1961年至2020年中国内地不同疫苗策略对控制日本脑炎的效果：一项定量分析。
Effect of different vaccine strategies for the control of Japanese encephalitis in mainland China from 1961 to 2020: A quantitative analysis.
作者信息
Shi Tianshan, Meng Lei, Li Donghua, Jin Na, Zhao Xiangkai, Zhang Xiaoshu, Liu Yanchen, Zheng Hongmiao, Zhao Xin, Li Juansheng, Shen Xiping, Ren Xiaowei
机构信息
Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China.
Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu 730000, China.
出版信息
Vaccine. 2022 Oct 12;40(43):6243-6254. doi: 10.1016/j.vaccine.2022.09.030. Epub 2022 Sep 20.
BACKGROUND
We aimed to quantify the impact of each vaccine strategy (including the P3-inactivated vaccine strategy [1968-1987], the SA 14-14-2 live-attenuated vaccine strategy [1988-2007], and the Expanded Program on Immunization [EPI, 2008-2020]) on the incidence of Japanese encephalitis (JE) in regions with different economic development levels.
METHODS
The JE incidence in mainland China from 1961 to 2020 was summarized by year, then modeled and analyzed using an interrupted time series analysis.
RESULTS
After the P3-inactivated vaccine was used, the JE incidence in Eastern China, Central China, Western China and Northeast China in 1968 decreased by 39.80 % (IRR = 0.602, P < 0.001), 7.80 % (IRR = 0.922, P < 0.001), 10.80 % (IRR = 0.892, P < 0.001) and 31.90 % (IRR = 0.681, P < 0.001); the slope/trend of the JE incidence from 1968 to 1987 decreased by 30.80 % (IRR = 0.692, P < 0.001), 29.30 % (IRR = 0.707, P < 0.001), 33.00 % (IRR = 0.670, P < 0.001) and 41.20 % (IRR = 0.588, P < 0.001). After the SA 14-14-2 live-attenuated vaccine was used, the JE incidence in Eastern China and Northeast China in 1988 decreased by 2.60 % (IRR = 0.974, P = 0.009) and 14.70 % (IRR = 0.853, P < 0.001); the slope/trend of the JE incidence in Eastern China and Central China from 1988 to 2007 decreased by 4.60 % (IRR = 0.954, P < 0.001) and 4.70 % (IRR = 0.953, P < 0.001). After the EPI was implemented, the JE incidence in Eastern China, Central China and Western China in 2008 decreased by 10.50 % (IRR = 0.895, P = 0.013), 18.00 % (IRR = 0.820, P < 0.001) and 24.20 % (IRR = 0.758, P < 0.001), the slope/trend of the JE incidence in Eastern China from 2008 to 2020 decreased by 17.80 % (IRR = 0.822, P < 0.001).
CONCLUSIONS
Each vaccine strategy has different effects on the JE incidence in regions with different economic development. Additionally, some economically underdeveloped regions have gradually become the main areas of the JE outbreak. Therefore, mainland China should provide economic assistance to areas with low economic development and improve JE vaccination plans in the future to control the epidemic of JE.
背景
我们旨在量化每种疫苗策略（包括P3灭活疫苗策略[1968 - 1987年]、SA 14 - 14 - 2减毒活疫苗策略[1988 - 2007年]以及扩大免疫规划[EPI，2008 - 2020年]）对不同经济发展水平地区日本脑炎（JE）发病率的影响。
方法
总结1961年至2020年中国大陆地区JE发病率的年度数据，然后采用中断时间序列分析进行建模和分析。
结果
使用P3灭活疫苗后，1968年中国东部、中部、西部和东北地区的JE发病率分别下降了39.80%（IRR = 0.602，P < 0.001）、7.80%（IRR = 0.922，P < 0.001）、10.80%（IRR = 0.892，P < 0.001）和31.90%（IRR = 0.681，P < 0.001）；1968年至1987年JE发病率的斜率/趋势分别下降了30.80%（IRR = 0.692，P < 0.001）、29.30%（IRR = 0.707，P < 0.001）、33.00%（IRR = 0.670，P < 0.001）和41.20%（IRR = 0.588，P < 0.001）。使用SA 14 - 14 - 2减毒活疫苗后，1988年中国东部和东北地区的JE发病率分别下降了2.60%（IRR = 0.974，P = 0.009）和14.70%（IRR = 0.853，P < 0.001）；1988年至2007年中国东部和中部地区JE发病率的斜率/趋势分别下降了4.60%（IRR = 0.954，P < 0.001）和4.70%（IRR = 0.953，P < 0.001）。实施EPI后，2008年中国东部、中部和西部地区的JE发病率分别下降了10.50%（IRR = 0.895，P = 0.013）、18.00%（IRR = 0.820，P < 0.001）和24.20%（IRR = 0.758，P < 0.001），2008年至2020年中国东部地区JE发病率的斜率/趋势下降了17.80%（IRR = 0.822，P < 0.001）。
结论
每种疫苗策略对不同经济发展地区的JE发病率有不同影响。此外，一些经济欠发达地区逐渐成为JE疫情的主要发生区域。因此，中国大陆应向经济发展水平较低的地区提供经济援助，并在未来改进JE疫苗接种计划以控制JE疫情。
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