Using Seroprevalence and Immunisation Coverage Data to Estimate the Global Burden of Congenital Rubella Syndrome, 1996-2010: A Systematic Review.
Using Seroprevalence and Immunisation Coverage Data to Estimate the Global Burden of Congenital Rubella Syndrome, 1996-2010: A Systematic Review.
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DOI：
10.1371/journal.pone.0149160
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Dabbagh AJ
中科院分区：
文献类型：
--
作者：
Vynnycky E;Adams EJ;Cutts FT;Reef SE;Navar AM;Simons E;Yoshida LM;Brown DW;Jackson C;Strebel PM;Dabbagh AJ
在常规监测中，先天性风疹综合征 (CRS) 的负担通常被低估。根据最近的世卫组织关于风疹的立场文件和全球疫苗和免疫联盟最近为符合条件的国家资助风疹疫苗接种的举措，需要更新估计数。先前的估计仅考虑了 1996 年的 78 个（发展中国家）国家。我们回顾了文献，以确定在各国引入含风疹疫苗（RCV）之前进行的风疹血清流行率研究。这些数据以及常规计划和大规模活动中估计的疫苗接种覆盖率被纳入数学模型中，以估计 1996 年和 2000-2010 年每个国家、地区和全球的 CRS 发病率。到 2010 年，广泛引入 RCV 的三个地区（美洲、欧洲和东地中海）的估计 CRS 有所下降，达到每 100,000 名活产<2 例（美洲和欧洲）和每 100,000 例活产 25 例（95% CI 4-61）（东地中海）。 2010 年估计发病率范围为西太平洋地区（不包括中国）每 10 万活产 90 例（95% CI：46-195），非洲和东南亚每 10 万活产 116 例（95% CI：56-235）和 121 例（95% CI：31-238）。预计病例数最多的是非洲（39,000 例，95% CI：18,000–80,000）和东南亚（49,000 例，95% CI：11,000–97,000）。 2010 年，全球估计有 105,000 例（95% CI：54,000–158,000）CRS 病例，而 1996 年为 119,000 例（95% CI：72,000–169,000）。虽然接种疫苗后美洲、欧洲和东地中海的 CRS 发病率急剧下降，但其他地方估计的 CRS 发病率仍然很高。进行良好的血清流行率研究有助于提高这些估计的可靠性并监测风疹疫苗接种的影响。
The burden of Congenital Rubella Syndrome (CRS) is typically underestimated in routine surveillance. Updated estimates are needed following the recent WHO position paper on rubella and recent GAVI initiatives, funding rubella vaccination in eligible countries. Previous estimates considered the year 1996 and only 78 (developing) countries. We reviewed the literature to identify rubella seroprevalence studies conducted before countries introduced rubella-containing vaccination (RCV). These data and the estimated vaccination coverage in the routine schedule and mass campaigns were incorporated in mathematical models to estimate the CRS incidence in 1996 and 2000–2010 for each country, region and globally. The estimated CRS decreased in the three regions (Americas, Europe and Eastern Mediterranean) which had introduced widespread RCV by 2010, reaching <2 per 100,000 live births (the Americas and Europe) and 25 (95% CI 4–61) per 100,000 live births (the Eastern Mediterranean). The estimated incidence in 2010 ranged from 90 (95% CI: 46–195) in the Western Pacific, excluding China, to 116 (95% CI: 56–235) and 121 (95% CI: 31–238) per 100,000 live births in Africa and SE Asia respectively. Highest numbers of cases were predicted in Africa (39,000, 95% CI: 18,000–80,000) and SE Asia (49,000, 95% CI: 11,000–97,000). In 2010, 105,000 (95% CI: 54,000–158,000) CRS cases were estimated globally, compared to 119,000 (95% CI: 72,000–169,000) in 1996. Whilst falling dramatically in the Americas, Europe and the Eastern Mediterranean after vaccination, the estimated CRS incidence remains high elsewhere. Well-conducted seroprevalence studies can help to improve the reliability of these estimates and monitor the impact of rubella vaccination.