The potential impact of a vaccine on Neisseria gonorrhoeae prevalence among heterosexuals living in a high prevalence setting.
The potential impact of a vaccine on Neisseria gonorrhoeae prevalence among heterosexuals living in a high prevalence setting.
复制标题
疫苗对生活在高流行环境中的异性恋者中淋病奈瑟菌流行率的潜在影响。
DOI：
10.1016/j.vaccine.2023.07.048
复制
发表时间：
2023
期刊：
影响因子：
5.5
通讯作者：
Regan,DavidG
中科院分区：
文献类型：
--
作者：
Padeniya,ThiliniN;Hui,BenB;Wood,JamesG;Seib,KateL;Regan,DavidG
背景随着抗生素耐药性的出现和传播，淋病奈瑟菌的治疗受到威胁。因此，人们对开发淋病疫苗越来越感兴趣。我们使用数学模型来评估一种假设疫苗对生活在相对高氮环境中的异性恋者控制淋病的影响。淋病患病率（~ 3%）。方法建立n的数学模型。淋病在15 - 49岁异性恋者中的传播，按年龄和性别分层，并根据来自南非的流行率和性行为数据进行校准，南非是我们拥有数据的高流行率环境的一个例子。使用该模型，我们评估了疫苗对n的潜在影响。淋病在整个人口中的流行情况。我们考虑了淋病疫苗对n的不同影响。淋病感染和传播，并提供给不同年龄组。结果模型预测n。如果每年疫苗接种率为10%，预防获得性感染的疫苗效力为25%，保护期为5年，并向15 - 49岁的全部人口提供疫苗接种，则采用疫苗后10年内淋病患病率可降低~ 50%。如果只有15 - 24岁的人接种疫苗，在具有相同疫苗特性和吸收率的情况下，预计整个人群的流行率将降低25%。虽然在同一时期，仅针对高活动性个体和整个人群的疫苗接种规划的预测患病率下降幅度相似，但仅针对高活动性个体接种疫苗更有效，因为在该规划中，将整个人群的患病率降低50%所需的累计疫苗接种次数要低约3倍。结论提供淋病疫苗可显著降低淋病感染率。淋病在高流行异性恋环境中的患病率，即使每年接种部分有效的疫苗。
BackgroundTreatment ofNeisseria gonorrhoeaeis under threat with the emergence and spread of antimicrobial resistance. Thus, there is a growing interest in the development of a gonorrhoea vaccine. We used mathematical modelling to assess the impact of a hypothetical vaccine in controlling gonorrhoea among heterosexuals living in a setting of relatively highN. gonorrhoeaeprevalence (∼3 %).MethodsWe developed a mathematical model ofN. gonorrhoeaetransmission among 15–49-year-old heterosexuals, stratified by age and sex, and calibrated to prevalence and sexual behaviour data from South Africa as an example of a high prevalence setting for which we have data available. Using this model, we assessed the potential impact of a vaccine onN. gonorrhoeaeprevalence in the entire population. We considered gonorrhoea vaccines having differing impacts onN. gonorrhoeaeinfection and transmission and offered to different age-groups.ResultsThe model predicts thatN. gonorrhoeaeprevalence can be reduced by ∼50 % in 10 years following introduction of a vaccine if annual vaccination uptake is 10 %, vaccine efficacy against acquisition of infection is 25 % and duration of protection is 5 years, with vaccination available to the entire population of 15–49-year-olds. If only 15–24-year-olds are vaccinated, the predicted reduction in prevalence in the entire population is 25 % with equivalent vaccine characteristics and uptake. Although predicted reductions in prevalence for vaccination programmes targeting only high-activity individuals and the entire population are similar over the same period, vaccinating only high-activity individuals is more efficient as the cumulative number of vaccinations needed to reduce prevalence in the entire population by 50 % is ∼3 times lower for this programme.ConclusionProvision of a gonorrhoea vaccine could lead to substantial reductions inN. gonorrhoeaeprevalence in a high prevalence heterosexual setting, even with moderate annual vaccination uptake of a vaccine with partial efficacy.