Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
Hum Vaccin Immunother. 2019;15(11):2590-2605. doi: 10.1080/21645515.2019.1599676. Epub 2019 May 22.
There are knowledge gaps regarding evidence-based research on the burden of vaccine-preventable diseases among human immunodeficiency virus (HIV)-infected and HIV-exposed children aged <18 years in sub-Saharan Africa. It is therefore essential to determine the trend and burden of vaccine-preventable diseases. We completed a systematic review and meta-analysis to identify the incidence, prevalence and case-fatality rates (CFR) attributed to various vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa. The trends in the prevalence of vaccine-preventable diseases among HIV-infected and HIV-exposed children were also determined. Nine studies on tuberculosis (TB) were pooled to give an overall incidence rate estimate of 60 (95% confidence interval [CI] 30-70) per 1,000 child-years. The incidence of pneumococcal infections varied between 109-1509 per 100,000 while pertussis was between 2.9 and 3.7 per 1000 child-year. Twenty-two TB prevalence studies reported an estimated prevalence of 16%. Fifteen prevalence studies on hepatitis B infection were pooled together with an estimated prevalence of 5%. The pooled prevalence for pneumococcal infections was 2% while rotavirus diarrhoea reported a prevalence of 13%. Twenty-nine studies on TB were pooled to give an overall CFR estimate of 17% while pneumococcal infections in HIV-infected and exposed children were pooled together with a resultant rate of 15%. Some of the vaccine-preventable diseases still have high incidences, prevalence and CFR among HIV-infected and HIV-exposed children. There is also a dearth of research data on the burden of several vaccine-preventable diseases among HIV-infected and exposed children and a need for more studies in this area.
在撒哈拉以南非洲，针对感染人类免疫缺陷病毒（HIV）和暴露于 HIV 的 <18 岁儿童的疫苗可预防疾病的循证研究存在知识空白。因此，确定疫苗可预防疾病的趋势和负担至关重要。我们进行了系统评价和荟萃分析，以确定撒哈拉以南非洲感染 HIV 和暴露于 HIV 的儿童中各种疫苗可预防疾病的发病率、患病率和病死率（CFR）。还确定了感染 HIV 和暴露于 HIV 的儿童中疫苗可预防疾病患病率的趋势。有 9 项关于结核病（TB）的研究被汇总，得出每 1000 个儿童年的总发病率估计值为 60（95%置信区间 [CI] 30-70）。肺炎球菌感染的发病率在 109-1509/10 万之间，而百日咳的发病率在 2.9-3.7/1000 儿童年之间。22 项 TB 患病率研究报告的估计患病率为 16%。15 项乙型肝炎感染患病率研究被汇总在一起，估计患病率为 5%。肺炎球菌感染的汇总患病率为 2%，轮状病毒腹泻的患病率为 13%。29 项 TB 研究被汇总在一起，得出总的 CFR 估计值为 17%，而感染 HIV 和暴露于 HIV 的儿童中的肺炎球菌感染被汇总在一起，其发生率为 15%。一些疫苗可预防疾病在感染 HIV 和暴露于 HIV 的儿童中仍具有较高的发病率、患病率和 CFR。关于感染 HIV 和暴露于 HIV 的儿童中几种疫苗可预防疾病的负担，也缺乏研究数据，需要在这一领域开展更多研究。
