Estimating the incidence of rotavirus infection in children from India and Malawi from serial anti-rotavirus IgA titres.

Estimating the incidence of rotavirus infection in children from India and Malawi from serial anti-rotavirus IgA titres.
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DOI:
10.1371/journal.pone.0190256
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发表时间:
2017
期刊:
影响因子:
3.7
通讯作者:
Iturriza-Gomara M
Iturriza-Gomara M
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Bennett A;Nagelkerke N;Heinsbroek E;Premkumar PS;Wnęk M;Kang G;French N;Cunliffe NA;Bar-Zeev N;Lopman B;Iturriza-Gomara M

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鉴于低收入地区轮状病毒疫苗效果的差异,准确估计婴儿轮状病毒发病率至关重要。血清调查是估计发病率的实用方法,但血清学数据很容易出现错误分类。本研究使用混合模型根据印度韦洛尔和马拉维卡龙加婴儿的抗轮状病毒免疫球蛋白 A (IgA) 滴度来估计轮状病毒感染的发生率。使用在 36 个月内从 Vellore 的 373 名婴儿收集的血清样本和在 12 个月内从 Karonga 的 66 名婴儿收集的血清样本,每隔 6 个月收集一次 IgA 滴度。混合模型(两个成分高斯混合分布)适合时间点之间的滴度差异,以估计血清阳性风险并得出发病率估计值。在韦洛尔,在生命的前 6 个月中观察到每儿童年感染发生率最高为 1.05(95% 置信区间 [CI]:0.64,1.64)。随着随后的每个时间间隔,该值逐渐下降。相比之下,在卡龙加,出生后 6 个月的发病率最高(每个儿童每年 1.41 例感染 [95% CI:0.79,2.29])。这项研究表明,来自韦洛尔的婴儿比来自卡龙加的婴儿更早经历轮状病毒发病高峰。识别传播模式的这种差异对于制定疫苗策略非常重要,特别是在疫苗效果不佳的情况下。
Accurate estimates of rotavirus incidence in infants are crucial given disparities in rotavirus vaccine effectiveness from low-income settings. Sero-surveys are a pragmatic means of estimating incidence however serological data is prone to misclassification. This study used mixture models to estimate incidence of rotavirus infection from anti-rotavirus immunoglobulin A (IgA) titres in infants from Vellore, India, and Karonga, Malawi. IgA titres were measured using serum samples collected at 6 month intervals for 36 months from 373 infants from Vellore and 12 months from 66 infants from Karonga. Mixture models (two component Gaussian mixture distributions) were fit to the difference in titres between time points to estimate risk of sero-positivity and derive incidence estimates. A peak incidence of 1.05(95% confidence interval [CI]: 0.64, 1.64) infections per child-year was observed in the first 6 months of life in Vellore. This declined incrementally with each subsequent time interval. Contrastingly in Karonga incidence was greatest in the second 6 months of life (1.41 infections per child year [95% CI: 0.79, 2.29]). This study demonstrates that infants from Vellore experience peak rotavirus incidence earlier than those from Karonga. Identifying such differences in transmission patterns is important in informing vaccine strategy, particularly where vaccine effectiveness is modest.
DOI: 10.1093/aje/kwv134
发表时间: 2016-01-01
影响因子: 5
作者:
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