factors.