Zahraei Seyed Mohsen, Izadi Shahrokh, Mokhtari-Azad Talat
a Centre for Communicable Diseases Control , Ministry of Health and Medical Education , Tehran , Iran.
b Associate Professor of Epidemiology, Health Promotion Research Centre , School of Public Health, Zahedan University of Medical Sciences , Zahedan , Iran.
Hum Vaccin Immunother. 2016 Dec;12(12):3118-3124. doi: 10.1080/21645515.2016.1214346. Epub 2016 Jul 26.
Within the past few years, several measles outbreaks have occurred in the southeast of Iran. To learn about the effectiveness of the immunization services for producing a serologic response against measles, this follow-up study was designed and implemented in the southeast of Iran. In Iran, all routine immunization services provided by the public sector are free of charge. The follow-up study was designed and implemented in 5 Urban Health Centers located in 3 districts of Sistan-va-BaluchestanProvince, Iran. In the pre-vaccination phase, 270 12-month-old babies were blood sampled; and in the post-vaccination phase, 4 to 7 weeks after Measles, Mumps, Rubella (MMR) vaccination, 236 of them were blood sampled (34 dropouts), and their sera were tested for IgG anti-measles antibodies, using indirect ELISA, in the National Reference Measles Laboratory. Out of the 236 participants, who had been blood sampled in the post-vaccination phase, 10 (3.7%) were excluded from the calculations of seroconversion rate, because they had protective levels of antibody before the vaccination. The seroconversion rate for the remaining 226 participants was 91.2% (95% confidence interval: 86.7 to 94.5). Among the variables studied, stunting (height-for-age z-score < -2) showed a strong relationship with the remaining seronegative after the vaccination (odds ratio = 5.6; 95% confidence interval: 1.7-18.2). The chance of seroconversion was inversely related to the mothers' levels of education (up to 9 y of education vs. above nine years) (odds ratio = 0.2; 95% confidence interval: 0.06-0.4). In the study population, the seroconversion rates for anti-measles antibodies after MMR vaccination are acceptable, even though in order to achieve the elimination goal, higher standards need to be achieved.
在过去几年中,伊朗东南部发生了几起麻疹疫情。为了解免疫服务在产生针对麻疹的血清学反应方面的有效性,在伊朗东南部设计并实施了这项随访研究。在伊朗,公共部门提供的所有常规免疫服务都是免费的。该随访研究在伊朗锡斯坦-俾路支斯坦省3个区的5个城市卫生中心设计并实施。在接种疫苗前阶段,对270名12个月大的婴儿进行了血样采集;在接种疫苗后阶段,即麻疹、腮腺炎、风疹(MMR)疫苗接种后4至7周,对其中236名婴儿进行了血样采集(34名退出研究),并在国家麻疹参考实验室使用间接ELISA法检测了他们血清中的IgG抗麻疹抗体。在接种疫苗后阶段进行血样采集的236名参与者中,有10名(3.7%)被排除在血清转化率计算之外,因为他们在接种疫苗前就有保护性抗体水平。其余226名参与者的血清转化率为91.2%(95%置信区间:86.7至94.5)。在所研究的变量中,发育迟缓(身高年龄Z评分<-2)与接种疫苗后仍为血清阴性的情况有很强的相关性(优势比=5.6;95%置信区间:1.7-18.2)。血清转化的几率与母亲的教育水平呈负相关(9年及以下教育程度与9年以上教育程度相比)(优势比=0.2;95%置信区间:0.06-0.4)。在研究人群中,MMR疫苗接种后抗麻疹抗体的血清转化率是可以接受的,尽管为了实现消除目标,还需要达到更高的标准。