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dc.contributor.authorLeach, Amanda Jane
dc.contributor.authorWigger, Christine
dc.contributor.authorBeissbarth, Jemima
dc.contributor.authorWoltring, Donna
dc.contributor.authorAndrews, Ross
dc.contributor.authorChatfield, M. D.
dc.contributor.authorSmith-Vaughan, Heidi
dc.contributor.authorMorris, Peter S.
dc.date.accessioned2018-11-04T23:39:52Z
dc.date.available2018-11-04T23:39:52Z
dc.date.issued2016
dc.identifier.issn0165-5876en_US
dc.identifier.doi10.1016/j.ijporl.2016.05.011en_US
dc.identifier.urihttp://hdl.handle.net/10072/173548
dc.description.abstractObjectives: This study aims to monitor the prevalence of suppurative otitis media in remote Indigenous communities after introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in October 2011. We previously reported a decline in suppurative OM following replacement of PCV7 by 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) in October 2009. Methods: We continued regular surveillance in remote Indigenous communities between February 2010 and August 2013. This analysis reports the general health, otitis media (OM), nasopharyngeal (NP) carriage and middle ear microbiology in children less than 36 months of age who received a primary course of at least two doses of PHiD-CV10 or PCV13, and not more than one dose of another pneumococcal vaccine. Results: Mean ages of 511 PHiD-CV10- and 140 PCV13-vaccinated children were 19 and 13 months, respectively. Most children received 3-dose non-mixed PCV schedules. At the time of assessment, general health was poor and prevalence of risk factors was high in both groups: overall, around 14% of children had scabies, 20% had impetigo, 59% had runny nose and 39% had cough. Average household size was 8 persons, and 60% of the mothers smoked. Bilaterally normal middle ears were detected in 10% and 7%, respectively. OM with effusion (OME), almost all bilateral, was diagnosed in 52% and 50%, any suppurative OM (acute OM or any tympanic membrane perforation [TMP]) in 37% and 41%, and TMP in 14% and 12%, respectively. Children in the PCV13 group had significantly less NP carriage of combined Streptococcus pneumoniae (Spn) and non-typeable Haemophilus influenzae (NTHi) (62% versus 51%) but significantly more polymicrobial (Spn and NTHi) middle ear cultures (12% versus 43%), and significantly less Staphylococcus aureus-positive middle ears (40% versus 7%). Although NP carriage of pneumococcal serotype 19A was low in the PCV13 group, serotypes 19F and 23F persist. Conclusions: The general health, particularly ear health, of little children in remote Australian Indigenous communities remains in crisis. In particular, transition to PCV13 did not show substantial further improvement in ear health. Possible vaccine-related differences in microbiology, including potential beneficial effects of PHiD-CV10 on NTHi infection, need to be further evaluated in randomised trials.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherElsevier Ltd.en_US
dc.relation.ispartofpagefrom224en_US
dc.relation.ispartofpageto232en_US
dc.relation.ispartofjournalInternational Journal of Pediatric Otorhinolaryngologyen_US
dc.relation.ispartofvolume86en_US
dc.subject.fieldofresearchAboriginal and Torres Strait Islander Healthen_US
dc.subject.fieldofresearchcode111701en_US
dc.titleGeneral health, otitis media, nasopharyngeal carriage and middle ear microbiology in Northern Territory Aboriginal children vaccinated during consecutive periods of 10-valent or 13-valent pneumococcal conjugate vaccinesen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/en_US
dc.description.versionPublisheden_US
gro.rights.copyright© The Author(s) 2016. Published by Elsevier Ireland Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International (CC BY-NC-ND 4.0) License which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.en_US
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