Rivero-Calle Irene, Raguindin Peter Francis, Pardo-Seco Jacobo, Martinon-Torres Federico
Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, 15706 Galicia, Spain.
Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Hospital Clínico Universitario and Universidad de Santiago de Compostela (USC), 15706 Galicia, Spain.
Vaccines (Basel). 2022 Apr 12;10(4):592. doi: 10.3390/vaccines10040592.
We conducted an age-based risk analysis of meningococcal disease in Spain to provide prospects on a rational vaccine schedule in pediatrics. We used the National Hospital Registry to estimate meningococcal hospitalization rate. Population census for each year was used as the denominator in computing the hospitalization rate. We computed the odds ratio of each age using <1 year old as a reference group. From 1998 to 2017, 13,554 hospitalized cases were diagnosed, with a declining trend across the years. Infants (<1 year, n = 2425) and children (1−14 years, n = 6053) comprised the majority of all hospitalized meningococcal disease in Spain (62.5% or 8474/13,554). The incidence of hospitalization decreased dramatically with age from 56.2/100,000 in <1-year-old children to 1.3/100,000 in >5-year-old children. There was a dramatic decline in risk in 1 year (OR 0.58) to 4 years of age (OR 0.21). The risk continued to decline until 13 years old. Afterward, it had a minimal upward trajectory observed at 14−17 years old (OR 0.08). Infants and adolescents are at continued risk of invasive meningococcal disease in Spain. The highest risk occurs in infants. Surveillance data, together with evidence on long-term immunogenicity and capacity for herd effect, should be considered for a more relevant immunization schedule.
我们对西班牙的脑膜炎球菌病进行了基于年龄的风险分析，以提供儿科合理疫苗接种计划的前景。我们使用国家医院登记处的数据来估计脑膜炎球菌住院率。每年的人口普查数据用作计算住院率的分母。我们以1岁以下儿童为参照组，计算了各年龄段的优势比。1998年至2017年，共诊断出13554例住院病例，且逐年呈下降趋势。婴儿（<1岁，n = 2425）和儿童（1 - 14岁，n = 6053）占西班牙所有住院脑膜炎球菌病病例的大多数（62.5%，即8474/13554）。住院发病率随年龄显著下降，从<1岁儿童的56.2/10万降至>5岁儿童的1.3/10万。1岁（优势比0.58）至4岁（优势比0.21）的风险急剧下降。风险持续下降至13岁。此后，在14 - 17岁时观察到风险有轻微上升趋势（优势比0.08）。在西班牙，婴儿和青少年持续面临侵袭性脑膜炎球菌病的风险。风险最高的是婴儿。应考虑监测数据以及长期免疫原性和群体效应能力的证据，以制定更合理的免疫接种计划。
