Date of Conferral



Doctor of Public Health (DrPH)


Public Health


John Nemecek


Many children under the age of 5 die each year of invasive pneumococcal disease. Childhood vaccination against this disease reduces morbidity and mortality. Despite the introduction of a pneumococcal conjugate vaccine (PCV13) in a central African country in 2011, all provinces have not yet been vaccinated. The purpose of this quantitative quasi-experimental study was to determine whether there was an association between the introduction of PCV13 and new cases of pneumococcal disease in 2 provinces in central Africa. The sample size for the study was 380. The theoretical framework for this study was the epidemic model supported by the concept of herd immunity. Key research questions examined the incidence of pneumococcal disease in children by age, gender, and province. The independent variables were age, gender, province, and introduction of PCV13. The dependent variable was incidence of invasive pneumococcal disease. The research questions were evaluated using chi-square test of independence and logistic regression. The results of the study indicated that vaccination with PCV13 significantly reduced incident cases of invasive pneumococcal diseases (aOR 0.333, 95% CI 0.628-0.177, p = 0.001). However, this association was not significant for age (aOR 0.574, 95% CI 1.186-0.278, p = .134), and there were no significant gender differences (aOR 1.047, 95% CI 1.929-0.569, p = 0.882). Positive social change may result by enabling the protection of more children in the central Africa country provinces that have not yet adopted using PCV13 and by introducing the vaccine in other African countries.