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Impact of maternal dTpa vaccination on the incidence of pertussis in young infants.

母亲接种dTpa对小婴儿百日咳发病率的影响。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0228022
  • 作者列表:"Friedrich F","Valadão MC","Brum M","Comaru T","Pitrez PM","Jones MH","Pinto LA","Scotta MC
  • 发表时间:2020-01-28
Abstract

INTRODUCTION:Pertussis is an important public health problem worldwide, especially in infants. An increase in the incidence in many countries occurred after 2010, including Brazil. In 2013, dTpa vaccine was introduced in the Brazil national immunization schedule of pregnant women. The objective of this study was to evaluate the national trends in the incidence of pertussis in Brazil in children under 1 year old, and the impact of the introduction of dTpa vaccine during pregnancy. METHODS:The incidence of hospitalizations and non-hospitalized confirmed cases of pertussis in neonates (< 1 month age) and young infants (1 month-< 1 year age) were analyzed, comparing the incidence in pre maternal vaccination (2011-2013) with the post-vaccination (2015-2017). We used non-respiratory hospitalizations as comparison, during the same period. A database of the Brazilian Ministry of Health (DATASUS) was used to analyze cases from 2007 to 2017 and the subsets of 2011-2013 and 2015-2017, after Pertussis resurgence. The vaccination data was accessed through the link of the Information System of the National Immunization Program (pni.datasus.gov.br). RESULTS:Between 2007 and 2017, 17,818 children under one year of age were hospitalized due to pertussis in Brazil. In the pre maternal vaccination period 2011-2013, the mean annual incidence of non-hospitalized confirmed cases of pertussis in children under 1 month was 722.2 / 100,000 and in the period of 2015-2017 the average was 377.3 / 100,000, representing a decrease of 47.7% [IRR 0.52 (0.46-0.59)]. At those periods of time, the average incidence per year for children of one month-< 1 year aged was 64.9 / 100,000 (2011-2013) and 29.3 / 100,000 (2015-2017) [IRR 0.45 (CI 0.29-0.69)]. CONCLUSION:Vaccination of pregnant woman coincides with the reduction in the number of cases of pertussis in children under 1 month of age from 2015. Immunization of pregnant woman seems to have an important impact on the prevention of the disease in young infants who have not yet received their own pertussis vaccine.

摘要

导读: 百日咳是全球范围内的重要公共卫生问题,尤其是在婴幼儿中。2010 年后,包括巴西在内的许多国家的发病率都有所增加。2013 年,在巴西孕妇预防接种计划中引入了dTpa疫苗。本研究的目的是评估巴西 1 岁以下儿童百日咳发病率的国家趋势,以及怀孕期间引入dTpa疫苗的影响。 方法: 分析新生儿 (< 1 个月) 和小婴儿 (1 个月-< 1 岁) 百日咳住院和非住院确诊病例的发生率,比较母亲接种前 (2011-2013) 与接种后 (2015-2017) 的发病率。我们使用非呼吸住院作为比较,在同一时期。使用巴西卫生部 (DATASUS) 的数据库分析 2007-2017 年的病例以及百日咳复苏后 2011-2013 和 2015-2017 的子集。接种数据通过国家预防接种规划信息系统 (pni.datasus.gov.br) 链接访问。 结果: 在 2007 至 2017 之间,巴西有 17,818 名 1 岁以下儿童因百日咳住院。在孕前疫苗接种期 2011-2013,1 个月以下儿童百日咳非住院确诊病例年平均发病率为 722.2/100,000,2015 ~ 2017 年平均发病率为 377.3/100,000,代表减少 47.7% [IRR 0.52 (0.46-0.59)]。在这些时期,一个月 <1 岁的儿童每年的平均发病率为 64.9 / 100,000 (2011-2013) 和 29.3 / 100,000 (2015-2017) [IRR 0.45 (CI 0.29-0.69)]。 结论: 从 2015 年起,孕妇接种疫苗与 1 月龄以下儿童百日咳病例数的减少相吻合。孕妇预防接种对尚未接种过自己的百日咳疫苗的小婴儿预防该病有重要影响。

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呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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