Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
United Nations Children's Fund (UNICEF) China, Beijing 100600, China.
Vaccine. 2017 Nov 1;35(46):6275-6282. doi: 10.1016/j.vaccine.2017.09.057. Epub 2017 Oct 4.
Haemophilus influenzae type b (Hib) is an important cause of invasive bacterial disease in children worldwide. The limited awareness of disease burden is a major barrier to the introduction of Hib vaccine into China's National Immunization Program. Therefore, we conducted a systematic review and meta-analysis to estimate carriage of Hib and burden of its related diseases in Chinese children.
We systematically searched Pubmed, Web of Science, Ovid, Chinese National Knowledge Infrastructure (CNKI), and Wanfang databases for studies published up to December 31, 2016, reporting Hib carriage and burden of Hib diseases among children in Mainland China. Pooled estimates were obtained using random-effects models.
We included 27 studies with 15783 children across 14 provinces. The pooled carriage of Hib was 5.87% (95% CI 3.42-8.33) for healthy children. The pooled proportion of disease due to Hib were 4.06% (95% CI 3.29-4.83) for acute lower respiratory tract infection (ALRI) and 27.32% (95% CI 0.41-54.24) for bacterial meningitis. The proportion of ALRI caused by Hib was higher in northern China than that in the south. Significant heterogeneity was noted across and within regions (P<0.001). After the induction of Hib vaccine, meta-regression showed that carriage of Hib changed little (P=0.725), but the proportion of ALRI caused by Hib in children decreased (P<0.001).
Hib carriage persists at low levels among children in China. The proportion of ALRI due to Hib infection decreased with year. Incorporation of Hib vaccine into the National Immunization Program could reduce the burden of Hib disease in China.
乙型流感嗜血杆菌（Hib）是全球儿童侵袭性细菌病的重要病因。对疾病负担认识不足是 Hib 疫苗纳入中国国家免疫规划的主要障碍。因此，我们进行了系统评价和荟萃分析，以评估中国儿童 Hib 携带情况和 Hib 相关疾病负担。
我们系统检索了 Pubmed、Web of Science、Ovid、中国知网（CNKI）和万方数据库，检索截至 2016 年 12 月 31 日，报道中国大陆儿童 Hib 携带情况和 Hib 疾病负担的研究。采用随机效应模型汇总估计值。
我们纳入了 27 项研究，共纳入了来自 14 个省份的 15783 名儿童。健康儿童 Hib 携带率为 5.87%（95%CI 3.42-8.33）。Hib 引起的疾病中，急性下呼吸道感染（ALRI）占 4.06%（95%CI 3.29-4.83），细菌性脑膜炎占 27.32%（95%CI 0.41-54.24）。北方地区儿童 Hib 引起的 ALRI 比例高于南方。区域间和区域内均存在显著异质性（P<0.001）。Hib 疫苗接种后，Meta 回归显示 Hib 携带率变化不大（P=0.725），但 Hib 引起的 ALRI 比例下降（P<0.001）。
中国儿童 Hib 携带率处于低水平。Hib 感染引起的 ALRI 比例随时间下降。将 Hib 疫苗纳入国家免疫规划可降低 Hib 疾病在中国的负担。
