Expanded Programme on Immunization, Department of Immunization, Vaccines and Biologicals, World Health Organization, 1211 Geneva 27, Switzerland.
Vaccine. 2012 Apr 27;30 Suppl 1:A3-6. doi: 10.1016/j.vaccine.2011.10.007.
Diarrhoeal disease is one of the commonest causes of death in children, especially in developing countries in Africa and Asia. Rotavirus has been consistently identified as the commonest pathogen associated with severe diarrhoea. Hence, the availability of vaccines against this organism provides the opportunity to reduce child mortality. Data from efficacy trials in developing countries in Africa and Asia showed that the vaccine efficacy was lower than that observed in other countries. Nevertheless, the vaccines are expected to be of significant benefit in high mortality countries in these regions. While the reports published in this supplement add to our understanding about the performance of these vaccines in developing countries in these regions, questions remain over the overall impact of these vaccines when used in national programmes of developing countries in Africa and Asia, the optimal vaccination schedules and the impact of age restrictions for vaccine use on immunization coverage. Additional research is required to improve understanding on the performance of these vaccines in developing countries in Africa and Asia and measures that may improve performance. Data that will assist in the definition of the optimal immunization schedule and possibly allow relaxation of the age restrictions for vaccine use may help in enhancing the impact of the vaccines in these countries. Finally, disease surveillance and studies are required to document the impact of vaccination and monitor changes in disease epidemiology.
腹泻病是儿童死亡的最常见原因之一，特别是在非洲和亚洲的发展中国家。轮状病毒一直被认为是与严重腹泻相关的最常见病原体。因此，针对这种病原体的疫苗的出现为降低儿童死亡率提供了机会。来自非洲和亚洲发展中国家的疗效试验数据表明，疫苗的有效性低于其他国家观察到的水平。然而，预计这些疫苗在这些地区高死亡率国家将具有重大意义。虽然本增刊中的报告增加了我们对这些疫苗在这些地区发展中国家的表现的了解，但仍存在一些问题，例如这些疫苗在非洲和亚洲发展中国家的国家方案中使用时的总体影响、最佳免疫接种时间表以及疫苗使用年龄限制对免疫覆盖率的影响。需要开展更多的研究，以增进对这些疫苗在非洲和亚洲发展中国家的表现的了解，并采取可能提高其性能的措施。有助于确定最佳免疫接种时间表的数据，并可能放宽疫苗使用的年龄限制，这可能有助于提高这些国家疫苗的效果。最后，需要开展疾病监测和研究，以记录疫苗接种的效果，并监测疾病流行病学的变化。
