疫苗对全球细菌性脑膜炎的影响
Peter B McIntyre1, Katherine L O'Brien, Brian Greenwood
1National Centre for Immunisation Research and Surveillance of Vaccine-Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney, Sydney, NSW, Australia. peter.mcintyre@health.nsw.gov.au
Lancet (London, England)
|November 13, 2012
概括
蛋白质多糖合疫苗几乎消除了海莫菲勒斯流感脑膜炎. 肺炎球菌和脑膜炎球菌脑膜炎的减少不太明显,特别是在低收入国家.
科学领域:
- 传染性疾病 传染性疾病
- 疫苗学 疫苗学 疫苗学
- 流行病学 流行病学
背景情况:
- 细菌性脑膜炎主要是由Hemophilus influenzae,Streptococcus pneumoniae和Neisseria meningitidis引起的. 这种疾病主要是由于细菌性脑膜炎引起的.
- 对H. influenzae的疫苗影响的评估是最直接的,因为它具有主导的血清型和年龄组,来自高收入国家的可靠数据.
- 肺炎球菌和脑膜炎球菌脑膜炎的发病率测量存在挑战,原因是多种血清型,不同的年龄分布,流行病和有限的监测,特别是在低收入环境中.
研究的目的:
- 评估蛋白质多糖联疫苗对主要细菌脑膜炎病原体的有效性和影响.
- 突出测量疫苗对各种病原体和在各种全球环境中的疗效的挑战.
主要方法:
- 对疫情学数据和关于细菌性脑膜炎发病率的监测报告的审查,在疫苗引入之前和之后.
- 对疫苗有效性研究的分析,重点是H. influenzae,S. pneumoniae和N. meningitidis.
主要成果:
- 在疫苗实施后,观察到H. influenzae脑膜炎的几乎消除.
- 虽然肺炎球菌脑膜炎的疫苗血清型减少了90%以上,但所有年龄段脑膜炎的总体发病率下降了大约25%,低收入国家的数据有限.
- 血清组C脑膜炎球菌脑膜炎在几个高收入国家几乎已经被消除,这表明新的血清组A疫苗在非洲脑膜炎带的潜在成功.
结论:
- 蛋白质多糖合疫苗在减少H. influenzae脑膜炎方面取得了显著的成功.
- 需要进一步的研究和改善监测,以充分评估肺炎球菌和脑膜炎球菌疫苗的影响,特别是在资源有限的地区.
- 脑膜炎球菌血清组C疫苗的成功为在流行地区控制其他血清组,包括血清组A提供了希望.
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