Estimating the contribution of HIV-infected adults to household pneumococcal transmission in South Africa, 2016–2018: A hidden Markov modelling study

Deus Thindwa, Nicole Wolter, Amy Pinsent, Maimuna Carrim, John Ojal, Stefano Tempia, Jocelyn Moyes, Meredith McMorrow, Jackie Kleynhans, Anne von Gottberg, Neil French, Group Phirst, Cheryl Cohen and Stefan Flasche

PLOS Computational Biology, 2021, vol. 17, issue 12, 1-19

Abstract: Human immunodeficiency virus (HIV) infected adults are at a higher risk of pneumococcal colonisation and disease, even while receiving antiretroviral therapy (ART). To help evaluate potential indirect effects of vaccination of HIV-infected adults, we assessed whether HIV-infected adults disproportionately contribute to household transmission of pneumococci. We constructed a hidden Markov model to capture the dynamics of pneumococcal carriage acquisition and clearance observed during a longitudinal household-based nasopharyngeal swabbing study, while accounting for sample misclassifications. Households were followed-up twice weekly for approximately 10 months each year during a three-year study period for nasopharyngeal carriage detection via real-time PCR. We estimated the effect of participant’s age, HIV status, presence of a HIV-infected adult within the household and other covariates on pneumococcal acquisition and clearance probabilities. Of 1,684 individuals enrolled, 279 (16.6%) were younger children (

Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pcbi00:1009680

DOI: 10.1371/journal.pcbi.1009680

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