肺炎球菌疫苗对儿童中耳炎有效性的系统评价。
Effectiveness of Pneumococcal Vaccines on Otitis Media in Children: A Systematic Review.
机构信息
Department of Community Health, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.
Institute of Health Sciences, Federal University of Mato Grosso, Sinop, Brazil.
出版信息
Value Health. 2022 Jun;25(6):1042-1056. doi: 10.1016/j.jval.2021.12.012. Epub 2022 Feb 4.
OBJECTIVES
We aimed to determine the effectiveness of pneumococcal vaccines on otitis media (OM) and acute otitis media (AOM) in children.
METHODS
We conducted a systematic search in databases PubMed (MEDLINE), Embase, Lilacs, and Web of Science. We included observational studies that evaluated any pneumococcal vaccine - including 7, 10, and 13-valent pneumococcal conjugate vaccines (PCV7, PCV10, and PCV13) and 23-valent polysaccharide vaccines (PPSV23) as the intervention, in children aged less than five years.
RESULTS
Out of the 2112 screened studies, 48 observational studies complied with the eligibility criteria and therefore were included in this review. Of the included studies, 30 (63%) were before-after, eleven (23%) cohort, six (13%) time series, and one (2%) case-control study designs. Vaccine effectiveness (VE) in preventing OM or AOM varied by vaccine type. In children under 24 months VE ranged from 8% and 42.7% (PCV7), 5.6% to 84% (PCV10) and 2.2% to 68% (PCV13). In children aged less than 60 months, VE ranged between 13.2% and 39% for PCV7, 11% to 39% for PCV10 (only children under 48 months), and 39% to 41% (PCV13).
CONCLUSIONS
Our results demonstrate significant effect of pneumococcal vaccination in decreasing OM or AOM in children under five years old in several countries supporting the public health value of introducing PCVs in national immunization programs.
目的
我们旨在确定肺炎球菌疫苗在儿童中耳炎（OM）和急性中耳炎（AOM）中的有效性。
方法
我们在数据库 PubMed（MEDLINE）、Embase、Lilacs 和 Web of Science 中进行了系统搜索。我们纳入了评估任何肺炎球菌疫苗的观察性研究，包括 7、10 和 13 价肺炎球菌结合疫苗（PCV7、PCV10 和 PCV13）和 23 价多糖疫苗（PPSV23）作为干预措施，纳入的研究对象为年龄小于 5 岁的儿童。
结果
在筛选出的 2112 项研究中，有 48 项观察性研究符合纳入标准，因此被纳入本综述。纳入的研究中，30 项（63%）为前后对照研究，11 项（23%）为队列研究，6 项（13%）为时间序列研究，1 项（2%）为病例对照研究。预防 OM 或 AOM 的疫苗有效性（VE）因疫苗类型而异。在 24 个月以下的儿童中，PCV7 的 VE 范围为 8%至 42.7%，PCV10 的 VE 范围为 5.6%至 84%，PCV13 的 VE 范围为 2.2%至 68%。在 60 个月以下的儿童中，PCV7 的 VE 范围为 13.2%至 39%，PCV10 的 VE 范围为 11%至 39%（仅适用于 48 个月以下的儿童），PCV13 的 VE 范围为 39%至 41%。
结论
我们的结果表明，肺炎球菌疫苗在几个国家的 5 岁以下儿童中降低 OM 或 AOM 的效果显著，这支持了在国家免疫计划中引入 PCV 的公共卫生价值。
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