SEROLOGIC STATUS AND MEASLES ATTACK RATES AMONG VACCINATED AND UNVACCINATED CHILDREN IN RURAL SENEGAL
SEROLOGIC STATUS AND MEASLES ATTACK RATES AMONG VACCINATED AND UNVACCINATED CHILDREN IN RURAL SENEGAL
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DOI：
10.1097/00006454-199503000-00007
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发表时间：
1995-03-01
影响因子：
3.6
通讯作者：
SIMONDON, F
中科院分区：
文献类型：
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作者：
SAMB, B;AABY, P;SIMONDON, F
在塞内加尔农村地区进行的麻疹疫苗试验期间，在暴露后10天内检查了228名先前接种疫苗和313名12个月以上未接种疫苗的儿童的抗体状况，这些儿童在家中暴露于麻疹。36%的儿童患上了临床麻疹，137名儿童中有135人的临床诊断得到确认，采集了2份血样。疫苗有效性为90%（95%置信区间，83 - 94%）。血凝素抑制抗体（HI）或空斑中和抗体（PN）检测在预测麻疹易感性和预防麻疹方面同样有效。与血清阴性的未接种疫苗的儿童相比，在暴露时未检测到HI或PN抗体的接种疫苗的儿童对麻疹具有显著的保护作用（HI疫苗有效性，49%（95%置信区间，21 - 68%）; PN疫苗有效性，43%（95%置信区间，12 - 62%））。在血凝素抑制抗体试验阳性的儿童中，67%（6人中有4人）和PN试验阳性的儿童中，36%（36人中有13人）发生麻疹。HI或PN滴度高于125 mIU的儿童的发病率分别为2%（6/295）和3%（7/258）。由于在另一项研究中发现滴度小于或等于120 mIU几乎没有保护作用，因此该抗体水平可能是评估麻疹易感性和保护作用的最佳筛查值。然而，应该指出的是，许多血清反应阴性的疫苗接种儿童可以免受麻疹感染。
During a measles vaccine trial in a rural area of Senegal, antibody status was examined within 10 days of exposure for 228 previously vaccinated and 313 unvaccinated children more than 12 months old who were exposed to measles at home. Thirty-six percent of the children developed clinical measles, the clinical diagnosis being confirmed for 135 of the 137 children from whom 2 blood samples were collected. Vaccine efficacy was 90% (95% confidence interval, 83 to 94%). The hemagglutinin inhibiting antibodies (HI) or plaque neutralizing antibodies (PN) assays were equally efficient in predicting susceptibility and protection against measles. Vaccinated children who had no detectable HI or PN antibodies at exposure had significant protection against measles compared with seronegative unvaccinated children (HI vaccine efficacy, 49% (95% confidence interval, 21 to 68%); PN vaccine efficacy, 43% (95% confidence interval, 12 to 62%)). The attack rate was high for children with a titer of 40 to 125 mIU) 67% (4 of 6) of those with a positive hemagglutinin-inhibiting antibody test and 36% (13 of 36) of those with a positive PN test developed measles. Attack rates among children with HI or PN titers above 125 mIU were 2% (6 of 295) and 3% (7 of 258), respectively. Because titers of less than or equal to 120 mIU have been found to offer little protection in another study, this antibody level may be the best screening value for assessing susceptibility and protection against measles. However, it should be noted that many seronegative vaccinated children are protected against measles infection.