摘要
目的 评估河北省流行性脑脊髓膜炎(简称流脑)疫苗接种对流脑发病的影响,以期完善本地区疫苗免疫策略和免疫程序。方法 收集1970—2023年河北省流脑报告发病率,采用中断时间序列(interrupt time-series, ITS)方法,定量分析流脑疫苗接种前后和纳入扩大免疫规划前后流脑发病水平和变化趋势。结果 流脑疫苗接种前(1970—1979年)、纳入扩大免疫规划前(1980—2007年)和纳入后(2008—2023年)河北省流脑年均报告发病率分别为20.79/10万、1.66/10万、0.018/10万。中断时间序列分析显示,流脑发病率在无疫苗时代的初始水平为24.12/10万,流脑发病率平均逐年减少1.07/10万(t=-2.42,P<0.05)。1980年流脑疫苗开始接种后,发病率立即下降,年平均发病率较疫苗接种前减少18.39/10万,短期干预效果明显(t=-2.70,P<0.05);长期接种的发病率下降速率为0.13/10万,长期干预效果无统计学意义(P>0.05);疫情暴发抬升了整体发病率(t=7.80,P<0.05)。1980—2023年,流脑发病率初始水平5.13/10万(t=8.70,P<0.05),流脑发病率平均逐年减少0.23/10万(t=-6.42,P<0.05)。2008年流脑疫苗纳入扩大免疫规划,长期接种的发病率缓慢降低,平均每年降低0.008/10万,长期干预效果有统计学意义(t=2.50,P<0.05);疫情暴发流行对该阶段人群发病率影响无统计学意义(P>0.05)。结论 流脑疫苗接种使河北省流脑发病率整体呈下降趋势,并削平了暴发流行所致人群发病率上升的趋势,需长期保持。此外,应加强对流脑患者及健康带菌者的流行菌群分布情况的监测,并根据菌群变迁情况适时调整免疫策略,针对流行菌群选择和推广相应的疫苗。
Objective To evaluate the impact of meningococcal vaccine immunization on the incidence of meningococcal meningitis,aiming to refine the local immunization strategies and programs.Methods Data on the reported incidence of meningococcal meningitis in Hebei province for 1970-2023 were collected,and interrupted time-series(ITS)analysis was used to quantitatively analyze the levels and slope change of the incidence of meningococcal meningitis before and after vaccine immunization and before and after inclusion in the Expanded Program on Immunization(EPI).Results The annual average reported incidences of meningococcal meningitis in Hebei province before vaccination(1970-1979),before(1980-2007)and after(2008-2023)the inclusion of the vaccine in the EPI were respectively 20.79 per 100000,1.66 per 100000,and 0.018 per 100000.The interrupted time-series analysis from 1970 to 2023 showed an initial meningitis incidence rate of 24.12 per 100000(t=9.86,P<0.05),with an average annual decrease of 1.07 per 100000(t=-2.42,P<0.05).After the introduction of the meningococcal vaccine in 1980,the incidence of meningococcal meningitis decreased quickly with an annual average decline of 18.39 per 100000,showing a significant short-term intervention effect(t=-2.70,P<0.05);however,the rate of decrease slowed over the long term to 0.13 per 100000,with the long-term intervention effect not being significant(P>0.05).And the incidence was significantly increased due to the outbreak(t=7.80,P<0.05).From 1980 to 2023,the initial level of incidence was 5.13 per 100000(t=8.70,P<0.05),and decreased by 0.23/100000 per year on average(t=-6.42,P<0.05).After the inclusion of the vaccine in the EPI in 2008,the rate of decrease further slowed down to an average of 0.008 per 100,000 per year,with the long-term intervention effect being significant(t=2.50,P<0.05);the impact of epidemic outbreaks on incidence during this period was not statistically significant(P>0.05).Conclusions Meningococcal meningitis vaccination has led to a general downward trend in
作者
曹玉雯
贾肇一
王乐雨
何宝花
孙印旗
CAO Yuwen;JIA Zhaoyi;WANG Leyu;HE Baohua;SUN Yinqi(Hebei Provincial Key Laboratory of Pathogens and Epidemiology of Infection Diseases,Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang,Hebei 050021,China)
出处
《中国热带医学》
CAS
北大核心
2024年第6期691-696,共6页
China Tropical Medicine
基金
河北省医学科学研究课题计划项目(No.20200683)。
