Burden and serotype distribution of invasive Pneumococcal disease among high-risk patients from Latin America and the Caribbean: A systematic review and meta-analysis

Abstract

Background: Invasive pneumococcal diseases (IPD), caused by Streptococcus pneumoniae, entail significant morbidity and mortality, especially in high-risk populations. In Latin America and the Caribbean (LAC) data are scarce. Objective: To estimate the disease burden, serotype distribution, and healthcare resource use among highrisk children and adults with IPD in LAC. Methods: We conducted a systematic review following PRISMA guidelines and a preregistered protocol (PROSPERO CRD42025629682). We searched CENTRAL, PubMed, Embase, LILACS, EconLIT, Global Health, CINAHL, SciELO, surveillance networks, and grey literature sources (Jan 2000-Dec 2024). Results: Search yielded 6227 records, 181 studies were included, representing 63,671 IPD cases from 20 LAC countries. Pneumonia accounted for 52% of IPD cases, followed by meningitis 22% and bacteremia 20%. Median incidence was 13.13 cases per 100,000 persons per year, global case fatality rate was 17%, in meningitis 23% and in adults ≥60 years was 35%. In 36% of patients ICU admission was required. PostPCV introduction, vaccine serotypes declined while nonvaccine serotypes increased, particularly among children <5 years, with variability across LAC countries. Conclusion: This review highlights the burden and patterns of IPD serotypes among high-risk populations in LAC. Optimized vaccination strategies and continuous surveillance are required.