巴西BCG疫苗接种减少和儿科结核病增加:时空空间研究
Fabiana Rabe Carvalho1, Alice Ramos-Silva1,2, Debora Castanheira Pires3
1Universidade Federal Fluminense. Faculdade de Medicina. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas. Niterói, RJ, Brasil.
儿童结核病例在2020年有所下降,但有所上升,这与巴西菌卡尔梅特-格林 (BCG) 疫苗接种率下降到90%的情况相吻合. 有针对性的干预措施至关重要.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 空间分析 空间分析
背景情况:
- 结核病 (TB) 仍然是一个重大的全球卫生挑战,特别是在儿童群体中.
- 细菌卡尔梅特 - 格林 (BCG) 疫苗接种是预防儿童严重结核病的主要工具.
- 了解结核病发病率和BCG覆盖率的时空动态对于有效的控制策略至关重要.
研究的目的:
- 分析20多年来巴西儿科结核病 (TB) 病例的空间分布和时间趋势以及细菌卡尔梅特-格林 (BCG) 疫苗接种覆盖率.
- 确定10岁以下儿童结核病发病率的高风险区域和时间模式.
- 评估BCG疫苗接种覆盖率与儿科结核病率之间的关系.
主要方法:
- 以人口为基础的生态研究,利用2001年至2022年期间可通报疾病信息系统 (SINAN) 的数据.
- 使用全球莫兰指数和空间协会局部指标 (LISA) 的空间依赖性分析.
- 结点回归用于评估结核病和BCG率随时间变化的趋势.
主要成果:
- 记录了39840例儿科结核病例,其中超过60%发生在5岁以下的儿童中.
- 亚马逊州,马托格罗索州和里约热内卢州的发病率最高.
- 发现了儿科结核病例的显著空间自相关性,具有高发病率集群.
- 自2000年以来,儿童结核病例有所下降,但在2020年显著增加.
- 接种BCG疫苗的覆盖率下降到90%以下,2020年出现了显著下降,特别是在东北地区.
结论:
- 降低BCG疫苗接种覆盖率至90%以下,构成儿童结核病的重大风险.
- 迫切需要保持高疫苗接种率,并实施强有力的公共卫生政策来控制儿童结核病.
- 在结核病负担较高的地区,有针对性的干预措施至关重要,以减轻儿童的发病率.
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