津巴布韦引入轮状病毒疫苗前后 5 岁以下儿童急性腹泻相关轮状病毒基因型的分布。
Distribution of rotavirus genotypes associated with acute diarrhoea in Zimbabwean children less than five years old before and after rotavirus vaccine introduction.
机构信息
Department of Medical Microbiology (University of Zimbabwe-College of Health Sciences), Zimbabwe; National Virology Reference Laboratory, Ministry of Health and Child Care, Zimbabwe.
Department of Medical Microbiology (University of Zimbabwe-College of Health Sciences), Zimbabwe; National Virology Reference Laboratory, Ministry of Health and Child Care, Zimbabwe.
出版信息
Vaccine. 2018 Nov 12;36(47):7248-7255. doi: 10.1016/j.vaccine.2018.03.069. Epub 2018 Apr 5.
BACKGROUND
Sentinel surveillance for diarrhoea is important to monitor changes in rotavirus epidemiological trends and circulating genotypes among children under 5 years before and after vaccine introduction. The Zimbabwe Ministry of Health and Child Care introduced rotavirus vaccine in national immunization program in May 2014.
METHODS
Active hospital-based surveillance for diarrhoea was conducted at 3 sentinel sites from 2008 to 2016. Children aged less than 5 years, who presented with acute gastroenteritis as a primary illness and who were admitted to a hospital ward or treated at the emergency unit, were enrolled and had a stool specimen collected and tested for rotavirus by enzyme immunoassay (EIA). Genotyping of positive stools was performed using reverse-transcription polymerase chain reaction and genotyping assays. Pre-vaccine introduction, 10% of all positive stool specimens were genotyped and all adequate positive stools were genotyped post-vaccine introduction.
RESULTS
During the pre-vaccine period, a total of 6491 acute gastroenteritis stools were collected, of which 3016 (46%) tested positive for rotavirus and 312 (10%) of the rotavirus positive stools were genotyped. During the post-vaccine period, a total of 3750 acute gastroenteritis stools were collected, of which 937 (25%) tested positive for rotavirus and 784 (84%) were genotyped. During the pre-vaccine introduction the most frequent genotype was G9P[8] (21%) followed by G2P[4] (12%), G1P[8] (6%), G2P[6] (5%), G12P[6] (4%), G9P[6] (3%) and G8P[4] (3%). G1P[8] (30%) was most dominant two years after vaccine introduction followed by G9P[6] (20%), G2P[4] (15%), G9P[8] (11%) and G1P[6] (4%).
CONCLUSION
The decline in positivity rate is an indication of early vaccine impact. Diversity of circulating strains underscores the importance of continued monitoring and strain surveillance after vaccine introduction.
背景
通过哨点监测腹泻，可以在小儿轮状病毒疫苗引入前后，监测 5 岁以下儿童的轮状病毒流行病学趋势和循环基因型变化。津巴布韦卫生部和儿童保健部于 2014 年 5 月在国家免疫规划中引入了轮状病毒疫苗。
方法
2008 年至 2016 年，在 3 个哨点进行了主动的医院为基础的腹泻监测。小于 5 岁的因急性胃肠炎为首发疾病而住院或在急诊单元治疗的儿童被纳入研究，并采集粪便标本，用酶免疫法（EIA）检测轮状病毒。对阳性粪便进行逆转录聚合酶链反应和基因分型检测。在疫苗引入前，10%的所有阳性粪便标本进行基因分型，疫苗引入后所有足够的阳性粪便标本都进行基因分型。
结果
在疫苗引入前，共采集 6491 份急性胃肠炎粪便，其中 3016 份（46%）轮状病毒检测阳性，312 份（10%）阳性粪便进行了基因分型。在疫苗引入后，共采集 3750 份急性胃肠炎粪便，其中 937 份（25%）轮状病毒检测阳性，784 份（84%）进行了基因分型。在疫苗引入前，最常见的基因型是 G9P[8]（21%），其次是 G2P[4]（12%）、G1P[8]（6%）、G2P[6]（5%）、G12P[6]（4%）、G9P[6]（3%）和 G8P[4]（3%）。疫苗引入后两年，G1P[8]（30%）最为优势，其次是 G9P[6]（20%）、G2P[4]（15%）、G9P[8]（11%）和 G1P[6]（4%）。
结论
阳性率的下降表明了早期疫苗的影响。循环株的多样性突出表明，在疫苗引入后，需要继续监测和进行株监测。
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