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巴西呼吸道合胞病毒的季节性:对高危人群免疫政策的影响。

Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations.

作者信息

Freitas André Ricardo Ribas, Donalisio Maria Rita

机构信息

Faculdade de Medicina São Leopoldo Mandic, Campinas, SP, Brasil.

Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2016 May;111(5):294-301. doi: 10.1590/0074-02760150341. Epub 2016 Mar 29.

Abstract

Respiratory syncytial virus (RSV) infection is the leading cause of hospitalisation for respiratory diseases among children under 5 years old. The aim of this study was to analyse RSV seasonality in the five distinct regions of Brazil using time series analysis (wavelet and Fourier series) of the following indicators: monthly positivity of the immunofluorescence reaction for RSV identified by virologic surveillance system, and rate of hospitalisations per bronchiolitis and pneumonia due to RSV in children under 5 years old (codes CID-10 J12.1, J20.5, J21.0 and J21.9). A total of 12,501 samples with 11.6% positivity for RSV (95% confidence interval 11 - 12.2), varying between 7.1 and 21.4% in the five Brazilian regions, was analysed. A strong trend for annual cycles with a stable stationary pattern in the five regions was identified through wavelet analysis of the indicators. The timing of RSV activity by Fourier analysis was similar between the two indicators analysed and showed regional differences. This study reinforces the importance of adjusting the immunisation period for high risk population with the monoclonal antibody palivizumab taking into account regional differences in seasonality of RSV.

摘要

呼吸道合胞病毒(RSV)感染是5岁以下儿童因呼吸系统疾病住院的主要原因。本研究的目的是利用时间序列分析(小波分析和傅里叶级数分析)对巴西五个不同地区的RSV季节性进行分析,分析指标如下:通过病毒学监测系统确定的RSV免疫荧光反应月度阳性率,以及5岁以下儿童因RSV导致的细支气管炎和肺炎的住院率(国际疾病分类第十版编码J12.1、J20.5、J21.0和J21.9)。共分析了12501份样本,RSV阳性率为11.6%(95%置信区间11 - 12.2),在巴西五个地区之间,该阳性率在7.1%至21.4%之间变化。通过对指标的小波分析,确定了五个地区具有稳定平稳模式的年度周期的强烈趋势。通过傅里叶分析得出的RSV活动时间在两个分析指标之间相似,并显示出区域差异。本研究强调了在考虑RSV季节性区域差异的情况下,调整使用单克隆抗体帕利珠单抗对高危人群进行免疫接种时间的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfa5/4878298/53a0a523c455/0074-0276-mioc-111-5-0294-gf01.jpg

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