# P-596. Pneumococcal Burden and Serotype Distribution for Invasive Disease among High-Risk Population in Latin America and the Caribbean: a Systematic Review and Meta-analysis

## TL;DR

This study reviews pneumococcal disease burden and serotype distribution in high-risk populations across Latin America and the Caribbean, finding significant variation and the need for updated vaccination strategies.

## Contribution

The study provides the first comprehensive meta-analysis of pneumococcal disease in high-risk populations in Latin America and the Caribbean, highlighting serotype trends and vaccine coverage.

## Key findings

- Serotypes 14, 19A, 6B, 3, and 23F accounted for over 60% of isolates.
- PCV13 covers 77% of these serotypes, with higher-valent vaccines expected to increase coverage.
- Non-vaccinal serotypes have increased significantly in the region over the past decade.

## Abstract

Data regarding invasive pneumococcal disease (IPD) burden, circulating serotypes and use of resources in high-risk populations (immunocompromised hosts, adults ≥65 y, and children < 5 y) in Latin America and the Caribbean (LAC) is scarce

We performed a systematic review and meta-analysis, registered in PROSPERO CRD42025629682, following Cochrane, MOOSE, and PRISMA guidelines. MEDLINE, Embase, LILACS, regional surveillance reports, grey literature, and conference proceedings between 01/01/2000 and 03/31/2025 were searched. Two reviewers independently screened titles/abstracts and full texts, and assessed the risk of bias of included studies. Conflicts were resolved by consensus, and data on population, clinical setting, IPD incidence or prevalence, serotype distribution, case-fatality ratio (CFR), and healthcare utilization were extracted. Random-effects meta-analyses estimated pooled incidence rates and CFRs; serotype coverage by available and pipeline PCVs were summarized. Full pooled estimates and stratified analyses by age, risk group, CFR, use of resources were analized

Of 6,136 unique records screened, 198 studies from 18 LAC countries met inclusion criteria, 60% were pediatric cohorts including children < 5yo, 25% persons with immunocompromising conditions (mainly HIV infection or solid-organ transplantation), and 15 % older adults >65yo. Preliminary results indicates wide heterogeneity in reported IPD incidence (12–170 cases/100,000 person-year) and CFRs (4–29%). Serotypes 14, 19A, 6B, 3, and 23F, represented >60% of typed isolates during all periods. During the last 10 years a significant increase of non-vaccinal serotypes in all region was observed. Coverage of these serotypes by PCV13 averaged 77% (95% CI 71–83%) and is projected to increase theoretical coverage with higher-valent PCVs (PCV15/20/21)

These findings provide an updated evidence base to support national immunization programs and guide future serotype-specific surveillance in the region

All Authors: No reported disclosures