Response thresholds for epidemic meningitis in sub-Saharan Africa following the introduction of MenAfriVac®
Response thresholds for epidemic meningitis in sub-Saharan Africa following the introduction of MenAfriVac®
复制标题
DOI：
10.1016/j.vaccine.2015.09.107
复制
发表时间：
2015-11-17
期刊：
影响因子：
5.5
通讯作者：
Stuart, James M.
中科院分区：
文献类型：
--
作者：
Trotter, Caroline L.;Cibrelus, Laurence;Stuart, James M.
工作背景：自2010年以来，非洲脑膜炎带国家一直在通过大规模宣传活动引进一种新的A群脑膜炎球菌结合疫苗（MenAfriVac（R））。随着脑膜炎奈瑟菌血清群A（NmA）引起的脑膜炎的随后下降和其他血清群（主要是N。脑膜炎血清群W（NmW），世界卫生组织（WHO）发起了一项审查的发病率阈值，指导响应脑膜炎流行在非洲meningitis belt.Methods：脑膜炎监测数据从2002年至2013年非洲脑膜炎带国家被用来构建一个单一的NmW数据集。估计了不同的每周发病率（用作启动疫苗接种反应的阈值）在预防进一步病例方面的表现。用于定义流行病的累积季节性发作率也是varied.Results：观察到在不同阈值的效果相当大的变化。在预测定义为100/10（5）人口的季节性累积发病率的流行病时，10例/10（5）人口/周的流行病阈值表现良好。根据这一相同的流行阈值，在越过流行阈值和人群免受脑膜炎球菌疫苗接种运动的保护之间有6周的间隔，估计每起事件可通过疫苗接种预防17例病例。降低阈值增加了每起事件可能预防的病例数，缩短响应间隔也是如此。如果在10/10（5）的阈值上将间隔时间缩短到4周，则预防的病例数将增加到每起事件54例。结论：与降低阈值相比，缩短接种时间可以预防更多的病例。一旦越过脑膜炎流行的门槛，就必须酌情迅速开展疫苗接种运动。(C)2015爱思唯尔有限公司版权所有。
Background: Since 2010, countries in the African meningitis belt have been introducing a new serogroup A meningococcal conjugate vaccine (MenAfriVac (R)) through mass campaigns. With the subsequent decline in meningitis due to Neisseria meningitidis serogroup A (NmA) and relative increase in meningitis due to other serogroups, mainly N. meningitidis serogroup W (NmW), the World Health Organisation (WHO) initiated a review of the incidence thresholds that guide response to meningitis epidemics in the African meningitis belt.Methods: Meningitis surveillance data from African meningitis belt countries from 2002 to 2013 were used to construct a single NmW dataset. The performance of different weekly attack rates, used as thresholds to initiate vaccination response, on preventing further cases was estimated. The cumulative seasonal attack rate used to define an epidemic was also varied.Results: Considerable variation in effect at different thresholds was observed. In predicting epidemics defined as a seasonal cumulative incidence of 100/10(5) population, an epidemic threshold of 10 cases/10(5) population/week performed well. Based on this same epidemic threshold, with a 6 week interval between crossing the epidemic threshold and population protection from a meningococcal vaccination campaign, an estimated 17 cases per event would be prevented by vaccination. Lowering the threshold increased the number of cases per event potentially prevented, as did shortening the response interval. If the interval was shortened to 4 weeks at the threshold of 10/10(5), the number of cases prevented would increase to 54 per event.Conclusions: Accelerating time to vaccination could prevent more cases per event than lowering the threshold. Once the meningitis epidemic threshold is crossed, it is of critical importance that vaccination campaigns, where appropriate, are initiated rapidly. (C) 2015 Elsevier Ltd. All rights reserved.