2008 年至 2018 年土耳其小儿水痘相关住院情况:通用单剂量水痘疫苗的影响(VARICOMP 研究)》。

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Ener Cagri Dinleyici, Zafer Kurugol, Ilker Devrim, Nuri Bayram, Nazan Dalgic, Olcay Yasa, Hasan Tezer, Halil Ozdemir, Ergin Ciftci, Anil Tapisiz, Solmaz Celebi, Mustafa Hacimustafaoglu, Dilek Yilmaz, Nevin Hatipoglu, Ates Kara
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引用次数: 0

摘要

背景:土耳其于2013年2月在国家免疫计划中引入了12月龄单剂量水痘疫苗。本研究旨在评估水痘相关的儿童住院情况,以及单剂量水痘减毒活疫苗在实行水痘疫苗通用接种的头 5.5 年中所产生的影响:方法:我们分析了从儿童医疗记录中收集的数据:10 年间共有 4373 名儿童(2458 名男孩和 1915 名女孩;72.3% 以前健康)因水痘住院,其中疫苗接种前有 2139 名儿童,疫苗接种后有 2234 名儿童。总体而言,接种水痘疫苗后水痘住院率明显下降[接种前与接种后相比;每年每 10 万人中有 3.79 人与 2.87 人相比;P < 0.001;几率比 0.75;95% 置信区间 0.64-0.88]。接种疫苗后,1 至 5 岁儿童中与水痘相关的住院率明显低于接种疫苗前,住院率下降了 60.2%(每 10 万名儿童中 2.43 人对 6.12 人;P < 0.001;几率比 0.39;95% 置信区间 0.34-0.46)。在 15 岁组中(P < 0.01 和 P < 0.05)。疫苗接种后的平均年龄高于疫苗接种前(P < 0.001)。疫苗接种后,继发性细菌感染(P < 0.01)、呼吸系统并发症(P < 0.01)和神经系统并发症(P < 0.001)的绝对数量明显降低。接种后严重水痘的发病率低于接种前(P < 0.001):在常规使用单剂水痘疫苗 5.5 年后,我们观察到接种水痘疫苗对水痘相关住院率的影响,尤其是在目标年龄组。但是,我们在其他年龄组中没有观察到群体保护。在国家免疫计划中接种第二剂水痘疫苗将有助于控制疾病活动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pediatric Varicella-related Hospitalization in Turkey Between 2008 and 2018: Impact of Universal Single Dose Varicella Vaccine (VARICOMP Study).

Background: A single-dose varicella vaccine at 12 months of age was introduced to the National Immunization Program in February 2013 in Turkey. This study aimed to evaluate varicella-related hospitalization in children and the impact of a single-dose live attenuated varicella vaccine over the first 5.5 years of introducing a universal varicella vaccination.

Methods: We analyzed data collected from the medical records of children <18 years old who required hospitalization due to varicella in 17 cities representing 50% of the childhood population in Turkey between 2008 and 2018. We calculated the rate of hospitalization for varicella per 100,000 children during the study period. The main objective of this study was to determine the yearly rate of hospitalization due to varicella and to compare these rates in the pre-vaccine and post-vaccine periods. The secondary objective was to compare demographic features, varicella-related complications, and outcomes between the pre-vaccine and post-vaccine periods.

Results: A total of 4373 children (2458 boys and 1915 girls; 72.3% previously healthy) were hospitalized for varicella over a 10-year period, including 2139 children during the pre-vaccine period and 2234 children during the post-vaccine period. Overall, varicella hospitalization rates decreased significantly after the introduction of varicella vaccination [pre-vaccine vs. post-vaccine period; 3.79 vs. 2.87 per 100,000 per year; P < 0.001; odds ratio 0.75; 95% confidence interval 0.64-0.88]. The incidence of varicella-related hospitalization among children between 1 and 5 years of age was significantly lower in the post-vaccine era than in the pre-vaccine era, with a 60.2% decrease in hospitalizations (2.43 vs. 6.12 per 100,000 children; P < 0.001, odds ratio 0.39; 95% confidence interval 0.34-0.46). In both the <1-year and 6- to 10-year age groups, the incidence of varicella-related hospitalizations was similar in the pre-vaccine and post-vaccine periods. The incidence of varicella-related hospitalization was higher in the post-vaccine era among 11-15 years and >15-year-old groups (P < 0.01 and P < 0.05). The mean age was higher during the post-vaccine period than during the pre-vaccine period (P < 0.001). The absolute number of secondary bacterial infections (P < 0.01), respiratory complications (P < 0.01), and neurological complications (P < 0.001) was significantly lower during the post-vaccine period. The incidence of severe varicella was lower during the post-vaccine period than during the pre-vaccine period (P < 0.001).

Conclusions: After 5.5 years of routine single-dose varicella vaccine use, we observed the impact of varicella vaccination on the incidence of varicella-related hospitalizations, especially in the target age group. However, we did not observe herd protection in the other age groups. The implementation of a second dose of the varicella vaccine in the National Immunization Program would help control disease activity.

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来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
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