Evaluating the impact of pneumococcal conjugate vaccines on childhood disease burden and antibiotic use: evidence from the United Kingdom and Sub-Saharan Africa

This thesis evaluated the impact of PCVs on invasive pneumococcal disease (IPD) burden and antibiotic use in the United Kingdom (UK) and across multiple countries in sub-Saharan Africa (SSA).<br><br>Methods:<br>A systematic review summarised existing research on PCV13 effectiveness in reducing childhood IPD incidence and all-cause mortality.

Three population-based studies were then conducted: (i) an interrupted time series analysis using IQVIA Medical Research Data (IMRD) from 2008–2019 to assess the impact of PCV13 on IPD incidence among UK children aged 0–18 years; (ii) an evaluation of oral antibiotic prescribing for IPD treatment in UK primary care; and (iii) an analysis of Demographic and Health Survey (DHS) data from 18 SSA countries to examine PCV coverage, antibiotic use for acute respiratory infections (ARI), and under-five mortality.<br><br>Results:<br>The systematic review identified 11 studies demonstrating thta PCV13 introduction resulted in substantial declines in pneumonia incidence in children under two years, and childhood mortality reductions of 28.6–47.0% in infants under one year.