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智利全国免疫规划引入 10 价肺炎球菌结合疫苗前后 24 月龄以下儿童急性中耳炎的发病频率。

Frequency of Acute Otitis Media in Children Under 24 Months of Age Before and After the Introduction of the 10-valent Pneumococcal Conjugate Vaccine Into the National Immunization Program in Chile.

机构信息

From the Otorhinolaringology Service, Hospital Dr Sótero del Río, Pontificia Universidad Católica de Chile, Faculty of Medicine, Universidad de Chile, Faculty of Medicine, Pontificia Universidad Católica de Chile, Pontificia Universidad Católica de Chile, and Department of Pediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile.

出版信息

Pediatr Infect Dis J. 2018 Feb;37(2):132-134. doi: 10.1097/INF.0000000000001722.

Abstract

BACKGROUND

Streptococcus pneumoniae is the leading cause of acute otitis media (AOM). Ten-valent pneumococcal conjugated vaccine (PCV-10) was introduced to the Chilean National Immunization Program (NIP) in 2011. The aim of this study was to estimate the frequency of AOM in children <24 months of age attending the emergency department (ED) of Hospital Sótero del Río (HSR) 4 years before and 4 years after the introduction of PCV-10 in the Chilean NIP.

METHODS

Register-based nested case-control study. Cases (n = 1907) were all children <24 months of age with a clinical diagnosis discharge of AOM at the ED of HSR, and controls (n = 244,334) were all other children <24 months of age attended at the same ED in the same time period, with any other discharge diagnosis. The data were obtained through HSR Statistical Service.

RESULTS

In the study period, there was a mean of 30,695 children <24 months managed each year at the ED of HSR. The percentage with AOM in the prevaccine period was 0.94% and in the postvaccine period was 0.62%, respectively (P = 0.026). Exposure to the PCV-10 was associated with a decreased risk to develop AOM in children <24 months, with an odds ratio of 0.659 (95% confidence interval: 0.60-0.72).

CONCLUSIONS

Our study showed a significant decrease in the percentage and risk of AOM in children <24 months of age who visited the ED of HSR after implementation of PCV-10 in the NIP in Chile.

摘要

背景

肺炎链球菌是急性中耳炎(AOM)的主要病因。十价肺炎球菌结合疫苗(PCV-10)于 2011 年被引入智利国家免疫规划(NIP)。本研究旨在评估在 PCV-10 引入智利 NIP 之前和之后的 4 年中,在急诊部(ED)就诊的<24 个月龄儿童 AOM 的发生率。

方法

基于登记的嵌套病例对照研究。病例(n=1907)为所有<24 个月龄、在 HSR ED 以临床诊断为 AOM 出院的儿童,对照组(n=244334)为在同一时期、同一 ED 就诊的所有其他<24 个月龄儿童,其出院诊断为任何其他疾病。数据通过 HSR 统计服务获得。

结果

在研究期间,HSR ED 平均每年管理<24 个月的儿童有 30695 人。疫苗前时期 AOM 的百分比为 0.94%,疫苗后时期为 0.62%(P=0.026)。在<24 个月的儿童中,接触 PCV-10 与降低患 AOM 的风险相关,比值比为 0.659(95%置信区间:0.60-0.72)。

结论

我们的研究表明,在智利 NIP 中实施 PCV-10 后,在 ED 就诊的<24 个月龄儿童 AOM 的百分比和风险显著降低。

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