麻疹疫苗接种能否降低儿童急性呼吸道感染（ARI）和腹泻的风险：一项多国研究？
Does Measles Vaccination Reduce the Risk of Acute Respiratory Infection (ARI) and Diarrhea in Children: A Multi-Country Study?
作者信息
Bawankule Rahul, Singh Abhishek, Kumar Kaushalendra, Shetye Sadanand
机构信息
International Institute for Population Sciences, Mumbai, India.
Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
出版信息
PLoS One. 2017 Jan 11;12(1):e0169713. doi: 10.1371/journal.pone.0169713. eCollection 2017.
BACKGROUND
Pneumonia and diarrhea occur either as complications or secondary infections in measles affected children. So, the integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD) by WHO and UNICEF includes measles vaccination as preventive measure in children. The objective of the study is to examine the effect of measles vaccination on Acute Respiratory Infection (ARI) and diarrhea in children in the Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan.
METHODS
We analyzed data from the most recent rounds of Demographic and Health Surveys (DHS) in the selected countries. We included children age 12-59 months in the analysis. We used multivariable binary logistic regression to examine the effect of measles vaccination on ARI and diarrhea in children. We also estimated Vaccination Effectiveness (VE).
FINDINGS
More than 60 percent of the children age 12-59 months were given measles vaccine before the survey in the Democratic Republic of Congo, Ethiopia, India and Pakistan. Children who were given the measles vaccine were less likely to suffer from ARI than unvaccinated children in India and Pakistan. Children who were given the measles vaccine had a lower risk of diarrhea than those who did not receive it in all the selected countries except Ethiopia. Measles vaccination was associated with reduction in ARI cases by 15-30 percent in India and Pakistan, and diarrhea cases by 12-22 percent in the Democratic Republic of Congo, India, Nigeria and Pakistan.
CONCLUSION
The receipt of the measles vaccine was associated with decrease in ARI and diarrhea in children. The immunization program must ensure that each child gets the recommended doses of measles vaccine at the appropriate age. The measles vaccination should be given more attention as a preventive intervention under the Global Action Plan for Pneumonia and Diarrhea (GAPPD) in all low and middle-income countries.
背景
肺炎和腹泻在患麻疹儿童中可作为并发症或继发感染出现。因此，世界卫生组织（WHO）和联合国儿童基金会（UNICEF）的综合全球肺炎和腹泻行动计划（GAPPD）将麻疹疫苗接种作为儿童的预防措施。本研究的目的是检验麻疹疫苗接种对刚果民主共和国、埃塞俄比亚、印度、尼日利亚和巴基斯坦儿童急性呼吸道感染（ARI）和腹泻的影响。
方法
我们分析了所选国家最近几轮人口与健康调查（DHS）的数据。分析中纳入了12 - 59月龄的儿童。我们使用多变量二元逻辑回归来检验麻疹疫苗接种对儿童ARI和腹泻的影响。我们还估算了疫苗接种效力（VE）。
研究结果
在刚果民主共和国、埃塞俄比亚、印度和巴基斯坦，超过60%的12 - 59月龄儿童在调查前接种了麻疹疫苗。在印度和巴基斯坦，接种麻疹疫苗的儿童患ARI的可能性低于未接种疫苗的儿童。在除埃塞俄比亚外的所有选定国家，接种麻疹疫苗的儿童患腹泻的风险低于未接种疫苗的儿童。在印度和巴基斯坦，麻疹疫苗接种使ARI病例减少了15% - 30%，在刚果民主共和国、印度、尼日利亚和巴基斯坦，麻疹疫苗接种使腹泻病例减少了12% - 22%。
结论
接种麻疹疫苗与儿童ARI和腹泻的减少有关。免疫规划必须确保每个儿童在适当年龄接种推荐剂量的麻疹疫苗。在所有低收入和中等收入国家的全球肺炎和腹泻行动计划（GAPPD）下，应更加重视麻疹疫苗接种作为一种预防性干预措施。
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