Changes in the incidence of pneumonia, bacterial meningitis, and infant mortality 5 years following introduction of the 13-valent pneumococcal conjugate vaccine in a "3+0" schedule.
Changes in the incidence of pneumonia, bacterial meningitis, and infant mortality 5 years following introduction of the 13-valent pneumococcal conjugate vaccine in a "3+0" schedule.
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DOI：
10.1371/journal.pone.0183348
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Amaya E
中科院分区：
文献类型：
--
作者：
Becker-Dreps S;Blette B;Briceño R;Alemán J;Hudgens MG;Moreno G;Ordoñez A;Rocha J;Weber DJ;Amaya E
肺炎链球菌每年导致世界上约826,000名儿童死亡，并导致许多卫生机构就诊。为了减轻肺炎球菌疾病的负担，许多国家已将肺炎球菌结合疫苗添加到其国家免疫计划中。尼加拉瓜是第一个有资格获得全球疫苗和免疫联盟资助的国家，在2010年推出了13价肺炎球菌结合疫苗(PCV13)，提供给2、4和6个月大的婴儿。这项研究的目标是评估该计划头五年对人口的影响。从莱昂省所有107个公共卫生机构收集了2008至2015年间因肺炎、肺炎相关死亡、儿童和成人细菌性脑膜炎以及婴儿死亡就诊的次数。生命统计数据提供了发生在卫生设施之外的与肺炎有关的死亡的额外统计。使用官方人口估计数作为暴露时间，对疫苗接种前(2008-2010年)和疫苗接种前(2011-2015年)的调整发病率和发病率比(IRRA)进行了回顾估计。婴儿肺炎住院的IRRA为0.70(95%可信区间：0.66，0.75)，一岁儿童的IRRA为0.92(95%可信区间：0.85，0.99)。新生儿死亡的IRRA为0.56(95%CI：0.41，0.77)。在整个人口中，在疫苗接种期间，因肺炎而进行的门诊就诊和住院治疗以及与肺炎相关的死亡率和细菌性脑膜炎的发病率较低。在计划实施的头五年中，观察到在接种疫苗的年龄组中因肺炎而前往卫生机构就诊的人数和婴儿死亡率有所减少，这是任何其他单一公共卫生干预措施都难以实现的。未来的研究有必要了解缺乏加强剂量(例如12个月)是否可能是一岁儿童肺炎住院人数与婴儿相比略有减少的原因。
Streptococcus pneumoniae causes about 826,000 deaths of children in the world each year and many health facility visits. To reduce the burden of pneumococcal disease, many nations have added pneumococcal conjugate vaccines to their national immunization schedules. Nicaragua was the first country eligible for GAVI Alliance funding to introduce the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010, provided to infants at 2, 4, and 6 months of age. The goal of this study was to evaluate the population impact of the first five years of the program. Numbers of visits for pneumonia, pneumonia-related deaths, and bacterial meningitis in both children and adults, and infant deaths between 2008 and 2015 were collected from all 107 public health facilities in León Department. Vital statistics data provided additional counts of pneumonia-related deaths that occurred outside health facilities. Adjusted incidence rates and incidence rate ratios (IRRa) in the vaccine (2011–2015) and pre-vaccine periods (2008–2010) were estimated retrospectively using official population estimates as exposure time. The IRRa for pneumonia hospitalizations was 0.70 (95% confidence interval [CI]: 0.66, 0.75) for infants, and 0.92 (95% CI: 0.85, 0.99) for one year-olds. The IRRa for post-neonatal infant mortality was 0.56 (95% CI: 0.41, 0.77). In the population as a whole, ambulatory visits and hospitalizations for pneumonia, as well as pneumonia-related mortality and rates of bacterial meningitis were lower in the vaccine period. During the first five years of program implementation, reductions were observed in health facility visits for pneumonia in immunized age groups and infant mortality, which would be hard to achieve with any other single public health intervention. Future study is warranted to understand whether the lack of a booster dose (e.g., at 12 months) may be responsible for the small reductions in pneumonia hospitalizations observed in one year-olds as compared to infants.
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影响因子：
3.7
作者：
Said MA;Johnson HL;Nonyane BA;Deloria-Knoll M;O'Brien KL;AGEDD Adult Pneumococcal Burden Study Team;Andreo F;Beovic B;Blanco S;Boersma WG;Boulware DR;Butler JC;Carratalà J;Chang FY;Charles PG;Diaz AA;Domínguez J;Ehara N;Endeman H;Falcó V;Falguera M;Fukushima K;Garcia-Vidal C;Genne D;Guchev IA;Gutierrez F;Hernes SS;Hoepelman AI;Hohenthal U;Johansson N;Kolek V;Kozlov RS;Lauderdale TL;Mareković I;Masiá M;Matta MA;Miró Ò;Murdoch DR;Nuermberger E;Paolini R;Perelló R;Snijders D;Plečko V;Sordé R;Strålin K;van der Eerden MM;Vila-Corcoles A;Watt JP
通讯作者：
Watt JP
影响因子：
5.5
作者：
Becker-Dreps, Sylvia;Amaya, Erick;Weber, David J.
通讯作者：
Weber, David J.
影响因子：
168.9
作者：
Cutts, FT;Zaman, SMA;Adegbola, RA
通讯作者：
Adegbola, RA
DOI：
10.4067/s0716-10182015000300005
发表时间：
2015-04-01
期刊：
Revista chilena de infectología
影响因子：
--
作者：
Assandri, Elizabeth;Amorín, Belén;Pírez, María Catalina
通讯作者：
Pírez, María Catalina
影响因子：
168.9
作者：
Liu, Li;Oza, Shefali;Hogan, Dan;Chu, Yue;Perin, Jamie;Zhu, Jun;Lawn, Joy E.;Cousens, Simon;Mathers, Colin;Black, Robert E.
通讯作者：
Black, Robert E.