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老年人轮状病毒相关性急性胃肠炎的负担:在普遍开展儿童疫苗接种计划的情况下对流行病学的评估。

The burden of rotavirus-associated acute gastroenteritis in the elderly: assessment of the epidemiology in the context of universal childhood vaccination programs.

机构信息

Adelphi Values PROVE, Cheshire, UK.

Global Medical and Scientific Affairs, Msd International GmbH, Luzern, Switzerland.

出版信息

Expert Rev Vaccines. 2022 Jul;21(7):929-940. doi: 10.1080/14760584.2022.2066524. Epub 2022 May 10.

Abstract

INTRODUCTION

Rotaviruses (RVs) cause acute gastroenteritis (AGE) in infants and young children worldwide and also in older adults (≥60 years), however the burden among this age group is not well understood. Herd immunity through pediatric RV vaccination may reduce the burden of RVGE across all ages, however the impact of pediatric vaccination on burden in older adults is poorly understood.

AREAS COVERED

This systematic review was undertaken to identify studies related to the following objectives: understand the burden of RV in older adults, RV seroprevalence, and the impact of pediatric vaccination on this burden and highlight evidence gaps to guide future research. Of studies identified, 59 studies from two databases were included in this analysis following a review by two reviewers.

EXPERT OPINION

RV is an understudied disease in older adults. We found that 0-62% of patients with AGE tested positive for RV, with results varying by setting, country, and patient age. Results also suggest that pediatric vaccination benefits older adults through herd protection. Several studies showed a reduction in RV incidence after vaccination. However, there was variety in results and lack of consistency in outcomes reported. Further studies targeting older adults are needed to better characterize RV burden.

摘要

简介

轮状病毒(RV)可在全世界的婴幼儿和年长成人(≥60 岁)中引起急性肠胃炎(AGE),但该年龄组的负担情况尚不清楚。通过小儿 RV 疫苗接种获得群体免疫力,可能会降低所有年龄段的 RVGE 负担,但小儿疫苗接种对年长成人负担的影响尚不清楚。

涵盖领域

本系统评价旨在确定与以下目标相关的研究:了解年长成人中 RV 的负担、RV 血清流行率,以及小儿疫苗接种对该负担的影响,并强调证据空白,以指导未来的研究。在确定的研究中,对两名评审员进行审查后,从两个数据库中纳入了 59 项研究。

专家意见

RV 在年长成人中是一个研究不足的疾病。我们发现,在 AGE 患者中,有 0%-62%的患者 RV 检测呈阳性,结果因环境、国家和患者年龄而异。结果还表明,小儿疫苗接种通过群体保护使年长成人受益。有几项研究表明,接种疫苗后 RV 的发病率有所下降。然而,结果存在差异,报告的结果也不一致。需要针对年长成人开展进一步的研究,以更好地描述 RV 的负担。

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