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Influenza vaccine effectiveness and disease burden in children and adolescents with sickle cell disease: 2012-2017.

镰状细胞病儿童和青少年的流感疫苗有效性和疾病负担: 2012-2017。

  • 影响因子:2.28
  • DOI:10.1002/pbc.28358
  • 作者列表:"Kao CM","Lai K","McAteer JM","Elmontser M","Quincer EM","Yee MEM","Tippet A","Jerris RC","Lane PA","Anderson EJ","Bakshi N","Yildirim I
  • 发表时间:2020-08-01
Abstract

BACKGROUND:Data are limited on the burden of influenza and seasonal influenza vaccine effectiveness (VE) in children with sickle cell disease (SCD). METHODS:We used a prospectively collected clinical registry of SCD patients 6 months to 21 years of age to determine the influenza cases per 100 patient-years, vaccination rates, and a test-negative case-control study design to estimate influenza VE against medically attended laboratory-confirmed influenza infection. Influenza-positive cases were randomly matched to test-negative controls on age and influenza season in 1:1 ratio. We used adjusted logistic regression models to compare odds ratio (OR) of vaccination in cases to controls. We calculated VE as [100% × (1 - adjusted OR)] and computed 95% confidence intervals (CIs) around the estimate. RESULTS:There were 1037 children with SCD who were tested for influenza, 307 children (29.6%) had at least one influenza infection (338 infections, incidence rate 3.7 per 100 person-years; 95% CI, 3.4-4.1) and 56.2% of those tested received annual influenza vaccine. Overall VE pooled over five seasons was 22.3% (95% CI, -7.3% to 43.7%). Adjusted VE estimates ranged from 39.7% (95% CI, -70.1% to 78.6%) in 2015/2016 to -5.9% (95% CI, -88.4% to 40.4%) in the 2016/17 seasons. Influenza VE varied by age and was highest in children 1-5 years of age (66.6%; 95% CI, 30.3-84.0). Adjusted VE against acute chest syndrome during influenza infection was 39.4% (95% CI, -113.0 to 82.8%). CONCLUSIONS:Influenza VE in patients with SCD varies by season and age. Multicenter prospective studies are needed to better establish and monitor influenza VE among children with SCD.

摘要

背景: 关于镰状细胞病 (SCD) 儿童的流感负担和季节性流感疫苗有效性 (VE) 的数据有限。 方法: 我们使用前瞻性收集的6个月至21岁SCD患者的临床登记,以确定每100患者年的流感病例,疫苗接种率,以及测试阴性病例对照研究设计,以评估流感VE对医疗实验室确诊的流感感染的影响。流感阳性病例在年龄和流感季节以1:1的比例与测试阴性对照随机匹配。我们使用调整后的逻辑回归模型来比较病例和对照中疫苗接种的比值比 (OR)。我们计算VE为 [100% × (1-校正OR)],并计算估计值周围的95% 置信区间 (ci)。 结果: 有1037名SCD儿童接受了流感检测,307名儿童 (29.6%) 至少有一种流感感染 (338例感染,发病率3.7/100人年; 95% CI,3.4-4.1),56.2% 的受试儿童每年接受流感疫苗接种。五个季节汇总的总体VE为22.3% (95% CI,-7.3% 至43.7%)。在39.7% 个季节中,95% 至-70.1% (78.6% CI,-2015/2016至5.9%) 的VE估计值范围为95% (88.4% CI,-40.4% 至2016/17)。流感VE因年龄而异,在1-5岁儿童中最高 (66.6%; 95% CI,30.3-84.0)。流感感染期间急性胸部综合征的校正VE为39.4% (95% CI,-113.0至82.8%)。 结论: SCD患者的流感VE因季节和年龄而异。需要多中心前瞻性研究来更好地建立和监测SCD儿童中的流感VE。

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影响因子:1.74
发表时间:2020-02-01
DOI:10.1177/1049909119868657
作者列表:["Suarez ML","Schlaeger JM","Angulo V","Shuey DA","Carrasco J","Roach KL","Ezenwa MO","Yao Y","Wang ZJ","Molokie RE","Wilkie DJ"]

METHODS:OBJECTIVES:Sickle cell disease (SCD) is a serious illness with disabling acute and chronic pain that needs better therapies, but insufficient patient participation in research is a major impediment to advancing SCD pain management. The purpose of this article is to discuss the challenges of conducting an SCD study and approaches to successfully overcoming those challenges. DESIGN:In a repeated-measures, longitudinal study designed to characterize SCD pain phenotypes, we recruited 311 adults of African ancestry. Adults with SCD completed 4 study visits 6 months apart, and age- and gender-matched healthy controls completed 1 visit. RESULTS:We recruited and completed measures on 186 patients with SCD and 125 healthy controls. We retained 151 patients with SCD with data at 4 time points over 18 months and 125 healthy controls (1 time point) but encountered many challenges in recruitment and study visit completion. Enrollment delays often arose from patients' difficulty in taking time from their complicated lives and frequent pain episodes. Once scheduled, participants with SCD cancelled 49% of visits often because of pain; controls canceled 30% of their scheduled visits. To facilitate recruitment and retention, we implemented a number of strategies that were invaluable in our success. CONCLUSION:Patients' struggles with illness, chronic pain, and their life situations resulted in many challenges to recruitment and completion of study visits. Important to overcoming challenges was gaining the trust of patients with SCD and a participant-centered approach. Early identification of potential problems allowed strategies to be instituted proactively, leading to success.

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