From the Department of Paediatrics.
Department of Population Health, University of Otago, Christchurch, New Zealand.
Pediatr Infect Dis J. 2018 Oct;37(10):1041-1047. doi: 10.1097/INF.0000000000002071.
Vaccines against Haemophilus influenzae type B (Hib), Neisseria meningitidis and Streptococcus pneumoniae have been serially introduced into the New Zealand national immunization schedule since the 1990s. This study aimed to describe long-term trends in the rates of these invasive bacterial infections in children from New Zealand and compare these to recent UK data.
This population-based observational study used 2 national datasets that collect data about hospital discharges (National Minimum Dataset) and notifiable diseases (Epurv). Annual age-specific and age-standardized hospital admission rates and notification rates were analyzed for all children <15 years of age.
Hospital admissions for Hib reduced by 79% during the 2 years after the introduction of the Hib vaccine (5.94-1.24/100,000). Meningococcal disease notifications fell by 75% over 8 years after the introduction of MeNZB vaccine (26.15-2.48/100,000) and have continued to decline. Meningococcal disease rates were lower than in the United Kingdom despite the absence of an ongoing meningococcal vaccination program in New Zealand (8.16 compared with 10.37/100,000 for 2007-2011). There rates of notifications and hospital admissions for pneumococcal disease were discordant, but both reduced substantially after the introduction of pneumococcal conjugate vaccines. Maori children had the highest rates of disease and the greatest reduction in rates after the introduction of both meningococcal and pneumococcal vaccines.
Vaccines have had a substantial impact on the rates of invasive bacterial disease in children from New Zealand because of Hib, pneumococcus and meningococcus. Reductions in rates of disease have been greatest in Maori children, improving longstanding disparities in disease burden.
自 20 世纪 90 年代以来，新西兰国家免疫计划中陆续引入了针对乙型流感嗜血杆菌（Hib）、脑膜炎奈瑟菌和肺炎链球菌的疫苗。本研究旨在描述新西兰儿童这些侵袭性细菌感染的长期趋势，并与英国近期数据进行比较。
这项基于人群的观察性研究使用了两个收集有关住院（国家最低数据集）和传染病（Epurv）数据的国家数据集。对所有<15 岁的儿童进行了年龄特异性和年龄标准化的住院率和通报率的年度分析。
在 Hib 疫苗引入后的 2 年内，Hib 导致的住院率下降了 79%（5.94-1.24/100,000）。在 MeNZB 疫苗引入后的 8 年内，脑膜炎球菌病的通报率下降了 75%（26.15-2.48/100,000），并且仍在继续下降。尽管新西兰没有持续的脑膜炎球菌疫苗接种计划，但脑膜炎球菌病的发病率仍低于英国（2007-2011 年为 8.16 与 10.37/100,000）。肺炎球菌疾病的通报率和住院率不一致，但在引入肺炎球菌结合疫苗后均大幅下降。毛利儿童的发病率最高，在引入脑膜炎球菌和肺炎球菌疫苗后，发病率的下降幅度最大。
由于 Hib、肺炎球菌和脑膜炎球菌，疫苗对新西兰儿童侵袭性细菌疾病的发病率产生了重大影响。毛利儿童的发病率下降幅度最大，改善了长期以来疾病负担的不平等现象。
