孟加拉国幼儿轮状病毒胃肠炎的医院监测：确定轮状病毒疫苗计划的潜在影响。
Hospital-based Surveillance for Rotavirus Gastroenteritis Among Young Children in Bangladesh: Defining the Potential Impact of a Rotavirus Vaccine Program.
作者信息
Satter Syed M, Gastanaduy Paul A, Islam Khaleda, Rahman Mahmudur, Rahman Mustafizur, Luby Stephen P, Heffelfinger James D, Parashar Umesh D, Gurley Emily S
机构信息
From the *Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh; †Division of Viral Diseases, Centers for Disease Control and Prevention(CDC), Atlanta, Georgia; ‡Department of Epidemiology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh; §Center for Innovation in Global Health, Stanford University, Stanford, California; and ¶Western Pacific Regional Office, WHO, Manila, Philippines; Centers for Disease Control and Prevention(CDC), Atlanta, Georgia.
出版信息
Pediatr Infect Dis J. 2017 Feb;36(2):168-172. doi: 10.1097/INF.0000000000001381.
BACKGROUND
In anticipation of introduction of a rotavirus vaccine into the national immunization program of Bangladesh, active hospital-based surveillance was initiated to provide prevaccine baseline data on rotavirus disease.
METHODS
Children 5 years of age and younger admitted with acute gastroenteritis (AGE) (≥3 watery or looser-than-normal stools or ≥1 episode of forceful vomiting) at 7 hospitals throughout Bangladesh were identified. Clinical information and stool specimens were collected from every 4th patient. Specimens were tested for rotavirus antigen by enzyme immunoassays; 25% of detected rotaviruses were genotyped.
RESULTS
From July 2012 to June 2015, rotavirus was detected in 2432 (64%) of 3783 children hospitalized for AGE. Eight enrolled children died, including 4 (50%) who were rotavirus positive. Rotavirus was detected year-round in Bangladesh with peak detection rates of >80% during November-February. Most (86%) rotavirus AGE cases were 6-23 months of age. Sixty-nine percent of children with rotavirus had severe disease (Vesikari score, ≥11). Among 543 strains genotyped, G1P[8] (31%) and G12P[8] (29%) were the most common.
CONCLUSIONS
Rotavirus is a major cause of morbidity in Bangladeshi children, accounting for nearly two-thirds of AGE hospitalizations. These data highlight the potential value of rotavirus vaccination in Bangladesh, and will be the key for future measurement of vaccine impact.
背景
鉴于孟加拉国国家免疫规划即将引入轮状病毒疫苗，启动了以医院为基础的主动监测，以提供轮状病毒疾病的疫苗接种前基线数据。
方法
在孟加拉国各地的7家医院中，确定5岁及以下因急性胃肠炎（AGE）（≥3次水样便或比正常便稀或≥1次剧烈呕吐发作）入院的儿童。每4名患者收集临床信息和粪便标本。通过酶免疫测定法检测标本中的轮状病毒抗原；对25%检测到的轮状病毒进行基因分型。
结果
2012年7月至2015年6月，在3783名因AGE住院的儿童中，有2432名（64%）检测到轮状病毒。8名登记入组的儿童死亡，其中4名（50%）轮状病毒检测呈阳性。孟加拉国全年均检测到轮状病毒，11月至2月的检测率峰值>80%。大多数（86%）轮状病毒AGE病例年龄在6 - 23个月。69%的轮状病毒感染儿童患有严重疾病（韦西卡里评分≥11）。在543株基因分型的毒株中，G1P[8]（31%）和G12P[8]（29%）最为常见。
结论
轮状病毒是孟加拉国儿童发病的主要原因，占AGE住院病例的近三分之二。这些数据凸显了轮状病毒疫苗在孟加拉国的潜在价值，将成为未来衡量疫苗影响的关键。
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