津巴布韦针对儿童和青年成年人爆发疫情使用伤寒结合疫苗的效果：一项匹配病例对照研究。
Effectiveness of typhoid conjugate vaccine in Zimbabwe used in response to an outbreak among children and young adults: A matched case control study.
机构信息
Epicentre, 14-34 Avenue Jean Jaurès, 70519 Paris, France.
Ministry of Health and Child Welfare, Epidemiology and Disease Control Directorate, Harare, Zimbabwe.
出版信息
Vaccine. 2022 Jul 29;40(31):4199-4210. doi: 10.1016/j.vaccine.2022.04.093. Epub 2022 Jun 9.
BACKGROUND
Zimbabwe suffers from regular outbreaks of typhoid fever (TF), worse since 2017. Most cases were in Harare and a vaccination campaign with Typhoid Conjugate Vaccine (TCV) was conducted in March 2019. The vaccine effectiveness (VE) was assessed against culture-confirmed S. Typhi in children six months to 15 years and in individuals six months to 45 years in Harare.
METHODS
A matched case-control study was conducted in three urban suburbs of Harare targeted by the TCV vaccination campaign. Suspected TF cases were enrolled prospectively in four health facilities and were matched to facility (1:1) and community (1:5) controls.
FINDINGS
Of 504 suspected cases from July 2019 to March 2020, 148 laboratory-confirmed TF cases and 153 controls confirmed-negative were identified. One hundred and five (47 aged six months to 15 years) cases were age, sex, and residence matched with 105 facility-based controls while 96 cases were matched 1:5 by age, sex, and immediate-neighbour with 229 community controls. The adjusted VE against confirmed TF was 75% (95%CI: 1-94, p = 0.049) compared to facility controls, and 84% (95%CI: 57-94, p < 0.001) compared to community controls in individuals six months to 15 years. The adjusted VE against confirmed TF was 46% (95%CI: 26-77, p = 0.153) compared to facility controls, and 67% (95%CI: 35-83, p = 0.002) compared to community controls six months to 45 years old.
INTERPRETATION
This study confirms that one vaccine dose of TCV is effective to control TF in children between six months and 15 years old in an African setting.
背景
津巴布韦经常爆发伤寒（TF）疫情，自 2017 年以来情况更糟。大多数病例发生在哈拉雷，2019 年 3 月开展了伤寒结合疫苗（TCV）疫苗接种运动。评估了该疫苗对 6 个月至 15 岁儿童和哈拉雷 6 个月至 45 岁个体中经培养确认的伤寒血清型 Typhi 的疫苗有效性（VE）。
方法
在哈拉雷的三个城市郊区开展了一项 TCV 疫苗接种运动针对的匹配病例对照研究。在四家医疗机构前瞻性纳入疑似 TF 病例，并在医疗机构（1:1）和社区（1:5）进行匹配对照。
结果
2019 年 7 月至 2020 年 3 月期间，从 504 例疑似病例中确定了 148 例实验室确诊的 TF 病例和 153 例阴性对照。105 例（6 个月至 15 岁的年龄、性别和居住地匹配）病例与 105 例医疗机构对照组相匹配，而 96 例病例按年龄、性别和紧邻邻居与 229 例社区对照组 1:5 匹配。与医疗机构对照组相比，针对确诊 TF 的调整 VE 为 75%（95%CI：1-94，p=0.049），与 6 个月至 15 岁的社区对照组相比，VE 为 84%（95%CI：57-94，p<0.001）。与医疗机构对照组相比，针对确诊 TF 的调整 VE 为 46%（95%CI：26-77，p=0.153），与 6 个月至 45 岁的社区对照组相比，VE 为 67%（95%CI：35-83，p=0.002）。
结论
本研究证实，在非洲环境中，一剂 TCV 可有效控制 6 个月至 15 岁儿童的 TF。
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