轮状病毒疫苗接种对<5岁腹泻住院儿童轮状病毒感染和临床症状保护效果的检测阴性设计病例对照研究  

Effectiveness of rotavirus vaccination against rotavirus infection and clinical symptoms among<5-year-old children hospitalized for diarrhea:a test-negative design case-control study

作　　者：朱妮[1] 张义[1] 陈飒[1] 冯瑄[1] 李华[1] 胡伟军[1] 张超[1] 曹磊[1] 张少白[1] 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)

机构地区：[1]陕西省疾病预防控制中心,陕西西安710054

出　　处：《中国疫苗和免疫》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)。

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.

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 

分 类 号：R183.4[医药卫生—流行病学]