Lietman T, Blower S M
Francis I. Proctor Foundation and Department of Ophthalmology, University of California San Francisco, San Francisco, CA 94143, USA.
Clin Infect Dis. 2000 Jun;30 Suppl 3:S316-22. doi: 10.1086/313881.
We use 2 simple mathematical models (one a preexposure vaccine model and the other a postexposure vaccine model) to provide general insight into the effects of vaccination on tuberculosis epidemics. We discuss how these models can be used as health policy tools: to identify which vaccines are "equivalent," to design control strategies, and to predict the epidemiological impact of different vaccination strategies. Our results show that even moderately effective vaccines could have a significant effect on reducing tuberculosis epidemics if they can be coupled with moderate to high treatment rates. We suggest that both preexposure and postexposure tuberculosis vaccines can be used to help eliminate tuberculosis in developing countries. In developed countries, only a preexposure vaccine (used in combination with a high level of treatment) would be necessary to eliminate tuberculosis.
我们使用两个简单的数学模型（一个是暴露前疫苗模型，另一个是暴露后疫苗模型）来全面洞察疫苗接种对结核病流行的影响。我们讨论了如何将这些模型用作卫生政策工具：确定哪些疫苗“等效”，设计控制策略，以及预测不同疫苗接种策略的流行病学影响。我们的结果表明，即使是效果一般的疫苗，如果能与中高治疗率相结合，也可能对减少结核病流行产生显著效果。我们建议，暴露前和暴露后结核病疫苗都可用于帮助发展中国家消除结核病。在发达国家，只需一种暴露前疫苗（与高水平治疗相结合使用）就足以消除结核病。
