Cardemil Cristina V, Jonas Anna, Gerber Sue, Weldon William C, Oberste M Steven, Beukes Anita, Sawadogo Souleymane, Patel Sadhna V, Zeko Sikota, Muroua Clementine, Gaeb Esegiel, Wannemuehler Kathleen, Goodson James L
Centers for Disease Control and Prevention, Global Immunization Division, United States.
Ministry of Health and Social Services, Namibia.
J Infect Dis. 2014 Nov 1;210 Suppl 1(Suppl 1):S136-42. doi: 10.1093/infdis/jiu086.
Poliovirus (PV) antibody seroprevalence studies assess population immunity, verify an immunization program's performance and vaccine efficacy, and guide polio eradication strategy. Namibia experienced a polio outbreak among adults in 2006, yet population seroimmunity was unknown.
We tested 2061 specimens from Namibian pregnant females aged 15-44 years for neutralizing antibody to PV types 1-3 (PV1-3); all females were sampled during the 2010 National HIV Sentinel Survey. We determined the proportion of females seropositive for PV antibody by 5-year age strata, and analyzed factors associated with seropositivity, including age, gravidity, human immunodeficiency virus (HIV) infection status, residence, and antiretroviral treatment, by log-binomial regression.
The seroprevalence was 94.6% for PV1, 97.0% for PV2, and 85.1% for PV3. HIV-positive females had significantly lower seroprevalence than HIV-negative females for PV1 (91.8% vs 95.3%; P<.01) and PV3 (80.0% vs 86.1%; P<.01) but not for PV2 (96.4% vs 97.1%; P=.3). The prevalence ratio of seropositivity for HIV-positive females versus HIV-negative females was 0.95 (95% confidence interval [CI], .92-.98) for PV1, 0.99 (95% CI, .97-1.01) for PV2, and 0.92 (95% CI, .87-.96) for PV3.
Despite relatively high PV seroprevalence, Namibia might remain at risk for a PV outbreak, particularly in lower-seroprevalence populations, such as HIV-positive females. Namibia should continue to maintain high routine polio vaccination coverage.
脊髓灰质炎病毒（PV）抗体血清流行率研究用于评估人群免疫力、验证免疫规划的实施情况和疫苗效力，并指导脊髓灰质炎根除策略。纳米比亚在2006年经历了一次成人脊髓灰质炎疫情，但人群血清免疫情况未知。
我们检测了2061份来自纳米比亚15至44岁孕妇的样本，以检测其对1 - 3型脊髓灰质炎病毒（PV1 - 3）的中和抗体；所有女性均在2010年全国艾滋病哨点监测期间采样。我们按5岁年龄组确定了PV抗体血清阳性女性的比例，并通过对数二项回归分析了与血清阳性相关的因素，包括年龄、妊娠次数、人类免疫缺陷病毒（HIV）感染状况、居住地和抗逆转录病毒治疗情况。
PV1的血清流行率为94.6%，PV2为97.0%，PV3为85.1%。HIV阳性女性的PV1（91.8%对95.3%；P<0.01）和PV3（80.0%对86.1%；P<0.01）血清流行率显著低于HIV阴性女性，但PV2（96.4%对97.1%；P = 0.3）并非如此。HIV阳性女性与HIV阴性女性血清阳性的患病率比值，PV1为0.95（95%置信区间[CI]，0.92 - 0.98），PV2为0.99（95%CI，0.97 - 1.01），PV3为0.92（95%CI，0.87 - 0.96）。
尽管纳米比亚的PV血清流行率相对较高，但该国可能仍面临PV疫情风险，尤其是在血清流行率较低的人群中，如HIV阳性女性。纳米比亚应继续保持高常规脊髓灰质炎疫苗接种覆盖率。
