摘要
目的评价轮状病毒(Rotavirus,RV)疫苗接种对<5岁腹泻住院儿童RV感染的保护效果(Vaccine effectiveness,VE)和对RV阳性腹泻住院儿童临床症状的影响。方法2022年3月-2023年9月在陕西省某儿童医院招募<5岁腹泻住院儿童开展检测阴性设计病例对照研究,检测儿童RV抗原并收集RV疫苗接种史,采用Logistic回归模型分析RV疫苗的VE以及RV疫苗接种与RV阳性住院儿童临床症状关联性。结果在RV检测阳性和阴性的<5岁腹泻住院儿童中,RV疫苗接种比例分别为18.24%(31/170)和30.52%(152/498);RV疫苗接种对<5岁RV腹泻住院儿童RV感染的调整VE(95%CI)为56.2%(31.5%-72.0%),其中对非重症、重症的调整VE分别为44.4%(3.3%-68.1%)、68.6%(31.3%-85.6%)。在RV检测阳性儿童中,接种RV疫苗比例在不同呕吐天数(≥2 d vs<2 d)和呕吐次数(≥2次vs<2次)之间具有显著性差异(调整OR=0.39,95%CI:0.17-0.92;调整OR=0.28,95%CI:0.08-0.95)。结论接种RV疫苗对<5岁腹泻住院儿童RV感染具有较好的保护效果并可减轻临床严重程度;适龄儿童需尽早接种RV疫苗。
Objective To evaluate the effectiveness of rotavirus(RV)vaccination against RV infection among<5-year-old children hospitalized for diarrhea and the impact of RV vaccination on clinical symptoms.Methods We enrolled<5-year-old children who were hospitalized for diarrhea in a children′s hospital of Shaanxi province between March 2022 and September 2023 for a test-negative design case-control study.We tested for RV antigen and collected RV vaccination history to estimate vaccine effectiveness(VE)and association between RV vaccination and clinical symptoms of RV-positive hospitalized children using a logistic regression model.Results In RV-positive and RV-negative children hospitalized for diarrhea,18.24%(31/170)and 30.52%(152/498)had received RV vaccine,respectively.The adjusted VE(95%CI)against RV infection was 56.2%(31.5%-72.0%),with 44.4%(3.3%-68.1%)VE against non-severe diarrhea and 68.6%(31.3%-85.6%)VE against severe diarrhea.RV vaccination rates were significantly different in children with diarrhea lasting≥2 vs<2 days and vomiting≥2 vs<2 times(adjusted OR=0.39,95%CI:0.17-0.92;adjusted OR=0.28,95%CI:0.08-0.95).Conclusions RV vaccination significantly protected<5-year-old children hospitalized for diarrhea against RV infection and alleviated clinical symptom.We suggest RV vaccination for age-eligible children as early as possible.
作者
朱妮
张义
陈飒
冯瑄
李华
胡伟军
张超
曹磊
张少白
Zhu Ni;Zhang Yi;Chen Sa;Feng Xuan;Li Hua;Hu Wejun;Zhang Chao;Cao Lei;Zhang Shaobai(Shaanxi Provincial Center for Disease Control and Prevention,Xi'an 710054,Shaanxi,China)
出处
《中国疫苗和免疫》
CSCD
北大核心
2024年第4期447-450,共4页
Chinese Journal of Vaccines and Immunization
基金
陕西省创新能力支撑计划(2022PT-26)。
关键词
轮状病毒疫苗
腹泻
住院
保护效果
检测阴性设计
病例对照研究
Rotavirus vaccine
Diarrhea
Hospitalization
Vaccine effectiveness
TTest-negative design
Case-control study