Prevalence of pneumococcal polysaccharide vaccine administration and incidence of invasive pneumococcal disease in children in Jamaica aged over 4 years with sickle cell disease diagnosed by newborn screening
Prevalence of pneumococcal polysaccharide vaccine administration and incidence of invasive pneumococcal disease in children in Jamaica aged over 4 years with sickle cell disease diagnosed by newborn screening
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DOI：
10.1179/027249309x12467994693851
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发表时间：
2009-09-01
影响因子：
--
通讯作者：
Reid, M.
中科院分区：
文献类型：
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作者：
Hardie, R.;King, L.;Reid, M.
背景：镰状细胞病患者易受细菌感染，尤其是肺炎链球菌等被囊化微生物引起的细菌感染，是儿童早期发病和死亡的重要原因。因此需要采取预防措施，如青霉素预防和免疫接种。虽然青霉素是预防的主要手段，但肺炎球菌疫苗接种对预防侵袭性肺炎球菌病(IPD)也很重要。目的：了解新生儿筛查确诊的SCD患者接种肺炎球菌多糖疫苗的情况，以及IPD在这组患者中的发病率。方法：本研究的数据来自肺炎球菌多糖疫苗(PPV)日志和电子临床数据库。搜索患者的病历以确认他们的疫苗状态，如果他们超过4岁，上述方法没有找到PPV数据。侵袭性肺炎球菌病(败血症或脑膜炎)的发作从临床数据库中获得。使用STATA版本9对数据进行分析。结果：在研究人群中，91%有资格接受PPV的参与患者已经适当接种了疫苗。此外，94.8%的重症SCD患者接受了适当的PPV治疗。研究人群的IPD发病率为480/10万人年，4岁以上儿童IPD的发病率为160/10万人年。结论：新生儿筛查确诊的SCD患儿接种PPV的高患病率对IPD的发病率有显著影响，改善了患者预后。
Background: Patients with sickle cell disease (SCD) are susceptible to bacterial infections, especially those caused by encapsulated organisms such as Streptococcus pneumoniae which is an important cause of morbidity and mortality in early childhood. Preventive measures such as penicillin prophylaxis and immunisation are therefore required. Although penicillin is the mainstay of prophylaxis, pneumococcal vaccination is also important for defence against invasive pneumococcal disease (IPD).Aim: To determine the prevalence of pneumococcal polysaccharide vaccination among patients with SCD diagnosed by newborn screening, and the incidence of IPD in this group of patients.Methods: In this retrospective study, data were obtained from the pneumococcal polysaccharide vaccine (PPV) log books and the electronic clinic database. Patients' dockets were searched to confirm their vaccine status if they were over 4 years of age and PPV data had not been found by the above methods. Episodes of invasive pneumococcal disease (sepsis or meningitis) were obtained from the clinic database. Data were analysed using STATA version 9.Results: Ninety-one per cent of participating patients in the study population who were eligible for PPV had been appropriately immunised. Also, 94.8% of patients with a severe form of SCD had appropriately received PPV. The incidence rate of IPD was 480/100,000 person years in the study population and 160/100,000 person years in patients over 4 years of age.Conclusion: The high prevalence of PPV administration in children with SCD diagnosed by newborn screening had a significant impact on the incidence of IPD with improved patient outcomes.