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影响伊朗东南部12月龄婴儿首次接种麻疹疫苗后血清转化率的因素

Factors affecting the seroconversion rate of 12-month-old babies after the first injection of measles vaccine in the southeast of Iran.

作者信息

Zahraei Seyed Mohsen, Izadi Shahrokh, Mokhtari-Azad Talat

机构信息

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.

出版信息

Hum Vaccin Immunother. 2016 Dec;12(12):3118-3124. doi: 10.1080/21645515.2016.1214346. Epub 2016 Jul 26.

Abstract

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.

摘要

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。

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