INTRODUCTION: The completeness and timeliness of the pertussis questionnaire-based enhanced surveillance system (ESS) among infants and reported pertussis data within the electronic nationwide notification system (NNS) in the years 2015, 2017 and 2019 were evaluated in a pilot study. METHODS: The completeness of the variables for demographic characteristics, date of symptom onset, hospitalisation and vaccination status were assessed in both systems. Timeliness of reporting in the NNS was analysed as the interval between symptom onset and a) the date of first specimen collection (diagnostic delay), and b) the date of the Regional Public Health Authority receiving notification (notification delay). RESULTS: A total of 121 confirmed pertussis cases were reported to the NNS in the study years, while in the ESS a total of 104 confirmed cases were reported in infants. In both systems most cases were in the age group of one completed month of life (20% versus 23%) and males (55% versus 55%). The majority of cases were hospitalised (81% versus 85%) and unvaccinated (77% versus 78%). Within the NNS, the first dose of vaccine was reported in 13 cases, the second dose in 11, and third dose in three cases. Within the NNS, 100% completeness of following variables was found: symptom onset, week and region of reporting, age, gender and place of isolation. Median diagnostic delay was nine days. Median notification delay was 18 days. CONCLUSIONS: Data completeness was high in the NNS, except for lack of vaccination data in those eligible by age. Efforts to improve the completeness of laboratory-related variables and timeliness are essential. Based on the study results, the project of improving the ESS for infants will continue with regular evaluation.

UVOD: V pilotni študiji sta bili ovrednoteni popolnost in pravočasnost izboljšanega sistema za spremljanje (ESS) oslovskega kašlja pri dojenčkih, ki temelji na vprašalnikih, ter podatkov o oslovskem kašlju, vnesenih v elektronski sistem obveščanja na državni ravni (NNS), v letih 2015, 2017 in 2019. METODE: Pri obeh sistemih je bila ocenjena popolnost spremenljivk za demografske značilnosti, datum pojava simptomov ter hospitalizacijo in stanje cepljenja. Pravočasnost poročanja v sistem NNS je bila analizirana kot interval med pojavom simptomov in a) datumom prvega odvzema vzorcev (diagnostična zamuda); b) datumom, ko je regionalni organ za javno zdravje prejel informacije (zamuda pri obveščanju). REZULTATI: V obravnavanih letih je bilo v sistem NNS vnesenih 121 potrjenih primerov oslovskega kašlja, v sistemu ESS pa 104 potrjenih primerov pri dojenčkih. V obeh sistemih: večina primerov je bila v starostni skupini dopolnjenega 1 meseca (20 % v primerjavi s 23 %) in moškega spola (55 % v primerjavi 55 %). Večina primerov je bila hospitaliziranih (81 % v primerjavi s 85 %) in necepljenih (77 % v primerjavi z 78 %). V sistemu NNS je bila prva doza cepiva vnesena pri 13 primerih, druga doza pri 11 primerih in tretja doza pri 3 primerih. V sistemu NSN je bila ugotovljena 100-odstotna popolnost naslednjih spremenljivk: pojav simptomov, teden in regija poročanja, starost, spol in mesto izolacije. Povprečna diagnostična zamuda je bila 9 dni. Povprečna zamuda pri obveščanju je bila 18 dni. ZAKLJUČKI: Popolnost podatkov v sistemu NNS je bila na visoki ravni, razen pomanjkanja podatkov o cepljenju za primerne starosti. Treba si je prizadevati za izboljšanje popolnosti spremenljivk, povezanih z laboratoriji, in pravočasnosti. Na podlagi rezultatov študije se bo projekt izboljšanega sistema ESS pri dojenčkih nadaljeval z rednimi vrednotenji.

• Keywords
• Completeness, Infants, Pertussis, Surveillance, Timeliness, Whooping cough,
• Publication type
• Journal Article MeSH

