基于2015-2021年血清监测数据的俄罗斯联邦不同年龄组人口抗白喉免疫状况评估

A. A. Basov, N. M. Maksimova, S. O. Vysochanskaya, O. V. Tsvirkun, K. A. Yatskovsky, S. E. Aduguzelov
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引用次数: 0

摘要

的相关性。白喉是威胁人类生命的危险疾病之一。免疫是创造有利的流行病学形势的唯一手段。确保人口对这种感染具有免疫力,可防止白喉在人口中出现上升和传播。评估白喉特异性免疫状况的方法之一是每年进行血清学监测。目标基于2015-2021年血清监测数据评估俄罗斯联邦人口不同年龄组的抗白喉免疫状况材料和方法。分析2015-2021年俄罗斯联邦85个调查对象的白喉血清学监测数据和人群疫苗接种状况。就俄罗斯的血清监测而言,仅在7年内,就检查了439,874人是否存在白喉抗体,其中包括3-4岁年龄组的73,559名儿童,74,424名15-17岁的青少年和291,891名18岁及以上的成年人。在同一期间,对来自俄罗斯联邦20名受试者的12,154份受控血清进行了检查。在3-4岁年龄组- 1834名儿童,15-17岁- 1366名青少年,18-29岁- 1711名成年人,30-39岁- 1724名成年人,40-49岁- 1918名成年人,50-59岁- 1798名成年人,60岁及以上- 1803名成年人。在被动血凝过程中检测白喉抗体的存在。抗体的保护效价为稀释血清的效价为1:20或更高,抗白喉免疫的强度评估如下:稀释血清的抗体效价为1:20 - 1:40 -低效价,1:80-1:160 -中效价,1:20 20或更高- JSC“Biomed”im抗体的高效价。米契尼科夫。结果和讨论。在俄罗斯,改善白喉监测系统仍然是这种感染的私人流行病学的一项紧迫任务。在研究期间获得的数据使我们能够确定俄罗斯联邦全国人口的人口免疫力足以防止白喉的发生和传播。促成这一结果的主要因素是规定的年龄组中白喉疫苗的长期高覆盖率(在每个年龄组中接种疫苗的人数中,95%以上的人接种了疫苗)。在对不同年龄人群的免疫水平进行比较时,发现50岁及以上年龄组接种疫苗者的百分比在统计学上显著低于50岁以下年龄组。俄罗斯整体血清学研究数据显示,各年龄组白喉抗体保护滴度较高的人群比例为:3-4岁- 96.7±0.1%,15-17岁- 98.3±0.1%,18-29岁- 96,0±0,4% - 97,5±0,3%,30-39岁- 95,9±0,4% - 97,5±0.3%,40-49岁- 95,7±0,4% - 97,7±0,3%。血清阴性个体在50-59岁和60岁及以上人群中所占比例最大。对俄罗斯联邦某些科目中血清阴性者所占比例的分析显示,50-59岁和60岁及以上年龄组血清阴性者所占比例超过10%的领土数量明显高于其他年龄组。结论。因此,当计划公司进行“补充”免疫接种时,建议对50岁以上血清阴性的人强制重新接种疫苗。根据《国家疫苗接种日历》及时重新接种疫苗,跟踪所有指标组中易患白喉者的比例,然后对血清反应阴性的老年人重新接种疫苗,这将使人口免疫力保持在较高水平(95%以上),并确保该国多年来白喉发病率始终保持在较低水平。
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Assessment of the State of Antidiphtheria Immunity in Different Age Groups of the Population of the Russian Federation Based on Seromonitoring Data for 2015–2021
Relevance . Diphtheria is one of the dangerous diseases that threaten human life. Immunization is the only means of creating a favorable epidemiological situation. Ensuring the immunity of the population to this infection prevents the occurrence of the rise and spread of diphtheria among the population. One of the ways to assess the state of specific immunity to diphtheria is annual serological monitoring. Aims . Assessment of the state of antidiphtheria immunity in different age groups of the population of the Russian Federation based on seromonitoring data for 2015–2021. Materials and methods . The data of serological monitoring of diphtheria and the state of vaccination of the population by indicator groups from 85 subjects of the Russian Federation in 2015–2021 were analyzed. In just 7 years, in terms of seromonitoring in Russia, 439,874 people were examined for the presence of antibodies to diphtheria, including 73,559 children in the age group of 3–4 years, 74,424 adolescents aged 15–17 years, and 291,891 adults aged 18 and older. During the same period, 12,154 controlled blood sera from 20 subjects of the Russian Federation were examined. In the age group of 3–4 years – 1834 children, 15–17 years – 1366 teenagers, 18–29 years – 1711 adults, 30–39 years – 1724 adults, 40–49 years – 1918 adults, 50–59 years – 1798 adults, 60 years and older – 1803 adults. The presence of antibodies to diphtheria was determined in the course of passive hemagglutination. The protective titers of antibodies were taken to be dilution of sera with a titer of 1:20 or more, the intensity of anti-diphtheria immunity was assessed as follows: antibody titers in dilution of sera 1:20–1:40 – low titers, 1:80–1:160 – medium and 1:320 or more – high titers of antibodies of JSC «Biomed» im. I. I. Mechnikov. Results and discussion . In Russia, improving the surveillance system for diphtheria continues to be an urgent task of the private epidemiology of this infection. The data obtained during the study allowed us to characterize the population immunity of the population of the Russian Federation, as a whole across the country, as sufficient to prevent the occurrence and spread of diphtheria. The main factor contributing to this was the long-term high coverage of vaccinations against diphtheria of persons in the decreed age groups (more than 95% of those vaccinated from the number of persons to be vaccinated in each age group). When comparing the level of immunization of the population depending on age, it was found that the percentage of vaccinated persons in the age group of people 50 years and older was statistically significantly lower than in the group of people younger than 50 years. The data of serological studies in Russia as a whole showed a high proportion of people with protective titers of antibodies to diphtheria in each age group – 3–4 years – 96.7 ± 0.1%, 15–17 years – 98.3 ± 0.1%, 18–29 years – 96,0 ± 0,4% – 97,5 ± 0,3%, 30–39 – 95,9 ± 0,4% – 97,5 ± 0.3%, 40–49 years old – 95,7 ± 0,4% – 97,7 ± 0,3%. The largest proportion of seronegative individuals is detected among groups aged 50–59 years and 60 years and older. The analysis of the share of seronegative persons in certain subjects of the Russian Federation revealed that the number of territories with a share of seronegative persons of more than 10% in the age groups of 50–59 years and 60 years and older was significantly higher than in other age groups. Conclusion . Thus, when planning companies for «сatch-up» immunization, it is advisable to provide mandatory revaccination of seronegative persons over 50 years of age. Timely revaccination according to the National Vaccination Calendar, tracking the proportion of persons susceptible to diphtheria in all indicator groups, followed by revaccination of seronegative persons in older ages will allow maintaining a high level of population immunity (more than 95%) and ensuring a consistently low incidence of diphtheria in the country for many years.
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Epidemiologiya i Vaktsinoprofilaktika
Epidemiologiya i Vaktsinoprofilaktika Medicine-Infectious Diseases
CiteScore
1.10
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58
审稿时长
8 weeks
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