Effectiveness of rBS/WC cholera vaccine against bacterial infectious diarrhea: A test-negative study on children aged 2–6 years in Guangzhou China

IF 4.5 3区医学 Q2 IMMUNOLOGY Vaccine Pub Date : 2025-05-22 Epub Date: 2025-04-27 DOI:10.1016/j.vaccine.2025.127139

Qianyi Long , Hui Wang , Qing He , Wenhui Liu , Chunhuan Zhang , Zhoubin Zhang , Lei Luo

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Abstract

Background

Recombinant B-subunit/Whole Cell Cholera Vaccine (rBS/WC) represents a new and effective way to protect against and control diarrhea. A test-negative case-control study was conducted to investigate the cross-protective effect of cholera vaccine immunization against bacterial infectious diarrhea in a real-world setting.

Methods

Using a test-negative design, children aged 2–6 years with infectious diarrhea in Guangzhou City were selected as study subjects. A 1:4 propensity score matching based on the basic characteristics of the included study subjects, and vaccine effects were calculated after correcting for confounders.

Results

A total of 2796 children with laboratory-confirmed infectious diarrhea were enrolled in the study, and 316 pairs were successfully enrolled in the matching after Propensity Score Matching(PSM), totaling 1306. By conditional logistic regression analysis, The results showed that the total protective effect of ≥1 dose of rBS/WC vaccine against bacterial infectious diarrhea in children aged 2–6 years was 57.7 % (95 % CI: 30.3–74.3); the rBS/WC vaccine had the best protective effect of 74.8 % (95 % CI: 16.8–95.6) within 6 months of vaccination and then showed a decreasing trend. The vaccine's protective effect was 54.6 % (95 % CI: 22.1–73.5) against Salmonella and 69.2 % (95 % CI: −133.7–95.9) against Escherichia coli. Stratified analyses revealed higher point estimates of the protective effect obtained by vaccination among healthy children with good hygiene.

Conclusions

These findings support the idea that the rBS/WC vaccination program is effective in the real world in preventing bacterial diarrhea in children. For people who are susceptible to bacterial diarrhea, the cholera vaccine is a good preventive option.

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rBS/WC霍乱疫苗预防细菌性感染性腹泻的有效性：广州2-6岁儿童试验阴性研究

背景b亚单位/全细胞霍乱组合疫苗（rBS/WC）是预防和控制腹泻的一种新的有效方法。一项检测阴性的病例对照研究旨在调查霍乱疫苗免疫对细菌性感染性腹泻的交叉保护作用。方法采用阴性试验设计，选取广州市2 ~ 6岁感染性腹泻患儿为研究对象。在校正混杂因素后，根据纳入研究对象的基本特征和疫苗效果进行1:4倾向评分匹配。结果共纳入2796例实验室确诊的感染性腹泻患儿，经倾向评分匹配（PSM）成功配对316对，共计1306对。条件logistic回归分析结果显示，≥1剂rBS/WC疫苗对2 ~ 6岁儿童细菌性感染性腹泻的总保护效果为57.7% (95% CI: 30.3 ~ 74.3)；在接种后6个月内，rBS/WC疫苗的保护效果最好，为74.8% (95% CI: 16.8 ~ 95.6)，随后呈下降趋势。该疫苗对沙门氏菌的保护效果为54.6% (95% CI: 22.1 ~ 73.5)，对大肠杆菌的保护效果为69.2% （95% CI:−133.7 ~ 95.9）。分层分析显示，在具有良好卫生习惯的健康儿童中，接种疫苗获得的保护作用的点估计值较高。结论：这些发现支持了rBS/WC疫苗接种计划在现实世界中预防儿童细菌性腹泻的有效性。对于易患细菌性腹泻的人来说，霍乱疫苗是一种很好的预防选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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