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印度的登革热疫苗推广:对巴基斯坦公共卫生准备工作的启示

Dengue vaccine rollout in India: lessons for Pakistan's public health preparedness.

作者信息

Sah Santosh, Ahsan Areeba, Tariq Rabeea, Yadav Tularam

机构信息

Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, Pakistan.

Primary Healthcare Centre (PHCC) Jhorahat, Gramthan, Koshi, Nepal.

出版信息

Ann Med Surg (Lond). 2025 Jul 16;87(8):5360-5362. doi: 10.1097/MS9.0000000000003585. eCollection 2025 Aug.

Abstract

Dengue fever continues to challenge public health systems across South Asia, with Pakistan and India facing recurrent outbreaks marked by rising case numbers and hospitalizations. While conventional approaches, such as vector control and public awareness campaigns, have had limited long-term success, vaccines now offer a promising complement to existing strategies. India's recent approval of the TAK-003 (Qdenga) dengue vaccine marked a turning point in regional prevention efforts. Through strategic partnerships, tiered pricing, improved cold chain infrastructure, and the use of seroprevalence data to guide rollout, India has developed a framework that balances innovation with accessibility. In contrast, Pakistan's dengue response remains largely reactive, with critical gaps in surveillance, diagnostic capacity, and institutional readiness. Drawing lessons from India's experience, this article highlights key areas for policy improvement in Pakistan. These include investing in vaccine delivery infrastructure, streamlining regulatory processes, strengthening technical advisory bodies and promoting transparent communication to build public trust. Integrating school-based immunization programs and mobile outreach for underserved populations can ensure equitable access. With a phased, evidence-based approach rooted in local epidemiology, Pakistan has the opportunity to incorporate dengue vaccination into its broader public health strategy, reducing disease burden and increasing preparedness for future outbreaks.

摘要

登革热继续对南亚地区的公共卫生系统构成挑战,巴基斯坦和印度都面临病例数和住院人数不断上升的反复疫情。虽然病媒控制和公众宣传活动等传统方法长期成效有限,但疫苗现在为现有策略提供了一种有前景的补充。印度最近批准TAK - 003(Qdenga)登革热疫苗标志着该地区预防工作的一个转折点。通过战略伙伴关系、分层定价、改善冷链基础设施以及利用血清流行率数据指导疫苗推广,印度制定了一个在创新与可及性之间取得平衡的框架。相比之下,巴基斯坦对登革热的应对在很大程度上仍属被动反应,在监测、诊断能力和机构准备方面存在重大差距。本文借鉴印度的经验,突出了巴基斯坦政策改进的关键领域。这些领域包括投资疫苗配送基础设施、简化监管流程、加强技术咨询机构以及促进透明沟通以建立公众信任。将基于学校的免疫计划与针对服务不足人群的流动外展相结合,可以确保公平获取疫苗。通过基于当地流行病学的分阶段、循证方法,巴基斯坦有机会将登革热疫苗接种纳入其更广泛的公共卫生战略,减轻疾病负担并增强对未来疫情的应对能力。

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