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Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis: protocol for a randomised c

O'Grady, Kerry-Ann F., Grimwood, Keith, Cripps, Allan, Mulholland, Edward K., Morris, Peter S., Torzillo, Paul J., Wood, Nicholas A., Smith-Vaughan, Heidi C., Revell, Amber, Wilson, Andrew, van Asperen, Peter, Richmond, Peter, Thornton, Ruth, Rablin, Sheree and Chang, Anne B. (2013). Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis: protocol for a randomised controlled trial. Trials,14(282):1-11.

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Title Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis: protocol for a randomised controlled trial
Author O'Grady, Kerry-Ann F.
Grimwood, Keith
Cripps, Allan
Mulholland, Edward K.
Morris, Peter S.
Torzillo, Paul J.
Wood, Nicholas A.
Smith-Vaughan, Heidi C.
Revell, Amber
Wilson, Andrew
van Asperen, Peter
Richmond, Peter
Thornton, Ruth
Rablin, Sheree
Chang, Anne B.
Journal Name Trials
Publication Date 2013
Volume Number 14
Issue Number 282
Start Page 1
End Page 11
Total Pages 11
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background
Recurrent protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis are characterised by a chronic wet cough and are important causes of childhood respiratory morbidity globally. Haemophilus influenzae and Streptococcus pneumoniae are the most commonly associated pathogens. As respiratory exacerbations impair quality of life and may be associated with disease progression, we will determine if the novel 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) reduces exacerbations in these children.

Methods

A multi-centre, parallel group, double-blind, randomised controlled trial in tertiary paediatric centres from three Australian cities is planned. Two hundred six children aged 18 months to 14 years with recurrent PBB, CSLD or bronchiectasis will be randomised to receive either two doses of PHiD-CV or control meningococcal (ACYW135) conjugate vaccine 2 months apart and followed for 12 months after the second vaccine dose. Randomisation will be stratified by site, age (<6 years and ≥6 years) and aetiology (recurrent PBB or CSLD/bronchiectasis). Clinical histories, respiratory status (including spirometry in children aged ≥6 years), nasopharyngeal and saliva swabs, and serum will be collected at baseline and at 2, 3, 8 and 14 months post-enrolment. Local and systemic reactions will be recorded on daily diaries for 7 and 30 days, respectively, following each vaccine dose and serious adverse events monitored throughout the trial. Fortnightly, parental contact will help record respiratory exacerbations. The primary outcome is the incidence of respiratory exacerbations in the 12 months following the second vaccine dose. Secondary outcomes include: nasopharyngeal carriage of H. influenzae and S. pneumoniae vaccine and vaccine- related serotypes; systemic and mucosal immune responses to H. influenzae proteins and S. pneumoniae vaccine and vaccine-related serotypes; impact upon lung function in children aged ≥6 years; and vaccine safety.

Discussion

As H. influenzae is the most common bacterial pathogen associated with these chronic respiratory diseases in children, a novel pneumococcal conjugate vaccine that also impacts upon H. influenzae and helps prevent respiratory exacerbations would assist clinical management with potential short- and long-term health benefits. Our study will be the first to assess vaccine efficacy targeting H. influenzae in children with recurrent PBB, CSLD and bronchiectasis.
Keywords Bronchiectasis
Child
Chronic suppurative lung disease
Non-typeable Haemophilus influenzae
Pneumococcal conjugate vaccines
Protracted bacterial bronchitis
Randomised controlled trial
Respiratory exacerbations
Streptococcus pneumoniae
DOI http://dx.doi.org/10.1186/1745-6215-14-282   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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