Monitoring the introduction of pneumococcal conjugate vaccines into West Africa: design and implementation of a population-based surveillance system

PLoS Med. 2012 Jan;9(1):e1001161. doi: 10.1371/journal.pmed.1001161. Epub 2012 Jan 17.


Routine use of pneumococcal conjugate vaccines (PCVs) in developing countries is expected to lead to a significant reduction in childhood deaths. However, PCVs have been associated with replacement disease with non-vaccine serotypes. We established a population-based surveillance system to document the direct and indirect impact of PCVs on the incidence of invasive pneumococcal disease (IPD) and radiological pneumonia in those aged 2 months and older in The Gambia, and to monitor changes in serotype-specific IPD. Here we describe how this surveillance system was set up and is being operated as a partnership between the Medical Research Council Unit and the Gambian Government. This surveillance system is expected to provide crucial information for immunisation policy and serves as a potential model for those introducing routine PCV vaccination in diverse settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Catchment Area, Health
  • Gambia / epidemiology
  • Geography
  • Health Plan Implementation / economics
  • Health Plan Implementation / methods*
  • Humans
  • Mass Screening
  • Nurses
  • Pneumococcal Vaccines / economics
  • Pneumococcal Vaccines / immunology*
  • Population Surveillance / methods*
  • Sample Size
  • Vaccines, Conjugate / economics
  • Vaccines, Conjugate / immunology*


  • Pneumococcal Vaccines
  • Vaccines, Conjugate