Vogel Alison M, Trenholme Adrian A, Stewart Joanna M, Best Emma, McBride Charissa, Lennon Diana R
Middlemore Hospital, Private Bag 93311, Otahuhu, Manukau 1640, Auckland, New Zealand.
N Z Med J. 2013 Jul 12;126(1378):26-35.
To assess the change in admission rates for all Lower Respiratory Infection (LRI) including pneumonia for children resident in Counties Manukau District Health Board (CMDHB) with the introduction of the Pneumococcal Conjugate Vaccine 7 valent (PCV7) in June 2008.
National Minimum dataset ICD10 coded LRI admissions to any NZ hospital August 2001-July 2011 for children <2 year resident in CMDHB were analysed using Poisson regression, omitting 1 August 2008 to 31 July 2009, the first-year post vaccine introduction.
Pneumonia but not bronchiolitis admissions have been declining since 2001. Pneumonia admissions decreased significantly after PCV7 introduction (incidence risk ratio (IRR) (95% CI) 1.51 (1.08-1.77), additional to the gradual decline since 2001. There was significant decline for Pacific children post PCV7 introduction IRR 1.70(1.39, 2.07) but not for Maori children, IRR 1.05 (0.78-1.40). Maori and Pacific children are at increased risk of admission with LRI compared to European children (relative risk (RR) (95%CI) 4.6 (4.3-5.0) and 5.0(3.7-5.3) respectively) as are those living in Decile 9, 10 compared with those from other deciles, RR 1.43 (1.36-1.50).
The introduction of PCV7 is associated with reduced admissions for pneumonia in young children yet there has been less impact for Maori in CMDHB.
评估2008年6月引入7价肺炎球菌结合疫苗（PCV7）后，马努考县地区卫生委员会（CMDHB）辖区内儿童包括肺炎在内的所有下呼吸道感染（LRI）的住院率变化。
对2001年8月至2011年7月入住新西兰任何医院的CMDHB辖区内2岁以下儿童的国家最低数据集（ICD10编码）的LRI住院病例进行泊松回归分析，排除疫苗引入后的第一年，即2008年8月1日至2009年7月31日的数据。
自2001年以来，肺炎住院病例数一直在下降，但细支气管炎住院病例数未下降。引入PCV7后，肺炎住院病例数显著下降（发病率风险比（IRR）（95%置信区间）为1.51（1.08 - 1.77），这是在2001年以来逐渐下降的基础上的额外下降。PCV7引入后，太平洋儿童的住院病例数显著下降，IRR为1.70（1.39，2.07），但毛利儿童未下降，IRR为1.05（0.78 - 1.40）。与欧洲儿童相比，毛利儿童和太平洋儿童患LRI住院的风险增加（相对风险（RR）（95%置信区间）分别为4.6（4.3 - 5.0）和5.0（3.7 - 5.3）），与其他十分位数地区的儿童相比，生活在第9、10十分位数地区的儿童患LRI住院的风险也增加，RR为1.43（1.36 - 1.50）。
引入PCV7与幼儿肺炎住院率降低有关，但对CMDHB辖区内的毛利儿童影响较小。
