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Impact of Vaccination on Haemophilus influenzae Type b Carriage in Healthy Children Less Than 5 Years of Age in an Urban Population in Nepal
The Journal of Infectious Diseases ( IF 5.0 ) Pub Date : 2021-02-05 , DOI: 10.1093/infdis/jiab072
Sonu Shrestha 1 , Lisa K Stockdale 1 , Madhav C Gautam 2 , Meeru Gurung 2 , Shuo Feng 1 , Pratistha Maskey 2 , Simon Kerridge 1 , Sarah Kelly 1 , Merryn Voysey 1 , Bhishma Pokhrel 2 , Piyush Rajbhandari 3 , Stephen Thorson 2 , Bibek Khadka 2 , Ganesh Shah 2 , Karin S Scherer 1 , Dominic Kelly 1 , David R Murdoch 4 , Shrijana Shrestha 2 , Andrew J Pollard 1
Affiliation  

Background Reduction in detection of asymptomatic carriage of Haemophilus influenzae type b (Hib) can be used to assess vaccine impact. In Nepal, routine vaccination against Hib in children at 6, 10, and 14 weeks of age was introduced in 2009. Before vaccine introduction, Hib carriage was estimated at 5.0% among children aged <13 years in Nepal, with higher rates among children under 5. Large-scale evaluation of Hib carriage in children has not been investigated since the introduction of the pentavalent diphtheria-tetanus-pertussis/Hib/hepatitis B (DTP-Hib-HepB) vaccine in Nepal. Methods A total of 666 oropharyngeal swabs were collected between August and December 2018 from healthy children between 6 months and 5 years of age attending the vaccination clinic at Patan Hospital, Kathmandu, Nepal. Of these 666 swabs, 528 (79.3%) were tested for Hib by culture. Demographic and vaccination data were collected. Results Among 528 swabs tested for Hib, 100% came from fully vaccinated children. No swabs were positive for Hib (95% confidence interval, .0–.7). The absence of Hib in 2018 suggests vaccine-induced protection against Hib carriage 9 years after vaccine introduction. Conclusions Following 3 doses of pentavalent DTP-Hib-HepB vaccine, Hib carriage in children under the age of 5 years in Nepal is no longer common. Ongoing high coverage with Hib vaccine in early childhood is expected to maintain protection against Hib disease in Nepal.

中文翻译:

接种疫苗对尼泊尔城市人口中 5 岁以下健康儿童携带 b 型流感嗜血杆菌的影响

背景 减少无症状携带 b 型流感嗜血杆菌 (Hib) 的检测可用于评估疫苗影响。在尼泊尔,2009 年在 6、10 和 14 周大的儿童中引入了针对 Hib 的常规疫苗接种。在引入疫苗之前,尼泊尔 13 岁以下儿童的 Hib 携带率估计为 5.0%,儿童中的比例更高下 5. 自尼泊尔引入五价白喉-破伤风-百日咳/Hib/乙型肝炎 (DTP-Hib-HepB) 疫苗以来,尚未对儿童携带 Hib 进行大规模评估。方法 2018 年 8 月至 2018 年 12 月期间,在尼泊尔加德满都帕坦医院疫苗接种诊所就诊的 6 个月至 5 岁健康儿童共采集 666 份口咽拭子。在这 666 个拭子中,有 528 个(79. 3%) 通过培养检测 Hib。收集人口统计和疫苗接种数据。结果 在 528 份检测 Hib 的拭子中,100% 来自完全接种疫苗的儿童。没有拭子对 Hib 呈阳性(95% 置信区间,0.0-.7)。2018 年 Hib 的缺失表明在疫苗引入 9 年后疫苗诱导的对 Hib 携带的保护。结论 尼泊尔 5 岁以下儿童接种 3 剂五价 DTP-Hib-HepB 疫苗后,Hib 携带不再常见。预计儿童早期 Hib 疫苗的持续高覆盖率将维持对尼泊尔 Hib 病的保护。2018 年 Hib 的缺失表明在疫苗引入 9 年后疫苗诱导的对 Hib 携带的保护。结论 尼泊尔 5 岁以下儿童接种 3 剂五价 DTP-Hib-HepB 疫苗后,Hib 携带不再常见。预计儿童早期 Hib 疫苗的持续高覆盖率将维持对尼泊尔 Hib 病的保护。2018 年 Hib 的缺失表明在疫苗引入 9 年后疫苗诱导的对 Hib 携带的保护。结论 尼泊尔 5 岁以下儿童接种 3 剂五价 DTP-Hib-HepB 疫苗后,Hib 携带不再常见。预计儿童早期 Hib 疫苗的持续高覆盖率将维持对尼泊尔 Hib 病的保护。
更新日期:2021-02-05
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