ヒトパピロマウイルスワクチン接種プログラムの導入後の集団レベルでの影響と群生効果: 更新された体系的レビューとメタ解析
Mélanie Drolet1, Élodie Bénard2, Norma Pérez1
1Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada.
Lancet (London, England)
|July 1, 2019
まとめ
ヒトパピローマウイルス (HPV) ワクチン接種は,少女と女性のHPV感染,陰茎,子宮頸部内皮内腫瘍 (CIN2+) を有意に減少させます. ワクチン接種は群生効果を示し,未接種者および雄の診断が減少しています.
科学分野:
- 公衆衛生
- ワクチン学
- 流行病学について
背景:
- ヒトパピローマウイルス (HPV) ワクチン接種が10年以上に渡って実施されているため,実際の世界の人口レベルでの影響に関する最新の証拠が必要です.
- 以前のシステマティック・レビューでは,HPVワクチン接種の重要性が強調されていますが,マルチコホートワクチン接種の効果に関するさらなるデータが必要です.
研究 の 目的:
- HPVワクチン接種の影響に関する集団レベルのデータの体系的なレビューとメタ分析を行う.
- HPV感染,陰性,頸部内皮新生症2級 (CIN2+) に対するHPVワクチンの有効性に関する証拠を要約する.
- マルチコホートHPVワクチン接種戦略の影響を定量化する.
主な方法:
- MEDLINEとEmbaseのデータベースを用いた体系的なレビューとメタ分析 (2014年2月〜2018年10月)
- 一般集団におけるワクチン接種前とワクチン接種後のHPV関連エンドポイント (感染,,CIN2+) を比較した研究を含む.
- 性別,年齢,ワクチン接種開始から数年の分別による層別分析; ランダム効果モデルが相対リスクの集積に使用された.
主要な成果:
- HPV16/ 18の有意な減少 (13歳から19歳の少女では83%,20歳から24歳の女性では66%) とHPV31/ 33/45の有意な減少 (13歳から19歳の少女では54%) が観察されました.
- 性器の診断は少女 (15-19) で67%女性 (20-24歳) で54%減少し,男性でも減少した.
- CIN2+の割合は,ワクチン接種から5~9年後の少女 (1~19歳) と女性 (20~24歳) で51%減少した.
結論:
- HPVワクチン接種プログラムは,HPV感染,陰茎,CIN2+に対する人口レベルの大きな影響を示しています.
- 高いワクチン接種率とマルチコホートワクチン接種戦略は,直接的な効果と集団免疫を高めます.
- 証拠は,世界中でHPVワクチン接種プログラムの継続的な実施と拡大を支持しています.
関連する概念動画
Introduction and Methods of Leveling
474
Leveling is a surveying procedure used to determine elevation differences between distant points. Elevation refers to the vertical distance above or below a reference datum, typically mean sea level (MSL). In the United States, elevations are often referenced to the mean sea level station at Father Point Rimouski along the St. Lawrence Seaway. To make the datum accessible, permanent markers are established throughout the region. These markers, called benchmarks, have known elevations. If the...
474
Vaccinations
51.3K
Overview
51.3K
Review and Preview
8.3K
In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
Percentiles are a type of fractile that partition data into...
Percentiles are a type of fractile that partition data into...
8.3K
Review and Preview
10.9K
Data are individual items of information obtained from a population or sample. Data may be classified as qualitative (categorical), quantitative continuous, or quantitative discrete. Because it is not practical to measure the entire population in a study, researchers use samples to represent the population. A random sample is a representative group from the population chosen by using a method that gives each individual in the population an equal chance of being included in the sample. Random...
10.9K
Introduction To Survival Analysis
763
Survival analysis is a statistical method used to study time-to-event data, where the "event" might represent outcomes like death, disease relapse, system failure, or recovery. A unique feature of survival data is censoring, which occurs when the event of interest has not been observed for some individuals during the study period. This requires specialized techniques to handle incomplete data effectively.
The primary goal of survival analysis is to estimate survival time—the time...
The primary goal of survival analysis is to estimate survival time—the time...
763
Analysis of Population Pharmacokinetic Data
690
Analysis of population pharmacokinetic data involves studying the behavior of drugs within diverse populations to understand their pharmacokinetic parameters. Traditional pharmacokinetic methods typically involve collecting samples from a few individuals and estimating these parameters. While these methods are commonly used, they have limitations in capturing the variability in drug response among individuals or heterogeneous populations. Population pharmacokinetics is employed to address these...
690


