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儿童(9-59 月龄)麻疹疫苗接种运动后短期门诊就诊减少:一项整群随机试验的亚研究。

Reduction in Short-term Outpatient Consultations After a Campaign With Measles Vaccine in Children Aged 9-59 Months: Substudy Within a Cluster-Randomized Trial.

机构信息

OPEN, University of Southern Denmark, Odense, Denmark.

Indepth Network, Bandim Health Project, Bissau, Guinea-Bissau.

出版信息

J Pediatric Infect Dis Soc. 2020 Nov 10;9(5):535-543. doi: 10.1093/jpids/piaa091.

Abstract

BACKGROUND

We assessed a measles vaccination campaign's potential short-term adverse events.

METHODS

In a cluster-randomized trial assessing a measles vaccination campaign's effect on all-cause mortality and hospital admission among children aged 9-59 months in Guinea-Bissau, children received a measles vaccination (intervention) or a health check-up (control). One month to 2 months later, we visited a subgroup of children to ask mothers/guardians about outpatient consultations since enrollment. In log-binomial models, we estimated the relative risk (RR) of nonaccidental outpatient consultations.

RESULTS

Among 8319 children (4437 intervention/3882 control), 652 nonaccidental outpatient consultations occurred (322 intervention/330 control). The measles vaccination campaign tended to reduce nonaccidental outpatient consultations by 16% (RR, 0.84 [95% confidence interval {CI}, .65-1.11]), especially if caused by respiratory symptoms (RR, 0.68 [95% CI, .42-1.11]). The reduction tended to be larger in children who prior to trial enrollment had a pentavalent vaccination (diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b) as the most recent vaccination (RR, 0.61 [95% CI, .42-.89]) than in children who prior to trial enrollment had a routine measles vaccination as the most recent vaccination (RR, 0.93 [95% CI, .68-1.26]) (P = .04 for interaction).

CONCLUSIONS

In the short term, a measles vaccination campaign seems not to increase nonaccidental outpatient consultations but may reduce them.

CLINICAL TRIALS REGISTRATION

NCT03460002.

摘要

背景

我们评估了麻疹疫苗接种活动的潜在短期不良事件。

方法

在一项评估麻疹疫苗接种活动对几内亚比绍 9-59 个月儿童全因死亡率和住院率影响的整群随机试验中,儿童接受麻疹疫苗接种(干预组)或健康检查(对照组)。接种后 1 至 2 个月,我们访问了儿童的一个亚组,询问母亲/监护人自入组以来的门诊就诊情况。在对数二项式模型中,我们估计了非意外伤害性门诊就诊的相对风险(RR)。

结果

在 8319 名儿童(4437 名干预组/3882 名对照组)中,发生了 652 例非意外伤害性门诊就诊(322 名干预组/330 名对照组)。麻疹疫苗接种活动似乎使非意外伤害性门诊就诊减少了 16%(RR,0.84 [95%置信区间 {CI},0.65-1.11]),尤其是由呼吸道症状引起的就诊(RR,0.68 [95% CI,0.42-1.11])。与在试验入组前最近一次接种五联疫苗(白喉、破伤风、百日咳、乙型肝炎和流感嗜血杆菌 b 型)的儿童相比,最近一次接种常规麻疹疫苗的儿童的减少幅度更大(RR,0.61 [95% CI,0.42-0.89])(交互作用 P=0.04)。

结论

短期内,麻疹疫苗接种活动似乎不会增加非意外伤害性门诊就诊次数,但可能会减少就诊次数。

临床试验注册

NCT03460002。

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