忽视自我清除是否会影响结核病疫苗影响估计?
Danny Scarponi1, Rebecca A Clark2, Chathika Krishan Weerasuriya2
1Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK danny.scarponi@lshtm.ac.uk.
BMJ global health
|August 9, 2023
概括
结核病感染的自我清除可能是常见的. 将其包含在数学模型中略微低估了针对未感染个体的疫苗的好处.
科学领域:
- 流行病学 流行病学
- 数学生物学 数学生物学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 数学模型对于估计结核疫苗影响至关重要.
- 现有的模型通常假定感染后结核病的终身风险.
- 最近的证据表明,Mycobacterium结核病 (Mtb) 的自我清除可能很普遍.
研究的目的:
- 探索将Mtb自我清除纳入如何影响结核病疫苗影响估计.
- 在不同的自我清除场景下分析中国和印度疫苗的影响.
- 评估自我清除对针对感染者,未感染者或所有个体的疫苗的影响.
主要方法:
- 校准了一种结核病模型,有和没有自我清除.
- 不同的自我清除速率和防止再次感染的保护.
- 在2025年引入的模拟新疫苗具有不同的疗效和目标人群.
- 预计到2050年相对疾病发病率的减少.
主要成果:
- 自我清除增加了针对未感染个体的疫苗的估计发病率减少 (在中国高达12%,在印度高达8%).
- 针对感染个体的疫苗的影响有所不同,最大变化为14% (中国) 和15% (印度).
- 观察到对疫苗的最小影响是有效的,无论感染状态如何.
结论:
- 在结核病疫苗模型中忽视自我清除并不会大大偏差整体影响估计.
- 可能会低估针对未感染个体的疫苗的相对优势.
- 模型应考虑对更细致的疫苗影响评估进行自我清除.
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