Bizri Abdul Rahman, Althaqafi Abdulhakeem, Kaabi Nawal, Obeidat Nathir, Al Akoury Nadine, Haridy Hammam
American University of Beirut Medical Center, Beirut, Lebanon.
Department of Medicine, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia.
Infect Dis Ther. 2021 Jun;10(2):663-685. doi: 10.1007/s40121-021-00420-y. Epub 2021 Mar 22.
Implementing vaccination programmes at the national level is key to managing vaccine-preventable diseases (VPDs) in the overall population. Although paediatric immunization programmes have significantly reduced the burden of VPD, disease burden in adults still poses a substantial challenge, particularly in low- and middle-income countries such as those within the Middle East and North Africa (MENA) region. Invasive bacterial diseases (IBDs) are an important public health concern within this region, although vaccines are available to prevent the three most common causative organisms associated with IBD: Neisseria meningitidis (NM), Streptococcus pneumoniae (SP), and Haemophilus influenzae (HI). For this review, three separate PubMed searches were used to identify English-language publications describing the epidemiology of NM, SP, and HI in adults within the MENA region. Of the 161 total publications retrieved among all 3 literature searches, 39 were included in this review (NM: 8 publications; SP: 27 publications; HI: 4 publications). Publications describing epidemiology in paediatric or overall populations were excluded. Overall, these studies generally observed a high burden of IBD among adults in this region. Although NM, SP, and HI are communicable diseases in several countries, the surveillance systems in the MENA region are largely inadequate, resulting in poor responses to outbreaks and hindering improvement in outcomes of communicable diseases. Improving IBD surveillance would provide necessary estimates of disease burden, resulting in better vaccination strategies and improved outcomes. In conclusion, the present review provides a summary of the available information on the epidemiology of vaccine-preventable IBD in adults within the MENA region and highlights the need for increased disease surveillance and preventive strategies in these countries.
在国家层面实施疫苗接种计划是管理总体人群中疫苗可预防疾病（VPD）的关键。尽管儿科免疫计划已显著减轻了VPD的负担，但成人的疾病负担仍然构成重大挑战，特别是在中东和北非（MENA）地区等低收入和中等收入国家。侵袭性细菌疾病（IBD）是该地区一个重要的公共卫生问题，尽管有疫苗可预防与IBD相关的三种最常见病原体：脑膜炎奈瑟菌（NM）、肺炎链球菌（SP）和流感嗜血杆菌（HI）。在本次综述中，我们进行了三次独立的PubMed检索，以识别描述MENA地区成人中NM、SP和HI流行病学的英文出版物。在所有三次文献检索中总共检索到161篇出版物，其中39篇纳入了本综述（NM：8篇出版物；SP：27篇出版物；HI：4篇出版物）。描述儿科或总体人群流行病学的出版物被排除。总体而言，这些研究普遍观察到该地区成人中IBD负担较高。尽管在一些国家NM、SP和HI属于传染病，但MENA地区的监测系统在很大程度上并不完善，导致对疫情的应对不力，并阻碍了传染病治疗效果的改善。改善IBD监测将提供疾病负担的必要估计，从而制定更好的疫苗接种策略并改善治疗效果。总之，本综述总结了MENA地区成人中疫苗可预防IBD流行病学的现有信息，并强调了这些国家加强疾病监测和预防策略的必要性。
