Effect of 10-valent pneumococcal conjugate vaccine on the incidence of radiologically- confirmed pneumonia and clinically-defined pneumonia in Kenyan children:

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Effect of 10-valent pneumococcal conjugate vaccine on the incidence of radiologically- confirmed pneumonia and clinically-defined pneumonia in Kenyan children: an interrupted time-series analysis Micah Silaba, MMed, Michael Ooko, MSc, Christian Bottomley, PhD, Joyce Sande, MMed, Rachel Benamore, FRCR, Kate Park, FRCR, James Ignas, MD, Kathryn Maitland, FMedSci, Neema Mturi, MMed, Anne Makumi, MSc, Mark Otiende, MSc, Stanley Kagwanja, Dip MIS, Sylvester Safari, Dip MIS, Victor Ochola, BSc, Tahreni Bwanaali, MBA, Evasius Bauni, PhD, Fergus Gleeson, FRCR, Maria Deloria Knoll, PhD, Ifedayo Adetifa, PhD, Kevin Marsh, FMedSci, Thomas N Williams, FMedSci, Tatu Kamau, MPH, Shahnaaz Sharif, MD, Orin S Levine, PhD, Laura L Hammitt, MD, J Anthony G Scott, FMedSci The Lancet Global Health Volume 7, Issue 3, Pages e337-e346 (March 2019) DOI: 10.1016/S2214-109X(18)30491-1 Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 Flow chart showing the selection of patients for radiographs and the reasons for missing radiographs The Lancet Global Health 2019 7, e337-e346DOI: (10.1016/S2214-109X(18)30491-1) Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Monthly incidence of admission to Kilifi County Hospital among children aged 2–59 months with WHO-defined radiologically-confirmed pneumonia and modelled predictions The dashed lines show the transition period during which PCV10 was introduced among children younger than 5 years. The model excluded datapoints for December, 2012, and December, 2013, to account for two nurses' strikes at Kilifi County Hospital. The Lancet Global Health 2019 7, e337-e346DOI: (10.1016/S2214-109X(18)30491-1) Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 Monthly incidence of admission to Kilifi County Hospital among children aged 2–59 months with (A) clinically-defined pneumonia and (B) diarrhoea Clinically-defined pneumonia includes severe or very severe pneumonia, according to WHO definitions.19 The dashed lines show the transition period during which PCV10 was introduced among children younger than 5 years. The model excluded datapoints for December, 2012, and December, 2013, to account for two nurses' strikes at Kilifi County Hospital. The Lancet Global Health 2019 7, e337-e346DOI: (10.1016/S2214-109X(18)30491-1) Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions