Effect of vaccines on bacterial meningitis worldwide
Effect of vaccines on bacterial meningitis worldwide
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DOI：
10.1016/s0140-6736(12)61187-8
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发表时间：
2012-11-10
期刊：
影响因子：
168.9
通讯作者：
van de Beek, Diederik
中科院分区：
文献类型：
--
作者：
McIntyre, Peter B.;O'Brien, Katherine L.;van de Beek, Diederik
流感嗜血杆菌、肺炎链球菌和脑膜炎奈瑟氏菌是引起急性细菌性脑膜炎的三种细菌。蛋白-多糖结合疫苗的效果测量对于流感嗜血杆菌脑膜炎最为可靠，因为一种血清型和一个年龄组占病例的90%以上，并且在这些疫苗使用时间最长的高收入国家中最好地测量发病率。肺炎球菌性脑膜炎和脑膜炎球菌性脑膜炎是由多种血清型引起的，年龄分布广泛;由于流行病和缺乏监测，特别是在低收入国家，其发病率的测量变得复杂。在引入疫苗后，几乎消除了流感嗜血杆菌脑膜炎。尽管疫苗血清型导致的疾病减少了90%以上，但所有年龄段的肺炎球菌脑膜炎减少了约25%，低收入环境的数据很少。据记录，在几个高收入国家，C血清群脑膜炎球菌脑膜炎已接近消灭，这预示着新的A血清群脑膜炎球菌结合疫苗在非洲脑膜炎地带的效果良好。
Three bacteria-Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis-account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account for more than 90% of cases and the incidence has been best measured in high-income countries where these vaccines have been used longest. Pneumococcal and meningococcal meningitis are caused by diverse serotypes and have a wide age distribution; measurement of their incidence is complicated by epidemics and scarcity of surveillance, especially in low-income countries. Near elimination of H influenzae meningitis has been documented after vaccine introduction. Despite greater than 90% reductions in disease attributable to vaccine serotypes, all-age pneumococcal meningitis has decreased by around 25%, with little data from low-income settings. Near elimination of serogroup C meningococcal meningitis has been documented in several high-income countries, boding well for the effect of a new serogroup A meningococcal conjugate vaccine in the African meningitis belt.