Background
Methods
Vaccine schedule
Study setting and participant eligibility criteria
Swab collection, antibiotic use and vaccination history
Microbiological analysis
Statistical analysis
Ethical Approval and Funding
Results
Participant characteristics
2003 | 2005 | Total | |
---|---|---|---|
No. Children
| 902 | 818 | 1720 |
Mean age in months (95% CI)
| 25 (24–26) | 35 (33–36) | 30.0 (29–31) |
Sex male (%)
| 447 (50%) | 403 (49%) | 850 (49%) |
Vaccine uptake
Year
| 2003 | 2005 | ||
No. communities
| 29 | 17 | ||
No. children swabbed
| 902 | 818 | ||
Children (%) | Risk Difference | P | ||
Vaccinated (>1 dose)
| 87% | 96% | 9% [7,12] | 0.0000 |
Vaccinated (primary)
| 76% | 84% | 9% [5,12] | 0.0000 |
Vaccinated (primary+23v)
| 35% | 62% | 27% [22,31] | 0.0000 |
Spn (% children)
| 82% | 76% | -6% [-10,-2] | 0.002 |
0–6 mo n = 83
| 83% | 74% | -9.7 [-28,8] | 0.3098 |
6–12 mo n = 220
| 80% | 78% | -1.6 [-13,10] | 0.7791 |
12–24 mo n = 477
| 84% | 76% | -8.2 [-16, -0.2] | 0.0331 |
24–48 mo n = 597
| 84% | 78% | -5.3 [-12,1] | 0.0989 |
48- n = 343
| 77% | 74% | -2.9 [-13,7] | 0.5677 |
7PCV-type
| 11% | 8% | -4% [-6, -0.1] | 0.0105 |
23PPV-type
| 42% | 33% | -9% [-14,-5] | 0.0001 |
23PPV-type, non-7PCV
| 31% | 25% | -6% [-10,-2] | 0.0061 |
19A
| 12% | 9% | -3% [-6,-1] | 0.0196 |
Non-23PPV
| 57% | 67% | 9% [5,14] | 0.0001 |
6A
| 4% | 2% | -1.5% [-3,0.1] | 0.0712 |
6C
| 4% | 4% | 0% [-2,2] | 0.9634 |
16F
| 12% | 10% | -2% [-5,1] | 0.1343 |
Prescribed beta-lactam
| 14% | 16% | 1% [-2,5] | 0.4763 |
Penicillin non-susceptible (MIC ≥ 0.12 μg/mL)
| 17% | 14% | -3% [-6,0.4] | 0.0899 |
Prescribed macrolide
| 1% | 6% | 5% [3,7] | 0.0000 |
Azithromycin resistant (MIC ≥ 2 μg/mL)
| 5% | 6% | 1% [-1,3] | 0.4888 |
Azithromycin resistant (MIC ≥ 32 μg/mL)
| 4% | 3% | -1% [-3,1] | 0.2328 |
Region | Central Australia | Darwin Rural¥
| East Arnhem | Katherine West | ||||
---|---|---|---|---|---|---|---|---|
Year | 2003 | 2005 | 2003 | 2005 | 2003 | 2005 | 2003 | 2005 |
No. communities | 11 | 2 | 6 | 6 | 7 | 4 | 5 | 5 |
No. children swabbed | 158 | 65 | 320 | 376 | 315 | 223 | 109 | 154 |
Percent children (95% Confidence Interval) | ||||||||
Spn positive
| 83(77–89) | 86(78–95) | 79(75–84) | 67(62–72)* | 85(81–89) | 87(83–92) | 82(74–89) | 78(71–85) |
Vaccinated (> = 1 dose)
| 96(93–99) | 97(93–101) | 88(84–91) | 96(94–98)* | 80(76–84) | 97(95–99)* | 89(83–95) | 94(90–98) |
Vaccinated (primary)
| 85(79–90) | 83(74–92) | 79(75–84) | 87(84–90)* | 71(66–76) | 82(77–87)* | 70(61–78) | 82(76–89) |
Vaccinated (primary+23v)
| 46(39–54) | 54(41–66) | 34(29–39) | 65(60–69)* | 30(24–34) | 59(52–65)* | 39(29–48) | 62(54–69)* |
7PCV-type positive
| 10(5–14) | 12(4–21) | 15(11–19) | 9(6–12) | 10(7–13) | 10(6–14) | 6(2–11) | 3(0–5) |
Serotype in 23PPV not in 7PCV
| 41(33–49) | 40(29–52) | 33(27–38) | 25(21–29) | 26(21–33) | 23(17–28) | 30(22–39) | 31(23–38) |
19A
| 14(8–19) | 15(6–24) | 17(12–21) | 10(7–13) | 8(5–11) | 6(3–9) | 5(1–9) | 10(5–14) |
6A
| 0.6(-1–2) | 3(-1–7) | 3(1–5) | 2(0–3) | 6(4–9) | 4(2–7) | 6(1–10) | 1(0–3) |
6C
| 3(0–6) | 2(-2–5) | 4(2–7) | 3(1–5) | 6(3–8) | 7(3–10) | 2(-1–4) | 5(2–9) |
16F
| 10(5–15) | 11(3–19) | 12(8–15) | 12(8–15) | 11(7–14) | 10(6–14) | 19(12–27) | 6(2–9)* |
Prescribed beta-lactam
| 28(21–35) | 38(26–51) | 17(13–21) | 16(12–20) | 7(4–9) | 12(7–16) | 9(4–15) | 10(5–14) |
Penicillin non-susceptible (MIC ≥ 0.12 μg/mL)
| 25(19–32) | 42(29–54) | 18(14–22) | 9(6–12)* | 14(10–18) | 16(11–21) | 13(6–19) | 13(8–18) |
Prescribed macrolide
| 0 | 2(-2–5) | 3(1–5) | 13(9–16)* | 0 | 0 | 2(-1–4) | 2(0–4) |
Azithromycin resistant (MIC ≥ 2 μg/mL)
| 9(4–12) | 22(11–32) | 3(1–5) | 5(3–8) | 3(1–4) | 3(1–5) | 11(5–17) | 5(1–8) |