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

Author

Listed:
  • Deus Thindwa
  • Nicole Wolter
  • Amy Pinsent
  • Maimuna Carrim
  • John Ojal
  • Stefano Tempia
  • Jocelyn Moyes
  • Meredith McMorrow
  • Jackie Kleynhans
  • Anne von Gottberg
  • Neil French
  • PHIRST group
  • Cheryl Cohen
  • Stefan Flasche

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 (

Suggested Citation

  • Deus Thindwa & Nicole Wolter & Amy Pinsent & Maimuna Carrim & John Ojal & Stefano Tempia & Jocelyn Moyes & Meredith McMorrow & Jackie Kleynhans & Anne von Gottberg & Neil French & PHIRST group & Chery, 2021. "Estimating the contribution of HIV-infected adults to household pneumococcal transmission in South Africa, 2016–2018: A hidden Markov modelling study," PLOS Computational Biology, Public Library of Science, vol. 17(12), pages 1-19, December.
    • Handle: RePEc:plo:pcbi00:1009680
    DOI: 10.1371/journal.pcbi.1009680
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