Invasive pneumococcal disease in the Gulf region: a narrative review of incidence, burden, and vaccine strategies.

Invasive pneumococcal disease (IPD) presents a significant public health challenge in the Gulf Cooperation Council (GCC) region, particularly affecting vulnerable populations such as young children and individuals with chronic conditions. This narrative review synthesizes recent data from Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE) to assess the epidemiology of IPD, the burden of disease, serotype distribution, and risk factors. Across the GCC, there is a notable variability in serotype distribution, with non-Pneumococcal Conjugate Vaccine (PCV) 13 serotypes like 8, 15B, 22F, 33F, etc. becoming prominent. In Kuwait, PCV13 provided 61.5% serotype coverage, while in Oman, coverage is limited to 37.1%. Qatar reports higher coverage of 78.26% for children under two, however PCV13 strains such as 3 and 19A remain dominant. Antibiotic resistance is rising in several countries, especially in Kuwait and the UAE, where multidrug-resistant strains are becoming more common. The review also highlights the challenges posed by socioeconomic factors, including limited healthcare access, particularly among expatriates. While PCV13 has led to reductions in vaccine-covered serotypes, the emergence of non-PCV13 serotypes suggests the need for higher-valency vaccines like PCV20. Strengthening surveillance, expanding local research, and improving vaccination strategies tailored to the region's unique demographic and healthcare landscape are essential for mitigating IPD burden.