2017 年乌克兰儿童白喉和破伤风血清流行病学。
Diphtheria and tetanus seroepidemiology among children in Ukraine, 2017.
机构信息
Centers for Disease Control and Prevention (CDC), Atlanta, USA.
Public Health Center, Ministry of Health of Ukraine, Kyiv, Ukraine; South Caucasus Field Epidemiology and Laboratory Training Program, CDC South Caucasus Office, Tbilisi, Georgia.
出版信息
Vaccine. 2022 Mar 15;40(12):1810-1820. doi: 10.1016/j.vaccine.2022.02.006. Epub 2022 Feb 10.
BACKGROUND
The drastic decline of Ukraine's immunization coverage since 2009 led to concerns about potential resurgence diphtheria and tetanus, along with other vaccine-preventable diseases.
METHODS
To assess population immunity against diphtheria and tetanus, we tested specimens from the serosurvey conducted in 2017 among children born in 2006-2015, the birth cohorts targeted by the nationwide outbreak response immunization following a circulating vaccine-derived poliovirus type 1 outbreak in Zakarpattya province in 2015. We surveyed four regions of Ukraine, using cluster sampling in Zakarpattya, Sumy, and Odessa provinces and simple random sampling in Kyiv City. We tested serum specimens for IgG antibodies against diphtheria and tetanus, using microbead assays (MBA). We estimated seroprevalence and calculated 95% confidence intervals. We also obtained information on the immunization status of surveyed children.
RESULTS
Seroprevalence of ≥0.1 IU/mL diphtheria antibodies was <80% in all survey sites (50.0%-79.2%). Seroprevalence of ≥0.1 IU/mL tetanus antibodies was ≥80% in Sumy, Kyiv City, and Odessa (80.2%-89.1%) and 61.6% in Zakarpattya. Across the sites, the proportion of children vaccinated age-appropriately with diphtheria-tetanus-containing vaccines (DTCV) was 28.5%-57.4% among children born in 2006-2010 and 34.1%-54.3% among children born in 2011-2015. The proportion of recipients of <3 DTCV doses increased from 7.1%-16.7% among children born in 2006-2010 to 19.8%-38.6% among children born in 2011-2015, as did the proportion of recipients of zero DTCV doses (2.6%-8.8% versus 8.0%-14.0%, respectively).
CONCLUSIONS
Protection against diphtheria among children born in 2006-2015 was suboptimal (<80%), particularly in Zakarpattya. Protection against tetanus was adequate (≥80%) except in Zakarpattya. Diphtheria-tetanus immunization status was suboptimal across all sites. Catch-up vaccination of unvaccinated/under-vaccinated children and other efforts to increase immunization coverage would close these immunity gaps and prevent the resurgence of diphtheria and tetanus in Ukraine, particularly in Zakarpattya.
背景
自 2009 年以来，乌克兰的免疫接种率大幅下降，令人担忧白喉和破伤风可能会再次流行，以及其他可通过疫苗预防的疾病。
方法
为了评估人群对白喉和破伤风的免疫力，我们检测了在 2017 年针对 2006-2015 年出生的儿童进行的血清学调查中的标本，这些出生队列是在 2015 年扎卡尔帕蒂亚省出现循环疫苗衍生脊髓灰质炎 1 型疫情后，全国疫情应对免疫接种活动的目标。我们在乌克兰的四个地区进行了调查，在扎卡尔帕蒂亚、苏梅和敖德萨省采用聚类抽样，在基辅市采用简单随机抽样。我们使用微珠检测法（MBA）检测血清标本中针对白喉和破伤风的 IgG 抗体。我们估计了血清阳性率并计算了 95%置信区间。我们还获得了接受调查儿童的免疫接种情况信息。
结果
所有调查点的白喉抗体血清阳性率<80%（50.0%-79.2%）。苏梅、基辅市和敖德萨的破伤风抗体血清阳性率≥80%（80.2%-89.1%），扎卡尔帕蒂亚的血清阳性率为 61.6%。在所有调查点，2006-2010 年出生的儿童中，有 28.5%-57.4%的儿童接受了适宜的含白喉破伤风类毒素疫苗（DTCV）接种，2011-2015 年出生的儿童中，有 34.1%-54.3%的儿童接受了适宜的 DTCV 接种。在 2006-2010 年出生的儿童中，接受<3 剂 DTCV 的儿童比例从 7.1%-16.7%增加到 2011-2015 年出生的儿童的 19.8%-38.6%，接受 0 剂 DTCV 的儿童比例也从 2.6%-8.8%增加到 8.0%-14.0%（分别）。
结论
2006-2015 年出生的儿童对白喉的保护作用不足（<80%），特别是在扎卡尔帕蒂亚。除扎卡尔帕蒂亚外，破伤风的保护作用充足（≥80%）。所有调查点的白喉破伤风免疫接种状况均不理想。为未接种/接种不足的儿童补种疫苗和采取其他措施提高免疫覆盖率，将缩小这些免疫差距，防止白喉和破伤风在乌克兰特别是在扎卡尔帕蒂亚的再次流行。
Zotero 插件