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肺炎球菌结合疫苗:印度提供的一种新型疫苗。

Pneumococcal conjugate vaccine: a newer vaccine available in India.

机构信息

Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana India.

出版信息

Hum Vaccin Immunother. 2012 Sep;8(9):1317-20. doi: 10.4161/hv.20654. Epub 2012 Aug 16.

Abstract

Streptococcus pneumoniae, or "pneumococcus," causes pneumonia and infections of the brain and blood that are responsible for significant mortality in children under five years as well as in the elderly. Pneumococcal diseases are a major public health problem worldwide. S. pneumoniae is responsible for 15-50% of all episodes of community-acquired pneumonia, 30-50% of all cases of acute otitis media, and a significant proportion of bacterial meningitis and bacteremia. S. pneumoniae kills at least one million children under the age of five every year, which is more than malaria, AIDS and measles combined. More than 70% of the deaths are in developing countries. In 2007, pneumococcal pneumonia was the leading infectious killer of children worldwide. Perhaps more importantly, pneumonia remains the leading killer of children in India. A recent UNICEF publication estimated that 410,000 children under age 5 y die of pneumonia each year in India, and recent data shows that an estimated 25% of all child deaths in India are due to pneumonia. The fact that this high burden of pneumonia has remained undiminished in India in spite of economic growth and decline in child mortality due to other diseases is a reminder of the importance of tackling pneumonia head-on with dedicated resources. The burden of pneumococcal meningitis, which constitutes about half of all childhood meningitis cases in most settings and a greater proportion of meningitis deaths, makes it difficult to avoid the conclusion that the pneumococcus is responsible for 1 million child deaths each year. Global Alliance for Vaccine and Immunization (GAVI) has offered to supply PCV at a cost of 0.15-0.30 USD/dose to India for inclusion in the national immunization schedule and commits to extending this support until the year 2015. Pneumococcal vaccination in not recommended in children aged 5 and above.

摘要

肺炎链球菌,也被称为“肺炎球菌”,可导致肺炎以及脑部和血液感染,是导致五岁以下儿童和老年人死亡的主要原因。肺炎球菌疾病是全球范围内的一个主要公共卫生问题。肺炎链球菌可引起 15-50%的社区获得性肺炎、30-50%的急性中耳炎、相当比例的细菌性脑膜炎和菌血症。肺炎链球菌每年导致至少 100 万 5 岁以下儿童死亡,这一数字超过疟疾、艾滋病和麻疹的总和。超过 70%的死亡发生在发展中国家。2007 年,肺炎球菌性肺炎是全球儿童的主要传染性致死病因。也许更重要的是,肺炎仍然是印度儿童的主要致死病因。联合国儿童基金会最近的一份出版物估计,印度每年有 41 万 5 岁以下儿童死于肺炎,最近的数据显示,印度约 25%的儿童死亡是由于肺炎。尽管经济增长,其他疾病导致的儿童死亡率下降,但印度的肺炎负担仍然没有减轻,这提醒我们,需要投入专门资源,积极应对肺炎问题。在大多数情况下,肺炎球菌性脑膜炎占所有儿童脑膜炎病例的一半左右,占脑膜炎死亡病例的更大比例,这使得我们很难不认为肺炎球菌每年导致 100 万儿童死亡。全球疫苗和免疫联盟(GAVI)已提议以每剂 0.15-0.30 美元的价格向印度提供 PCV,以纳入国家免疫计划,并承诺将这一支持延长至 2015 年。不建议 5 岁及以上儿童接种肺炎球菌疫苗。

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