Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA.
Clin Infect Dis. 2021 Jul 15;73(2):e410-e416. doi: 10.1093/cid/ciaa919.
Globally, pneumonia is the leading cause of death among children. Few data exist regarding the effect of Haemophilus influenzae type b (Hib) vaccine and 13-valent pneumococcal conjugate vaccine (PCV-13) on the burden of childhood pneumonia in African settings.
We collected data on children aged 1 to 59 months at 3 hospitals in Botswana. Hib vaccine and PCV-13 were introduced in Botswana in November 2010 and July 2012, respectively. We compared pneumonia hospitalizations and deaths prevaccine (January 2009 to October 2010) with postvaccine (January 2013 to December 2017) using seasonally adjusted, interrupted time-series analyses.
We identified 6943 pneumonia hospitalizations and 201 pneumonia deaths. In the prevaccine period, pneumonia hospitalizations and deaths increased by 24% (rate, 1.24; 95% CI, .94-1.64) and 59% (rate, 1.59; 95% CI, .87-2.90) per year, respectively. Vaccine introduction was associated with a 48% (95% CI, 29-62%) decrease in the number of pneumonia hospitalizations and a 50% (95% CI, 1-75%) decrease in the number of pneumonia deaths between the end of the prevaccine period (October 2010) and the beginning of the postvaccine period (January 2013). During the postvaccine period, pneumonia hospitalizations and deaths declined by 6% (rate, .94; 95% CI, .89-.99) and 22% (rate, .78; 95% CI, .67-.92) per year, respectively.
Pneumonia hospitalizations and deaths among children declined sharply following introduction of Hib vaccine and PCV-13 in Botswana. This effect was sustained for more than 5 years after vaccine introduction, supporting the long-term effectiveness of these vaccines in preventing childhood pneumonia in Botswana.
在全球范围内，肺炎是导致儿童死亡的主要原因。在非洲国家，有关乙型流感嗜血杆菌（Hib）疫苗和 13 价肺炎球菌结合疫苗（PCV-13）对儿童肺炎负担影响的数据很少。
我们在博茨瓦纳的 3 家医院收集了 1 至 59 个月大的儿童的数据。Hib 疫苗和 PCV-13 分别于 2010 年 11 月和 2012 年 7 月在博茨瓦纳推出。我们使用季节性调整的中断时间序列分析比较了疫苗接种前（2009 年 1 月至 2010 年 10 月）和疫苗接种后（2013 年 1 月至 2017 年 12 月）的肺炎住院和死亡情况。
我们确定了 6943 例肺炎住院和 201 例肺炎死亡病例。在疫苗接种前期间，肺炎住院和死亡的年增长率分别为 24%（率，1.24；95%置信区间，0.94-1.64）和 59%（率，1.59；95%置信区间，0.87-2.90）。疫苗接种的引入与肺炎住院人数减少 48%（95%置信区间，29-62%）和肺炎死亡人数减少 50%（95%置信区间，1-75%）相关，该变化发生在疫苗接种前结束时期（2010 年 10 月）与疫苗接种后开始时期（2013 年 1 月）之间。在疫苗接种后期间，肺炎住院和死亡的年下降率分别为 6%（率，0.94；95%置信区间，0.89-0.99）和 22%（率，0.78；95%置信区间，0.67-0.92）。
Hib 疫苗和 PCV-13 在博茨瓦纳推出后，儿童肺炎住院和死亡人数急剧下降。在疫苗接种后 5 年多的时间里，这种效果持续存在，支持了这些疫苗在博茨瓦纳预防儿童肺炎的长期有效性。
