Kalthan E, Gouandjika-Vasilache I, Mbailao R, Doté J W, Kossone M N, Gbangai M
Ministère de la santé et de la population, direction de la surveillance épidémiologique et de gestion d'urgence en santé publique, République centrafricaine.
Institut Pasteur de Bangui, laboratoire régional de référence OMS pour la poliomyélite en Afrique, République centrafricaine.
Med Trop Sante Int. 2021 Jun 20;1(2). doi: 10.48327/mtsibulletin.2021.114. eCollection 2021 Jun 30.
In 2019, the Central African Republic identified foci of circulating vaccine-derived poliovirus 2 (PVDV2c). The objective of this work is to describe the vaccination status of children paralyzed by PVDV2c and their contacts and to assess the circulation of this strain in these contacts.
The study population of this retrospective survey consists of children with acute flaccid paralysis (AFP) and their contacts. We included paralyzed children whose sequencing results showed the presence of PVDV2c.
A total of 21 children paralyzed by PVDVc and 64 contacts were enrolled in the survey. Fourteen out of 21 children who are paralyzed (66%) received at least one dose of bivalent oral polio vaccine (OPV) compared to 36 out of 64 contacts (57%, non-significant difference). Of the vaccinated patients, 7 had received less than three doses. For the injectable polio vaccine (IPV), vaccination coverage for both patients and contacts was 33%.The proportion of children who received both doses of OPV and IPV was 33% among patients and 25% in contacts. Contacts with VDPV2 were vaccinated with OPV and IPV, respectively 55 and 27%. VDPV2 and Sabin 2 were also found in contact stools, 34% and 9% respectively.
The absence or inadequacy of IPV vaccination has a serious impact on children by the occurrence of virus derived from the vaccine responsible for life-old paralysis. Protecting children from poliomyelitis requires a combination of a good cold chain, multiple doses and adherence to the vaccine schedule.
2019年，中非共和国发现了2型循环疫苗衍生脊髓灰质炎病毒（PVDV2c）的疫源地。这项工作的目的是描述因PVDV2c而瘫痪的儿童及其接触者的疫苗接种状况，并评估该毒株在这些接触者中的传播情况。
这项回顾性调查的研究人群包括急性弛缓性麻痹（AFP）儿童及其接触者。我们纳入了测序结果显示存在PVDV2c的瘫痪儿童。
共有21名因PVDVc而瘫痪的儿童和64名接触者参与了调查。21名瘫痪儿童中有14名（66%）至少接种了一剂二价口服脊髓灰质炎疫苗（OPV），而64名接触者中有36名（57%，无显著差异）。在接种疫苗的患者中，7人接种的剂量少于三剂。对于注射用脊髓灰质炎疫苗（IPV），患者和接触者的疫苗接种覆盖率均为33%。同时接种了两剂OPV和IPV的儿童比例在患者中为33%，在接触者中为25%。与VDPV2接触的人接种OPV和IPV的比例分别为55%和27%。在接触者粪便中也发现了VDPV2和萨宾2型，分别为34%和9%。
IPV疫苗接种的缺失或不足对儿童产生了严重影响，因为源自疫苗的病毒会导致终身瘫痪。保护儿童免受脊髓灰质炎侵害需要良好的冷链、多剂接种以及遵守疫苗接种计划相结合。
