Domínguez Angela, Varela Carmen, Soldevila Núria, Izquierdo Conchita, Guerrero María, Peñuelas Marina, Martínez Ana, Godoy Pere, Borràs Eva, Rius Cristina, Torner Núria, Avellón Ana María, Castilla Jesús
Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Vaccines (Basel). 2021 Oct 20;9(11):1214. doi: 10.3390/vaccines9111214.
We compared the cumulative incidence and characteristics of hepatitis A outbreaks in two groups of Spanish autonomous regions according to whether a universal or risk group vaccination strategy was followed. Outbreaks between 2010 and 2018 were analyzed. The cumulative incidence rate of outbreaks was estimated and compared by estimating the rate ratio (RR). The characteristics of the outbreaks and those of the first cases were compared. Adjusted OR (aOR) were calculated using a multivariate logistic regression model. Outbreak incidence was 16.04 per million persons in regions with universal vaccination and 20.76 in those with risk-group vaccination (RR 0.77; 95%CI 0.62-0.94). Imported outbreaks accounted for 65% in regions with universal vaccination and 28.7% in regions with risk-group vaccination (aOR 3.88; 95%CI 2.13-7.09). Adolescents and young adults aged 15-44 years and men who have sex with men were less frequently the first case of the outbreak in regions with a universal vaccination strategy (aOR 0.54; 95%CI 0.32-0.92 and 0.23; 95%CI 0.07-0.82, respectively). The cumulative incidence rate of outbreaks was lower in regions with universal vaccination. In all regions, independently of the vaccination strategy, activities to vaccinate persons belonging to high-risk groups for infection should be emphasized.
我们根据是否采用普遍接种或风险群体接种策略，比较了西班牙两组自治区甲型肝炎暴发的累积发病率和特征。分析了2010年至2018年期间的暴发情况。通过估计率比（RR）来估计和比较暴发的累积发病率。比较了暴发的特征以及首例病例的特征。使用多变量逻辑回归模型计算调整后的比值比（aOR）。普遍接种地区的暴发发病率为每百万人16.04例，风险群体接种地区为每百万人20.76例（RR 0.77；95%CI 0.62 - 0.94）。输入性暴发在普遍接种地区占65%，在风险群体接种地区占28.7%（aOR 3.88；95%CI 2.13 - 7.09）。在采用普遍接种策略的地区，15 - 44岁的青少年和年轻人以及男男性行为者较少成为暴发的首例病例（分别为aOR 0.54；95%CI 0.32 - 0.92和aOR 0.23；95%CI 0.07 - 0.82）。普遍接种地区的暴发累积发病率较低。在所有地区，无论接种策略如何，都应强调对属于高感染风险群体的人员进行接种的活动。
