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巴基斯坦婴幼儿中针对经影像学确诊肺炎的 b 型流感嗜血杆菌结合疫苗有效性。

Effectiveness of Haemophilus influenzae type b conjugate vaccine on radiologically-confirmed pneumonia in young children in Pakistan.

机构信息

Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.

出版信息

J Pediatr. 2013 Jul;163(1 Suppl):S79-S85.e1. doi: 10.1016/j.jpeds.2013.03.034.

DOI:10.1016/j.jpeds.2013.03.034
PMID:23773598
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5748937/
Abstract

OBJECTIVE

The effectiveness of Haemophilus influenzae type b (Hib) vaccine in preventing severe pneumonia in Asian children has been questioned, and many large Asian countries yet to introduce Hib conjugate vaccine in immunization programs. The primary objective of this study was to assess Hib conjugate vaccine effectiveness (VE) on radiologically-confirmed pneumonia in children born after introduction of Hib conjugate vaccine in Pakistan.

STUDY DESIGN

A matched case-control study enrolled cases of radiologically-confirmed pneumonia in several hospitals serving low-income populations during 2009-2011. Cases were matched by age and season with 3 hospital and 5 neighborhood controls. Pneumonia was diagnosed using standardized World Health Organization criteria for chest radiograph interpretation. Matched OR were estimated for VE.

RESULTS

A total of 1027 children with radiologically-confirmed pneumonia were enrolled; 975 cases, 2925 hospital controls, and 4875 neighborhood controls were analyzed. The coverage for 3 doses of diphtheria-tetanus-pertussis-hepatitis B-Hib conjugate vaccine was 13.7%, 18%, and 22.7% in cases, hospital controls and neighborhood controls, respectively. Estimated Hib VE for radiologically-confirmed pneumonia was 62% with 3 doses of vaccine using hospital controls and 70% using neighborhood controls.

CONCLUSIONS

Hib conjugate vaccine prevented a significant fraction of radiologically-confirmed pneumonia in children in Pakistan. Maximizing impact on child survival needs improved immunization coverage.

摘要

目的

Hib 疫苗（流感嗜血杆菌 b 型疫苗）在预防亚洲儿童重症肺炎的有效性受到了质疑，许多亚洲大国尚未在免疫规划中引入 Hib 结合疫苗。本研究的主要目的是评估 Hib 结合疫苗在巴基斯坦引入 Hib 结合疫苗后对儿童放射确诊肺炎的效果。

研究设计

一项病例对照研究，纳入了几家为低收入人群服务的医院在 2009-2011 年期间放射确诊肺炎的病例。病例按照年龄和季节与 3 家医院和 5 个社区对照进行匹配。肺炎采用标准化的世界卫生组织胸部 X 线解读标准进行诊断。对匹配的 OR 进行估计，以评估疫苗的效果。

结果

共纳入了 1027 例放射确诊肺炎患儿；对 975 例病例、2925 例医院对照和 4875 例社区对照进行了分析。3 剂白喉-破伤风-百日咳-乙型肝炎-Hib 结合疫苗的覆盖率分别为 13.7%、18%和 22.7%，病例、医院对照和社区对照。使用医院对照估计 Hib 疫苗对放射确诊肺炎的效果为 62%，使用社区对照则为 70%。

结论

Hib 结合疫苗可预防巴基斯坦儿童放射确诊肺炎的显著比例。为了最大限度地提高对儿童生存的影响，需要提高免疫覆盖率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9d0/5748937/497f7c87dff0/nihms926997f1.jpg

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