Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service program, Centers for Disease Control and Prevention, Atlanta, GA, USA.
National Public Health Laboratory, Ministry of Public Health and Population, Haiti.
Vaccine. 2013 Dec 17;32(1):69-73. doi: 10.1016/j.vaccine.2013.10.071. Epub 2013 Nov 1.
Haiti had set a national goal to eliminate measles and rubella, as well as congenital rubella syndrome (CRS) by 2010. A 2007-2008 nationwide measles and rubella vaccination campaign targeting 1-19 years, however, reached only 79% of the target population. To assess whether population immunity was adequate to support elimination, we conducted a national serosurvey.
We systematically selected 740 serum specimens collected from pregnant women in a 2012 national antenatal HIV sentinel serosurvey across four age strata: 15-19, 20-24, 25-29 and 30-39 years. Sera were tested for measles and rubella specific immunoglobulin G antibodies (IgG) using commercial immunoassays. We classified sera as seropositive, seronegative or indeterminate per manufacturer's instructions, and analyzed seroprevalence according to age strata, and rural or urban residence. We assessed immunity by estimating antibody concentrations in international units per milliliter (IU/mL) for seropositive and indeterminate sera. Measles IgG concentrations >0.12 IU/mL and rubella IgG concentrations >10 IU/mL were considered clinically protective.
Of 740 sera, 696 (94.1%) were seropositive and 20 (2.7%) were indeterminate for measles IgG; overall 716 (96.8%) sera had IgG concentrations >0.12 IU/mL. For rubella IgG, 691 (93.4%) sera were seropositive and 1 (0.1%) was indeterminate; a total of 687 (92.8%) had IgG concentrations >10 IU/mL. Measles seropositivity varied across age strata (p=0.003); seropositivity increased from 88.6% among 15-19 year olds to 98.4% among 30-39 year olds (Cochran-Armitage trend tes t ≤ 0.0001). Rubella seropositivity did not differ across age strata. There were no statistically significant differences in measles or rubella seropositivity by urban versus rural residence.
Despite previous low vaccination coverage for measles, results from this serosurvey indicate high levels of measles and rubella seropositivity in pregnant women, and contribute to the evidence for measles, rubella and CRS elimination from Haiti by the target date.
海地设定了到 2010 年消除麻疹和风疹以及先天性风疹综合征（CRS）的国家目标。然而，2007-2008 年针对 1-19 岁人群的全国性麻疹和风疹疫苗接种运动仅覆盖了目标人群的 79%。为了评估人群免疫力是否足以支持消除，我们进行了全国血清学调查。
我们系统地选择了 2012 年全国艾滋病毒产前哨点血清学调查中来自孕妇的 740 份血清样本，这些样本来自四个年龄组：15-19 岁、20-24 岁、25-29 岁和 30-39 岁。使用商业免疫分析检测血清中麻疹和风疹特异性免疫球蛋白 G 抗体（IgG）。我们根据制造商的说明将血清分类为血清阳性、血清阴性或不确定，并根据年龄组和农村或城市居住地分析血清阳性率。我们通过估计血清阳性和不确定血清的国际单位/毫升（IU/mL）中的抗体浓度来评估免疫力。麻疹 IgG 浓度>0.12IU/mL 和风疹 IgG 浓度>10IU/mL 被认为具有临床保护作用。
在 740 份血清中，696 份（94.1%）对麻疹 IgG 呈血清阳性，20 份（2.7%）呈不确定；总体而言，716 份（96.8%）血清 IgG 浓度>0.12IU/mL。风疹 IgG 方面，691 份（93.4%）血清呈血清阳性，1 份（0.1%）呈不确定；总共 687 份（92.8%）血清 IgG 浓度>10IU/mL。麻疹血清阳性率因年龄组而异（p=0.003）；15-19 岁年龄组的血清阳性率从 88.6%上升至 30-39 岁年龄组的 98.4%（Cochran-Armitage 趋势检验 ≤0.0001）。风疹血清阳性率不因年龄组而异。农村与城市居住地之间的麻疹或风疹血清阳性率无统计学差异。
尽管此前麻疹疫苗接种覆盖率较低，但此次血清学调查的结果表明，孕妇中麻疹和风疹的血清阳性率较高，这为海地在目标日期前消除麻疹、风疹和 CRS 提供了证据。
