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在过去十年里,我们在西班牙对轮状病毒有了哪些了解?

[What have we learnt about rotavirus in Spain in the last 10 years?].

作者信息

Díez-Domingo Javier, Garcés-Sánchez María, Giménez-Sánchez Francisco, Colomina-Rodríguez Javier, Martinón-Torres Federico

机构信息

FISABIO-Salud Pública, Valencia, España.

Pediatría, Centro de Salud Nazaret, Valencia, España.

出版信息

An Pediatr (Engl Ed). 2019 Sep;91(3):166-179. doi: 10.1016/j.anpedi.2019.01.024. Epub 2019 Apr 7.

Abstract

INTRODUCTION

Vaccines against rotavirus (RV) have been available in Spain since 2006, but they are neither recommended nor financed by the National Health System. Nevertheless, through recommendations of the Spanish Association of Paediatrics vaccination has achieved intermediate coverage.

MATERIAL AND METHODS

A systematic literature review was performed on studies carried out in Spain in the last 12 years (2006-2018) on RV infection and vaccination.

RESULTS

A total of 43 studies were identified that met the inclusion criteria. The disease burden in children less than 5 years in the Primary Care setting ranged from 15 to 19 cases per 1,000 children, and between 120 and 480 cases per 100,000 in the hospital setting, which has a significant economic and social impact. Vaccines against RV have shown an effectiveness of between 83% and 96%, and an impact of up to 70% in reducing hospital admissions, which is dependent on the achieved vaccine coverage. New research lines are identified, such as the role of the rotavirus vaccine and protection against seizures or the impact on the gut microbiota.

CONCLUSIONS

The current available information supports the significant burden of rotavirus disease in Spain and the high effectiveness of the available vaccines. This evidence should allow for an updated re-evaluation of the national recommendations on rotavirus vaccination.

摘要

引言

自2006年起,西班牙就有了轮状病毒(RV)疫苗,但国家卫生系统既不推荐也不资助接种该疫苗。尽管如此,通过西班牙儿科学会的建议,疫苗接种已实现了中等覆盖率。

材料与方法

对西班牙过去12年(2006 - 2018年)开展的关于RV感染和疫苗接种的研究进行了系统的文献综述。

结果

共确定了43项符合纳入标准的研究。在初级保健机构中,5岁以下儿童的疾病负担为每1000名儿童中有15至19例病例,在医院环境中为每10万人中有120至480例病例,这具有重大的经济和社会影响。RV疫苗的有效性在83%至96%之间,在减少住院方面的影响高达70%,这取决于所实现的疫苗覆盖率。确定了新的研究方向,如轮状病毒疫苗的作用以及对癫痫发作的预防或对肠道微生物群的影响。

结论

目前可得的信息支持了西班牙轮状病毒疾病的重大负担以及现有疫苗的高效性。这一证据应促使对国家关于轮状病毒疫苗接种的建议进行更新的重新评估。

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