13价肺炎球菌结合疫苗针对血清型19A所致儿童侵袭性肺炎球菌性疾病保护效果的Meta分析

Effectiveness of 13-valent pneumococcal conjugate vaccine against invasive disease caused by serotype 19A in children:a meta-analysis

目的通过Meta分析系统评价13价肺炎球菌结合疫苗(PCV13)针对血清型19A所致侵袭性肺炎球菌性疾病(IPD)对<5岁儿童的保护效果。方法以Streptococcus pneumoniae infection、invasive pneumococcal disease、13-valent pneumococcal polysaccharide conjugate vaccine、PCV13、effectiveness、infant、child、13价肺炎球菌结合疫苗、PCV13、效果、儿童为关键词,系统检索中国知网、万方数据、PubMed、SCOPUS、Web of Science搜索相关文献,检索不限定语言、地区、研究机构,检索时间限定为2010年1月起至2023年2月,检索研究类型包括队列研究、病例对照研究和随机对照试验,由两位研究者独立进行文献筛选、数据提取并使用纽卡斯尔-渥太华量表(The Newcastle-Ottawa Scale,NOS)进行文献质量评价,采用Stata软件开展数据分析。结果共搜索到相关文献2340篇,最终纳入文献10篇,其中病例对照研究5篇,间接队列研究5篇,文献质量较好。PCV13针对血清型19A所致儿童IPD的保护效果为83.91%(95%CI:78.92%~88.89%),根据研究类型开展亚组分析,结果显示病例对照研究(VE=87.34%,95%CI:79.74%~94.94%)与间接队列研究(VE=81.30%,95%CI:74.69%~87.92%)之间不存在组间差异(P=0.240)。漏斗图和Egger检验认为存在发表偏倚可能性小。结论PCV13对血清型19A所致儿童IPD具有较好的保护效果,建议进一步提高PCV13接种率以降低<5岁儿童IPD的疾病负担。

Objective Using Meta-analysis to evaluate the vaccine effectiveness of 13-valent pneumococcal conjugate vaccine(PCV13)against invasive Streptococcus pneumoniae disease(IPD)caused by serotype 19A in children<5 years old.Methods"Streptococcus pneumoniae infection""invasive pneumococcal disease""13-valent pneumococcal polysaccharide conjugate vaccine""PCV13""effectiveness""infant""child"and related terms were searched from China National Knowledge Infrastructure(CNKI),WANFANG DATA,PubMed,SCOPUS and Web of science with no limited on language,region and research institution.The retrieval time was limited from January 2010 to February 2023 and cohort study,case-control study and randomized controlled trial were included.Data were extracted from eligible studies by two independent reviewers,and after study quality assessment by NOS scale,Meta-analysis was completed using Stata 16.0 software.Results A total of 2340 related literatures were searched,and 10 literatures were finally included,including 5 case-control studies and 5 indirect cohort studies,which showed good literature quality.The vaccine effectiveness against serotype 19A IPD of PCV13 in children was 83.91%(95%CI:78.92%-88.89%),and the subgroup analysis(P=0.240)showed there was no significant difference among the case-control study(VE=87.34%,95%CI:79.74%-94.94%)and the indirect cohort study(VE=81.30%,95%CI:74.69%-87.92%).The funnel plot and Egger test suggested that the possibility of publication bias was small.Conclusion The present evidence indicates that PCV13 has a good vaccine effectiveness against serotype 19A IPD in children,and it is recommended to further increase the vaccination rate of PCV13 to reduce the disease burden of IPD in children<5 years old.