Early indication for a reduced burden of radiologically confirmed pneumonia in children following the introduction of routine vaccination against Haemophilus influenzae type b in Nha Trang, Vietnam.
Early indication for a reduced burden of radiologically confirmed pneumonia in children following the introduction of routine vaccination against Haemophilus influenzae type b in Nha Trang, Vietnam.
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DOI：
10.1016/j.vaccine.2014.10.055
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发表时间：
2014-12-05
期刊：
影响因子：
5.5
通讯作者：
Yoshida LM
中科院分区：
文献类型：
--
作者：
Flasche S;Takahashi K;Vu DT;Suzuki M;Nguyen TH;Le H;Hashizume M;Dang DA;Edmond K;Ariyoshi K;Mulholland EK;Edmunds WJ;Yoshida LM
很少有研究对东南亚 Hib 肺炎的负担进行了量化。我们评估了芽庄常规 Hib 疫苗接种的影响。基于人群的监测可以对混杂的病毒性肺炎进行统计调整。 Hib 疫苗接种大大减轻了儿童肺炎的负担。尽管 Hib 疫苗接种在全球范围内成功降低了疾病和死亡率，但东南亚疾病负担和 Hib 疫苗接种潜在影响的不确定性导致该地区一些国家推迟了疫苗接种。 2010 年 7 月，越南全国开始接种 Hib 疫苗，但没有跟进。在一项基于人群的观察性监测研究中，我们评估了常规 Hib 疫苗接种对越南芽庄经放射学证实的全因儿童肺炎的影响。 2007 年，庆和省芽庄唯一的医院庆和总医院建立了主动医院监测。所有入院时被诊断患有急性呼吸道疾病的儿童都会定期采集鼻咽样本和胸片。对于2007年2月至2012年3月期间入院的患者，胸片被解读为是否存在世界卫生组织主要终点肺炎，并通过PCR分析鼻咽拭子是否存在甲型或乙型流感、RSV和鼻病毒。我们采用泊松回归来估计 Hib 疫苗接种对放射学确诊的肺炎 (RCP) 的影响，同时统计地解释了疫苗接种后时代病毒循环的潜在差异，这可能会导致估计偏差。在研究期间收治的 3151 例病例中，有 166 例患有 RCP，并在 1601 年检测到了主要病毒。在引入 Hib 疫苗接种后，5 岁以下儿童的 RCP 调整后年发病率下降了 39% (12-58%)。这种下降在 2 岁以下儿童中最为明显，调整后 IRR：0.52（0.33-0.81），而在不符合疫苗接种条件的 2-4 岁儿童中没有观察到显着影响，调整后 IRR：0.96（0.52-1.72）。我们提供的早期证据表明，在疫苗接种之前，芽庄的 Hib 相关 RCP 负担相当大，并且在引入常规儿童免疫计划后不久，疫苗接种就大大减轻了这种负担。
The burden of Hib pneumonia in Southeast Asia has been quantified in few studies. We estimate the impact of routine vaccination against Hib in Nha Trang. Population-based surveillance allowed statistical adjustment for confounding viral pneumonia. Hib vaccination has substantially reduced the burden of childhood pneumonia. Despite the global success of Hib vaccination in reducing disease and mortality, uncertainty about the disease burden and the potential impact of Hib vaccination in Southeast Asia has delayed the introduction of vaccination in some countries in the region. Hib vaccination was introduced throughout Vietnam in July 2010 without catch-up. In an observational, population based surveillance study we estimated the impact of routine Hib vaccination on all cause radiologically confirmed childhood pneumonia in Nha Trang, Vietnam. In 2007 active hospital based surveillance was established in Khanh Hoa General Hospital, the only hospital in Nha Trang, Khanh Hoa province. Nasopharyngeal samples and chest radiographs are taken routinely from all children diagnosed with acute respiratory illness on admission. For admissions between 02/2007 and 03/2012 chest radiographs were interpreted for the presence of WHO primary endpoint pneumonia and nasopharyngeal swabs were analysed by PCR for the presence of Influenza A or B, RSV and rhinovirus. We employed Poisson regression to estimate the impact of Hib vaccination on radiologically confirmed pneumonia (RCP) while statistically accounting for potential differences in viral circulation in the post vaccination era which could have biased the estimate. Of 3151 cases admitted during the study period, 166 had RCP and major viruses were detected in 1601. The adjusted annual incidence of RCP in children younger than 5 years declined by 39% (12–58%) after introduction of Hib vaccination. This decline was most pronounced in children less than 2 years old, adjusted IRR: 0.52 (0.33–0.81), and no significant impact was observed in the 2–4 years old who were not eligible for vaccination, adjusted IRR: 0.96 (0.52–1.72). We present early evidence that the burden of Hib associated RCP in Nha Trang before vaccination was substantial and that shortly after introduction to the routine childhood immunisation scheme vaccination has substantially reduced that burden.
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影响因子：
3.6
作者：
Levine, OS;Lagos, R;Levine, MM
通讯作者：
Levine, MM
影响因子：
3.6
作者：
Baqui, Abdullah H.;El Arifeen, Shams;Santosham, Mathuram
通讯作者：
Santosham, Mathuram
影响因子：
5.5
作者：
Braikat, Mohamed;Barkia, Abdelaziz;Teleb, Nadia
通讯作者：
Teleb, Nadia
影响因子：
7.7
作者：
de Andrade, ALSS;de Andrade, JG;Fabio, JLD
通讯作者：
Fabio, JLD
DOI：
10.1093/cid/cir1052
发表时间：
2012-04
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Levine OS;O'Brien KL;Deloria-Knoll M;Murdoch DR;Feikin DR;DeLuca AN;Driscoll AJ;Baggett HC;Brooks WA;Howie SR;Kotloff KL;Madhi SA;Maloney SA;Sow S;Thea DM;Scott JA
通讯作者：
Scott JA