Cutts F T
WHO Collaborating Centre for the Clinical Evaluation of Vaccines in Developing Countries, Infectious and Tropical Disease Department, London School of Hygiene and Tropical Medicine, UK.
Br Med Bull. 1998;54(2):445-61. doi: 10.1093/oxfordjournals.bmb.a011700.
Over 3 million deaths from measles, neonatal tetanus and pertussis are prevented by vaccination each year. In the Americas, poliomyelitis has been eliminated, and measles is close to elimination. Globally, reported poliomyelitis incidence has declined by over 80% since 1988. Strategies have evolved from strengthening routine childhood immunization services, to establishing disease surveillance and defining specific activities for disease control and elimination. Efforts to ensure the supply and quality of vaccines are underway. New vaccines against major pathogens will be licensed soon. Some of these will be used for groups other than mothers and infants, requiring re-definition of the 'EPI target groups'. Despite global successes, in 1995, six of the world's most populous developing countries reported coverage levels below 70% and coverage is below 50% in several African countries. Immunization programmes will need to be tailored to the level of economic and health systems development of a country. Industrialized countries must offer sustained support to expand immunization programmes in ways that strengthen health systems in developing countries.
每年通过疫苗接种可预防300多万人死于麻疹、新生儿破伤风和百日咳。在美洲，脊髓灰质炎已被消灭，麻疹也接近被消灭。全球范围内，自1988年以来，报告的脊髓灰质炎发病率下降了80%以上。策略已从加强儿童常规免疫服务，发展到建立疾病监测以及确定疾病控制和消除的具体活动。确保疫苗供应和质量的工作正在进行。针对主要病原体的新疫苗将很快获得许可。其中一些疫苗将用于母亲和婴儿以外的群体，这就需要重新界定“扩大免疫规划目标群体”。尽管在全球范围内取得了成功，但在1995年，世界上人口最多的六个发展中国家报告的疫苗接种覆盖率低于70%，在一些非洲国家覆盖率低于50%。免疫规划需要根据一个国家的经济和卫生系统发展水平进行调整。工业化国家必须提供持续支持，以加强发展中国家卫生系统的方式扩大免疫规划。
