巴基斯坦卡拉奇（2020-2021）三价口服脊髓灰质炎病毒疫苗接种后的全身和粘膜免疫评价：一项横断面研究。

IF 5 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet regional health. Southeast Asia Pub Date : 2025-02-01 DOI:10.1016/j.lansea.2025.100531

Ali Faisal Saleem , Visalakshi Jeyaseelan , Zaubina Kazi , Mahjabeen Zehra , Muhammad Masroor Alam , Grace Macklin , Rocio Lopez Cavestany , Sajid Muhammad , Najeeb Rehman , Ondrej Mach

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引用次数: 0

摘要

背景：野生脊髓灰质炎病毒（WPV1）和循环疫苗衍生脊髓灰质炎病毒（cVDPV）的传播仍然是国际关注的重大突发公共卫生事件。目前，只有阿富汗和巴基斯坦仍然是1型野生脊灰的流行地。为了应对VDPV2与WPV1的共同传播，世卫组织技术咨询小组建议在巴基斯坦卡拉奇的四个城市周边地点（牛群、Ibrahim Hyderi、Ali Akber Shah、Rehri Goth）开展两次全国范围的三价口服脊髓灰质炎病毒疫苗（tOPV）运动。采集1个月至5岁儿童静脉血样本。患有急性疾病、需要住院治疗、原发性免疫缺陷或患有慢性内科疾病的儿童被排除在研究之外。粪便和血清检测在巴基斯坦国家卫生研究所进行。使用微量中和试验分析血清样本，定量脊髓灰质炎抗体的所有三种血清型：1型、2型和3型。在基线、7、14和28天（每次tOPV剂量后）收集的粪便样本进行脊髓灰质炎病毒检测。结果：在285名符合条件的儿童中，225名儿童同时接受了tOPV剂量并提供了3份可分析的血液样本，193名儿童提供了7份可分析的粪便样本。首次接种tOPV后，2型血清转换率为72% (44/61,95% CI: 59.8-81.8)；两次剂量后的累积血清转化率为93.4% （95% CI: 84.3-97.4）。在第一次和第二次tOPV运动后7天，32.7%和18.6%分别排出了Sabin（疫苗）2型脊髓灰质炎病毒。解释：该研究表明，两次tOPV接种后，粘膜免疫力增强，2型血清转化率和抗体血清阳性率较高。资助：世卫组织，日内瓦，瑞士。

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Post-vaccination campaign evaluation of systemic and mucosal immunity of trivalent oral poliovirus vaccine in Karachi, Pakistan (2020–2021): a cross-sectional study

Background

The transmission of wild poliovirus (WPV1) and circulating vaccine-derived poliovirus (cVDPV) continues to be a major Public Health Emergency of International Concern. Currently, only Afghanistan and Pakistan remain polio-endemic for WPV1. In response to the co-circulation of VDPV2 with WPV1, the Technical Advisory Group of WHO had recommended two nationwide campaigns of trivalent oral poliovirus vaccine (tOPV) for children aged <5 years in Pakistan in 2020. We assessed the humoral and mucosal immune responses in children who received two doses of tOPV (during vaccination campaigns) in Karachi, Pakistan.

Methods

A cross-sectional survey was conducted in four peri-urban sites (Cattle Colony, Ibrahim Hyderi, Ali Akber Shah, Rehri Goth) Karachi, Pakistan. Venous blood samples from children aged between 1 month and 5 years were obtained. Children who were acutely ill, requiring hospitalisation, with primary immunodeficiency, or with a chronic medical illness, were excluded from the study. Stool and serum testing was performed at the National Institute of Health, Pakistan. Sera samples were analysed using microneutralization assays to quantify polio antibodies for all three serotypes: type 1, 2, and 3. The stool samples collected at baseline, 7, 14, and 28 days (after each tOPV dose) were tested for the presence of poliovirus.

Findings

Of 285 eligible children, 225 had received both tOPV doses and provided three analysable blood samples, and 193 children provided seven viable stool samples. The seroconversion rate for type 2 was 72% (44/61, 95% CI: 59.8–81.8) after the first tOPV dose; cumulative seroconversion after two doses was 93.4% (95% CI: 84.3–97.4). Seven days after the first and second tOPV campaigns, 32.7% and 18.6% excreted Sabin (vaccine) poliovirus type 2, respectively.