婴儿死亡率和肺炎球菌疫苗:194个国家的时间序列趋势分析,1950-2020年
Carlos A Sanchez1, Oriana Rivera-Lozada2, Michelle Lozada-Urbano2
1Universidad Peruana de Ciencias Aplicadas, Lima, Peru csanchez.peru@gmail.com.
BMJ global health
|August 7, 2023
概括
预计肺炎球菌合疫苗 (PCV) 将降低婴儿死亡率 (IMR). 然而,全球IMR持续下降,与孕产妇死亡率的相关性更强,这表明PCV可能不是最近婴儿死亡率下降的主要驱动因素.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 由 *Streptococcus pneumoniae* (肺炎球菌) 引起的肺炎是导致婴儿死亡的主要原因.
- 自2000年以来,肺炎球菌联合疫苗 (PCV) 已用于1岁以下的婴儿.
研究的目的:
- 分析婴儿死亡率 (IMR) 与全球PCV引入之间的时间关系.
- 调查PCV的实施是否与所有原因的IMR所观察到的下降相关.
主要方法:
- 利用了国家一级IMR (联合国儿童基金会) 和PCV引入状态 (世卫组织) 的公开数据.
- 对194个国家进行了1950-2020年年度IMR的国家特定时间序列分析.
- 在有或没有PCV国家免疫计划的国家中比较IMR趋势.
主要成果:
- 150个国家在2000年后引入了PCV; 31个国家从未引入过.
- 在92.7%的IMR下降的国家中,IMR下降和孕产妇死亡率下降之间观察到强烈的相关性.
- 没有PCV引入的国家也显示IMR下降,与MMR有很强的相关性.
结论:
- 几十年来,全球婴儿死亡率一直在下降,这可能是由于母亲和儿童医疗保健的更广泛改进造成的.
- 最近观察到的IMR下降可能不是直接归因于引入肺炎球菌合疫苗 (PCV).
- 需要进一步的研究,以阐明PCV对婴儿死亡率趋势的具体影响,在其他公共卫生进展中.
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