布基纳法索 5 岁以下儿童接种五价轮状病毒疫苗的效果和影响。
Impact and effectiveness of pentavalent rotavirus vaccine in children <5 years of age in Burkina Faso.
机构信息
University Ouaga 1 Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso; National Public Health Laboratory, Ouagadougou, Burkina Faso.
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
出版信息
Vaccine. 2018 Nov 12;36(47):7170-7178. doi: 10.1016/j.vaccine.2017.12.056. Epub 2017 Dec 28.
BACKGROUND
Burkina Faso was one of the first African nations to introduce pentavalent rotavirus vaccine (RV5, RotaTeq) into its national immunization program in October 2013. We describe the impact and effectiveness of rotavirus vaccine on acute gastroenteritis (AGE) hospitalizations among Burkinabe children.
METHODS
Sentinel hospital-based surveillance for AGE was conducted at four hospitals during December 2013 - February 2017. Demographic, clinical, and vaccination information was collected and stool specimens were tested by EIA. Trends in rotavirus AGE hospitalizations and changes in the proportion of AGE hospitalizations due to rotavirus were examined at two sentinel sites from January 2014 - December 2016. Unconditional logistic regression models using data from all 4 surveillance sites were used to calculate vaccine effectiveness (VE, defined as 1-odds ratio) by comparing the odds of vaccination among rotavirus AGE (cases) and non-rotavirus AGE (controls) patients, controlling for age, season, hospital site and socioeconomic factors.
RESULTS
The proportion of AGE hospitalizations that tested positive for rotavirus declined significantly among children <5 years of age, from 36% (154/422) in 2014 to 22% (71/323, 40% reduction, p < .01) in 2015 and 20% (61/298, 44% reduction, p < .01) in 2016. Among infants, the percentage of AGE admissions due to rotavirus fell significantly from 38% (94/250) in 2014 to 21% (32/153, 44% reduction, p < .01) in 2015 and 17% (26/149, 54% reduction, p < .01) in 2016. The adjusted VE for full 3-dose series of RV5 against rotavirus hospitalization was 58% (95% [CI], 10%, 81%) in children 6-11 months of age and 19% (-78%, 63%) in children ≥12 months.
CONCLUSION
Rotavirus hospitalizations declined after introduction of pentavalent rotavirus vaccine in children, particularly among infants. RV5 significantly protected against severe rotavirus gastroenteritis in infants, but effectiveness decreased in older children.
背景
布基纳法索是 2013 年 10 月将五价轮状病毒疫苗（RV5，Rotateq）纳入国家免疫规划的首批非洲国家之一。我们描述了轮状病毒疫苗对布基纳法索儿童急性胃肠炎（AGE）住院的影响和效果。
方法
2013 年 12 月至 2017 年 2 月，在四家医院开展了基于哨点的医院 AGE 监测。收集人口统计学、临床和疫苗接种信息，并通过 EIA 检测粪便标本。在 2014 年 1 月至 2016 年 12 月期间，在两个哨点监测站检查轮状病毒 AGE 住院的趋势和轮状病毒引起的 AGE 住院比例的变化。使用来自所有 4 个监测站的数据，使用无条件逻辑回归模型，通过比较轮状病毒 AGE（病例）和非轮状病毒 AGE（对照）患者的疫苗接种几率，计算疫苗有效性（VE，定义为 1-比值比），控制年龄、季节、医院地点和社会经济因素。
结果
<5 岁儿童中，轮状病毒 AGE 住院的比例从 2014 年的 36%（154/422）显著下降到 2015 年的 22%（71/323，40%减少，p<0.01）和 2016 年的 20%（61/298，44%减少，p<0.01）。在婴儿中，轮状病毒 AGE 入院率从 2014 年的 38%（94/250）显著下降到 2015 年的 21%（32/153，44%减少，p<0.01）和 2016 年的 17%（26/149，54%减少，p<0.01）。RV5 对 6-11 月龄儿童轮状病毒住院的全 3 剂系列疫苗的调整后 VE 为 58%（95%[CI]，10%，81%），12 月龄及以上儿童为 19%（-78%，63%）。
结论
在儿童中引入五价轮状病毒疫苗后，轮状病毒住院率下降，尤其是在婴儿中。RV5 对婴儿严重轮状病毒胃肠炎有显著保护作用，但在较大儿童中的有效性降低。
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