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1.
基于肺炎球菌性疾病在全球范围内具有较高疾病负担的现实,世界卫生组织(WHO)推荐所有国家考虑将肺炎球菌结合疫苗(PCV)纳入本国的免疫规划。然而,由于肺炎球菌性疾病发病率低,病原学诊断和监测难度大,开展疫苗针对疾病的保护效果评估存在诸多困难。如能确定疫苗保护效力的替代指标,将极大地提升新疫苗研发的效率。基于已经上市的7价肺炎球菌结合疫苗(PCV7)临床试验过程中获得的疫苗针对疾病的保护效果和血清学效力的数据,WHO建立了PCV预防侵袭性肺炎球菌疾病(IPD)的抗体保护性阈值,建议将基于酶联免疫吸附试验(ELISA)方法检测的IgG水平达到0.35μg/mL作为PCV接种后预防IPD的保护性水平,并在新PCV疫苗注册审批时,应用该阈值来评估疫苗针对IPD的保护效果。但该替代指标不能用于评估针对非侵袭性肺炎球菌疾病的保护效果,同时该阈值只适用于人群水平,不能保证在个体水平为预防IPD提供完全保护。  相似文献   

2.
疫苗保护效果(Vaccine effectiveness, VE)评价是疫苗在真实世界应用后预防控制针对疾病效果的流行病学评估。筛查法是一种利用病例疫苗接种史的个体水平数据和病例来源人群的疫苗接种率计算VE的一种伪生态设计方法,具有容易执行、成本低廉的特点。本文对筛查法VE评价的原理、方法、适用情形、优缺点、应用等进行了综述,旨在帮助研究人员更好地了解和合理运用筛查法。  相似文献   

3.
疫苗的公共卫生意义在于疫苗的群体保护效应,即当疫苗接种率达到一定水平时,疫苗接种将会直接保护接种人群和间接保护未接种人群。扩大疫苗接种率达到足够的群体保护是预防甚至是根除某些传染性疾病的基本策略。此外,群体保护的评价在制定公共卫生策略方面具有十分重要的作用。近年来,国外关于疫苗群体保护的研究日益增多,包括人群观察性研究和群随机对照临床研究,但国内还未见相关的文献报道。本文旨在对评价疫苗群体保护的研究设计及方法进行阐述,为我国在该领域的相关研究提供参考。  相似文献   

4.
乙型肝炎疫苗免疫人群效果观察   总被引:44,自引:0,他引:44       下载免费PDF全文
为评价乙型肝炎 (乙肝 )疫苗在人群中应用的效果 ,采用多阶段整群系统随机抽样的方法 ,对河南省 13个县市中的 1890个家庭 ,5890人进行乙肝疫苗接种情况的调查。发现接种疫苗者HBsAg阳性率明显降低 ,抗 HBs阳性率明显升高。只接种 1针者无免疫保护作用 ;2岁内接种疫苗效果最好 ;5岁以下儿童中接种率达到 70 %时可使HBsAg阳性率降低到 1%以下。结果说明乙肝疫苗在人群中应用效果明显 ,小年龄接种和全程接种对效果影响显著 ,维持高的接种率才会使相应人群带毒率明显下降。  相似文献   

5.
目的以整群随机试验实现学校伤寒副伤寒综合干预项目的研究设计和实施应用,评价设计与应用效果。方法选择广西伤寒副伤寒高发区全州县为项目现场,采用整群随机试验方法确定干预组和对照组所需样本量。结果根据组群随机试验方法计算,共需要观察对象为28500人,以学校为单位,分为38个组群。根据组群的以往发病率、地理位置及性质(小学、中学、高中)分层配对,确定干预组分为19个组群共13563人,对照组为19个组群共14143人。对2组各主要混杂因子(学校性质、学生年龄与性别、学校卫生环境等)进行分析,2组之间总体相差不大,具有较好的均衡性与可比性。结论整群随机抽样法应用于伤寒、副伤寒学校干预试验研究,简单易行,能较好地控制组间混杂因子,但所需样本量较大。  相似文献   

