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首页> 外文期刊>Vaccine >Community cohort study of rotavirus and other enteropathogens: are routine vaccinations associated with sex-differential incidence rates?
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Community cohort study of rotavirus and other enteropathogens: are routine vaccinations associated with sex-differential incidence rates?

机译：轮状病毒和其他肠病原菌的社区队列研究：常规疫苗接种是否与性别差异发生率相关？

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OBJECTIVE: Community studies in West Africa have demonstrated that routine vaccinations may have non-targeted effects, the female-male mortality ratio being reduced after administration of BCG and increased after diphtheria-tetanus-pertussis (DTP). We examined whether immunisation status was associated with infection with rotavirus and other enteropathogens. METHODS: We recruited 200 children shortly after birth and followed them until 2 years of age with weekly morbidity interviews and stool sampling. Vaccination status for each child was classified according to the most recent vaccination as documented by vaccination card. MAIN OUTCOME MEASURES: The female-male incidence rate ratios (IRR) of infection with an enteropathogen and of enteropathogen-associated diarrhoea were estimated for children according to whether they had received BCG or DTP as their last vaccination. RESULTS: For children who received BCG as their last vaccine, the adjusted female-male IRRs for primary rotavirus-infection and diarrhoea were 1.05 (95% CI: 0.21-5.28) and 0.0 (95% CI: 0-3.02), respectively. For children who received DTP as their last vaccine, the adjusted female-male IRRs were 1.93 (0.89-4.21) and 1.92 (0.70-5.32), respectively, for rotavirus-associated infection and diarrhoea. Restricted to the rotavirus season, the female-male IRRs for rotavirus infection and diarrhoea were 2.56 (1.17-5.63) and 2.63 (0.94-7.34), respectively. The female-male IRR for rotavirus-associated diarrhoea differed significantly among BCG and DTP recipients (p=0.02). Infections with enteropathogens not associated with diarrhoea were associated with lower female-male IRRs after BCG of 0.82 (0.55-1.23) and higher female-male IRRs after DTP vaccination of 1.32 (1.03-1.70) for primary infection (p=0.05). Though there were few infections with other diarrhoea-causing enteropathogens, these were also associated with a lower female-male IRR after BCG of 0.62 (0.26-1.52) and a higher female-male IRR after DTP vaccination of 1.51 (1.04-2.20) for all infection. CONCLUSION: Routine immunisations may affect morbidity for non-targeted infections. As in studies of infant mortality, BCG is associated with lower risk for girls, whereas, DTP is associated with higher risk for girls relative to boys.
机译：目的：在西非进行的社区研究表明，常规疫苗接种可能具有非靶向作用，施用卡介苗后女性和男性的死亡率降低，而白喉-破伤风-百日咳（DTP）导致女性和女性的死亡率增加。我们检查了免疫状况是否与轮状病毒和其他肠病原体的感染有关。方法：我们在出生后不久招募了200名儿童，并随访他们直到2岁，并进行每周发病率访谈和粪便采样。根据疫苗接种卡上记录的最新疫苗接种，对每个孩子的疫苗接种状态进行分类。主要观察指标：根据儿童最近一次接种BCG或DTP疫苗的情况，估计儿童感染肠道病原体和与肠道病原体相关的腹泻的男女发病率比（IRR）。结果：对于最后一次接种卡介苗的儿童，原发轮状病毒感染和腹泻的经调整的雌雄IRR分别为1.05（95％CI：0.21-5.28）和0.0（95％CI：0-3.02）。对于轮状病毒相关感染和腹泻，接受DTP作为最后一种疫苗的儿童，经调整的雌雄IRR分别为1.93（0.89-4.21）和1.92（0.70-5.32）。受轮状病毒季节的限制，轮状病毒感染和腹泻的雌性和雄性IRR分别为2.56（1.17-5.63）和2.63（0.94-7.34）。轮状病毒相关性腹泻的雌雄IRR在BCG和DTP接受者之间有显着差异（p = 0.02）。与腹泻无关的肠病原菌感染与初次感染的BCG接种后的BCG值为0.82（0.55-1.23）的雌雄IRR较低和DTP疫苗接种为1.32（1.03-1.70）的雌雄IRR较高相关（p = 0.05）。尽管很少有其他引起腹泻的肠病原体感染，但它们与卡介苗接种后的雌雄IRR较低（0.62（0.26-1.52））和DTP疫苗接种1.51（1.04-2.20）后雌雄IRR较高相关所有感染。结论：常规免疫可能影响非目标感染的发病率。与婴儿死亡率研究一样，相对于男孩，卡介苗与女孩的风险较低有关，而与儿童相比，DTP与女孩的风险较高相关。

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