INTRODUCTION: The aim of this study is to analyse the impact of vaccination of infants with pneumococcal conjugate vaccine (PCV) on the incidence of invasive pneumococcal disease (IPD) in children under 5 years of age in the Czech Republic. MATERIAL AND METHODS: The present study includes all IPD cases reported in children aged 0-4 years within the surveillance program in 2007-2017. The impact of PCV is analysed for five categories of IPD: cases caused by all serotypes, cases caused by PCV7 serotypes (4, 6B, 9V, 14, 18C, 19F, and 23F), cases caused by three additional PCV10 serotypes (1, 5, and 7F), cases caused by three additional PCV13 serotypes (3, 6A, and 19A), and cases caused by non-PCV serotypes. To assess the impact of PCV, the study period was divided into the pre-vaccination period 2007-2008 and post-vaccination period 2009-2017, which was divided into three three-year parts: 2009-2011, 2012-2014, and 2015-2017. Analysis of differences between periods was based on the Poisson regression model where the population numbers were handled as an offset. RESULTS: The annual incidence of IPD in children under 5 years of age caused by all serotypes has had a downward trend since 2007: it dropped from 8.52/100 000 in 2007 to 2.67/100 000 in 2017, with slight increases in 2010 and 2013. All three post-vaccination periods show significantly lower (p<0.001) incidences in comparison to the pre-vaccination period, but they do not statistically significantly differ from each other. CONCLUSIONS: IPD surveillance data in the Czech Republic show that after the introduction of PCV vaccination of infants, there has been a significant decrease in the IPD incidence of children under 5 years of age. Continued IPD surveillance is essential to monitor for possible post-vaccination serotype replacement.

• MeSH
• DNA, Bacterial genetics   isolation & purification   MeSH
• Incidence MeSH
• Cohort Studies MeSH
• Infant MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Public Health Surveillance methods   MeSH
• Pneumococcal Infections epidemiology   prevention & control   MeSH
• Pneumococcal Vaccines therapeutic use   MeSH
• Child, Preschool MeSH
• Serogroup MeSH
• Streptococcus pneumoniae genetics   immunology   MeSH
• Vaccination methods   MeSH
• Vaccines, Conjugate therapeutic use   MeSH
• Treatment Outcome MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• DNA, Bacterial MeSH
• Pneumococcal Vaccines MeSH
• Vaccines, Conjugate MeSH

BACKGROUND: Pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies. METHODS: For each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100. RESULTS: After five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively. CONCLUSION: Overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.

• Keywords
• bacterial infection, clinical epidemiology,
• MeSH
• Incidence MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Pneumococcal Vaccines pharmacology   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Serogroup MeSH
• Streptococcus pneumoniae immunology   MeSH
• Vaccination methods   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe epidemiology   MeSH
• Names of Substances
• 10-valent pneumococcal conjugate vaccine MeSH Browser
• Pneumococcal Vaccines MeSH

Pneumococcal infection is a major cause of morbidity and mortality worldwide. The burden of disease associated with S. pneumoniae is largely preventable through routine vaccination. Pneumococcal conjugate vaccines (e.g. PCV7, PCV13) provide protection from invasive pneumococcal disease as well as non-invasive infection (pneumonia, acute otitis media), and decrease vaccine-type nasopharyngeal colonisation, thus reducing transmission to unvaccinated individuals. PCVs have also been shown to reduce the incidence of antibiotic-resistant pneumococcal disease. Surveillance for pneumococcal disease is important to understand local epidemiology, serotype distribution and antibiotic resistance rates. Surveillance systems also help to inform policy development, including vaccine recommendations, and monitor the impact of pneumococcal vaccination. National pneumococcal surveillance systems exist in a number of countries in Central and Eastern Europe (such as Croatia, Czech Republic, Hungary, Poland, Romania and Slovakia), and some have introduced PCVs (Czech Republic, Hungary, Kazakhstan, Russia, Slovakia and Turkey). Those countries without established programs (such as Kazakhstan, Russia and Ukraine) may be able to learn from the experiences of those with national surveillance systems. The serotype distributions and impact of PCV13 on pediatric pneumococcal diseases are relatively similar in different parts of the world, suggesting that approaches to vaccination used elsewhere are also likely to be effective in Central and Eastern Europe. This article briefly reviews the epidemiology of pneumococcal disease, presents the latest surveillance data from Central and Eastern Europe, and discusses any similarities and differences in these data as well the potential implications for vaccination policies in the region.

• Keywords
• Eastern Europe, burden, central Europe, epidemiology, mortality, pneumococcal conjugate vaccines, pneumococcal diseases, surveillance, vaccination,
• MeSH
• Epidemiological Monitoring * MeSH
• Humans MeSH
• Immunization Programs MeSH
• Pneumococcal Infections epidemiology   prevention & control   MeSH
• Pneumococcal Vaccines administration & dosage   immunology   MeSH
• Health Policy MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Geographicals
• Europe epidemiology   MeSH
• Names of Substances
• 13-valent pneumococcal vaccine MeSH Browser
• Pneumococcal Vaccines MeSH