6.
为比较不同整群抽样设计方法 的抽样误差及设计效应,评价不等概率抽样在死因监测中的应用效果.以陕西省107个县(市、区)作为抽样框架,采用等概率整群抽样和不等概率整群抽样等设计方案抽取样本,用复杂抽样方法 计算不同方案样本的抽样误差和设计效应.不同的抽样方案得到不同的抽样误差估计,分层整群抽样的标准误小于完全随机整群抽样;不等概率抽样(πPS抽样)的设计效率虽略逊于等概率的完全随机整群抽样,但扩大了监测范围.结论 :对于抽样框架明确的整群抽样调查数据,在统计分析时不应脱离预先设定的抽样设计方案和设计参数.死因监测采用不等概率抽样设计,能增加样本的权重,提高死亡率的地区代表性.  相似文献   

7.
离散选择试验(Discrete choice experiment,DCE)是一种模拟现实决策的定量多因素分析方法。研究纳入多种及不同水平的属性,衡量个人对不同属性的偏好,评估相关属性在个体决策中的重要性,并预测支付意愿。国际上将DCE应用于疫苗接种服务研究,分析供需双方对现有疫苗的偏好,探索提升疫苗接种率的策略,预测新疫苗的接受度和支付意愿。本研究系统回顾了国际上利用DCE研究疫苗接种服务研究的实践背景、试验设计与分析方法和研究主要发现,为国内开展相关研究提供参考。  相似文献   

8.
Vero细胞纯化狂犬疫苗人体反应及免疫效果观察   总被引:2,自引:1,他引:1  
自人用浓缩狂犬疫苗应用以来,对狂犬病防治起了积极作用,但在使用过程中因个体反应较重,并被迫放弃全程免疫的情况时有发生,影响了犬类致伤人员的免疫保护。1998年按照卫生部Vero细胞疫苗现场观察的(98)16号批件,选用海南生物所研制的纯化Vero细胞狂犬疫苗,对本站100名工作人员进行人体接种临床观察,其中30人分别作血清免疫学观察。现将结果报告如下:巨材料与方法l.互接种对象与分组选择未接种过狂犬疫苗,且无疫苗禁忌症的健康人群作为接种对象,其中30人按lmlX5针接种,另70人按IInlX3外接种。互.2疫苗选择与接种方法试验…  相似文献   

9.
新冠病毒疫苗接种对新冠疫情防控具有重要意义,目前已有多种类型包括mRNA、重组蛋白、腺病毒载体和灭活病毒疫苗在全世界范围内获批使用。临床试验和真实世界研究(RWR)结果显示候选疫苗具有较好的安全性和有效性。与此同时,疫苗对特定的亚群体,包括老年人、怀孕和哺乳妇女以及癌症、自身免疫性疾病患者的保护效果仍需进一步研究。另外,随着变异毒株在全球范围内逐渐流行,疫苗对变异毒株的有效性仍有待观察。本综述主要讨论目前公布关于新冠疫苗临床试验数据的有效性、安全性,对特殊人群的保护性,以及对不同病毒变异株的科学数据。  相似文献   

10.
目的了解水痘疫苗接种在水痘突发疫情中的保护效果。方法收集宁波市某区2010--2012年水痘疫情报告信息,计算接种疫苗与否水痘发病率的比值比(OR),疫苗保护率及疫苗的效果指数。随机抽取未出现疫情的小学生109名,使用ELISA法进行水痘IgG抗体检测,评价疫苗接种的效果。结果该区2010—2012年共发生3起一般水痘突发事件,共报告病例40例(无死亡病例),均为幼托儿童和小学生。疫情发生所在班级学生161人,接种疫苗和未接种疫苗者发病率比较差异有统计学意义(19.42%:59.09%,X2=16.01,P〈0.01),DR值为0.17(95%CI:0.07~0.43)。疫苗总体保护率为67.13%,疫苗效果指数为3.05。未出现疫情的109名学生中,有77人接种过疫苗,但水痘IgG抗体检测显示,仅40.26%(31/77)抗体阳性。结论幼托儿童、小学生接种水痘疫苗可有效降低水痘的发病率,水痘疫苗的质量及实际保护效果需进一步评估。  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

14.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

15.
Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L?1 to a maximum of 79?mg·L?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.  相似文献   

16.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

17.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

18.
19.
The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.  相似文献   

20.
Occupational health hazards in mining: an overview   总被引:1,自引:0,他引:1  
This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.  相似文献   

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