Use of vaccine trials to estimate burden of disease.
Use of vaccine trials to estimate burden of disease.
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使用疫苗试验来估计疾病负担。
DOI：
10.3329/jhpn.v22i3.272
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
E. Mulholland
中科院分区：
文献类型：
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作者：
E. Mulholland
疫苗试验是确定疫苗效力的最具信息性的方式，也可以提供有关疾病负担的宝贵信息。B型流感嗜血杆菌（HiB）的负担仍然是使用HiB疫苗的主要障碍，特别是在亚洲。最近在印度尼西亚和孟加拉国进行的研究采用了疫苗试验设计，使用已知有效的疫苗来估计这些社区中可通过疫苗预防的Hib疾病负担。针对肺炎和腹泻疾病的新疫苗通常只针对综合征的各种原因之一。在肺炎的情况下，在大多数情况下很难确定病因，因此疫苗试验提供了一种确定疫苗可预防疾病负担的方法。这对于肺炎球菌疫苗尤其重要，因为血清型替代可能降低疫苗在该领域的有效性。如果发现疫苗对它们所针对的综合征以外的综合征有影响，这种方法会低估疾病负担，如果对疫苗对所研究疾病的有效性有错误的假设，这种方法可能导致估计错误。
Vaccine trials, the most informative way of determining the efficacy of a vaccine, can also provide valuable information about the burden of disease. The burden of Haemophilus influenzae type b (Hib) remains a major barrier to the use of Hib vaccines, especially in Asia. Recent studies in Indonesia and Bangladesh have used vaccine-trial designs, with known effective vaccines, to estimate the vaccine-preventable burden of Hib disease in those communities. New vaccines against pneumonia and diarrhoeal diseases are usually directed at only one of various causes of the syndrome. In the case of pneumonia, it is very difficult to determine the aetiology in most cases, so the vaccine trial offers a means of determining the burden of vaccine-preventable diseases. This is particularly important for pneumococcal vaccines as serotype replacement may reduce the effectiveness of the vaccines in the field. This approach would underestimate disease burden if vaccines were found to have an impact on syndromes other than those against which they are directed, and might lead to errors in estimation if there were erroneous assumptions about the efficacy of the vaccine against the condition under investigation.