1Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
2National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti.
Am J Trop Med Hyg. 2020 Oct;103(4):1717-1725. doi: 10.4269/ajtmh.20-0112.
In Haiti, measles, rubella, and maternal and neonatal tetanus have been eliminated, but a diphtheria outbreak is ongoing as of 2019. We conducted a nationally representative, household-based, two-stage cluster survey among children aged 5-7 years in 2017 to assess progress toward maintenance of control and elimination of selected vaccine-preventable diseases (VPDs). We stratified Haiti into West region (West department, including the capital city) and non-West region (all other departments). We obtained vaccination history and dried blood spots, and measured antibody concentrations to VPDs on a multiplex bead assay. Among 1,146 children, national seropositivity was 83% (95% CI: 80-86%) for tetanus, 83% (95% CI: 81-85%) for diphtheria, 87% (95% CI: 85-89%) for measles, and 84% (95% CI: 81-87%) for rubella. None of the children had long-term immunity to tetanus or diphtheria (IgG concentration ≥ 1 international unit/mL). Seropositivity in the West region was lower than that in the non-West region. Vaccination coverage was 68% (95% CI: 61-74%) for ≥ 3 doses of tetanus- and diphtheria-containing vaccine (DTP3), 84% (95% CI: 80-87%) for one dose of measles-rubella vaccine (MR1), and 20% (95% CI: 16-24%) for MR2. The seroprevalence of measles, rubella, and diphtheria antibodies is lower than population immunity levels needed to prevent disease transmission, particularly in the West region; reintroduction of these diseases could lead to an outbreak. To maintain VPD control and elimination, Haiti should achieve DTP3 and MR2 coverage ≥ 95%, and include tetanus and diphtheria booster doses in the routine immunization schedule.
在海地，麻疹、风疹和孕产妇及新生儿破伤风已被消除，但截至 2019 年，白喉仍有疫情发生。我们于 2017 年开展了一项全国代表性的、基于家庭的两阶段聚类调查，对象为 5-7 岁儿童，旨在评估在维持控制和消除选定疫苗可预防疾病（VPD）方面的进展。我们将海地分为西部地区（西部省，包括首都）和非西部地区（所有其他省份）。我们获取了疫苗接种史和干血斑，并采用多重 bead 分析测定 VPD 抗体浓度。在 1146 名儿童中，全国破伤风血清阳性率为 83%（95%CI：80-86%），白喉为 83%（95%CI：81-85%），麻疹为 87%（95%CI：85-89%），风疹为 84%（95%CI：81-87%）。没有儿童对破伤风或白喉具有长期免疫力（IgG 浓度≥1 国际单位/mL）。西部地区的血清阳性率低于非西部地区。≥3 剂含破伤风和白喉疫苗（DTP3）的接种率为 68%（95%CI：61-74%），1 剂麻疹-风疹疫苗（MR1）为 84%（95%CI：80-87%），2 剂麻疹-风疹疫苗（MR2）为 20%（95%CI：16-24%）。麻疹、风疹和白喉抗体的血清阳性率低于预防疾病传播所需的人群免疫水平，特别是在西部地区；这些疾病的重新引入可能导致疫情爆发。为了维持 VPD 的控制和消除，海地应实现 DTP3 和 MR2 覆盖率≥95%，并在常规免疫计划中纳入破伤风和白喉加强剂量。
