小儿麻痹症的数字-全球视角

K. Badizadegan, D. A. Kalkowska, K. Thompson
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引用次数: 6

摘要

背景:对国家免疫规划和全球根除脊髓灰质炎倡议(GPEI)的投资已经导致世界范围内麻痹性脊髓灰质炎的大幅减少。然而,由于免疫规划和全球根除脊髓灰质炎行动的投资而预防的病例仍然不完全具有特征。方法使用一个整合脊髓灰质炎传播、免疫和疫苗动力学的全球模型,我们提供脊髓灰质炎发病率和预防麻痹病例数的估计。我们将结果与世界卫生组织历来公布的报告病例和估计数进行比较。我们估计,与没有脊髓灰质炎疫苗的反事实世界相比,脊髓灰质炎疫苗的存在和使用在1960-1987年期间预防了500万例麻痹性脊髓灰质炎病例,在1988-2021年期间预防了2400万例麻痹性脊髓灰质炎病例。自1988年根除脊髓灰质炎决议以来,我们的估计表明,GPEI预防了250万至600万例麻痹性脊髓灰质炎病例,而没有GPEI的世界则假设在常规免疫规划中使用不同程度的脊髓灰质炎疫苗强度。对历史病例的分析为理解和宣传根除脊髓灰质炎投资的益处提供了重要背景。前瞻性研究将需要探索未来投资的预期效益,其结果将取决于是否以及何时在全球根除脊髓灰质炎。
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Polio by the Numbers—A Global Perspective
Abstract Background Investments in national immunization programs and the Global Polio Eradication Initiative (GPEI) have resulted in substantial reductions in paralytic polio worldwide. However, cases prevented because of investments in immunization programs and GPEI remain incompletely characterized. Methods Using a global model that integrates polio transmission, immunity, and vaccine dynamics, we provide estimates of polio incidence and numbers of paralytic cases prevented. We compare the results with reported cases and estimates historically published by the World Health Organization. Results We estimate that the existence and use of polio vaccines prevented 5 million cases of paralytic polio for 1960–1987 and 24 million cases worldwide for 1988–2021 compared to a counterfactual world with no polio vaccines. Since the 1988 resolution to eradicate polio, our estimates suggest GPEI prevented 2.5–6 million cases of paralytic polio compared to counterfactual worlds without GPEI that assume different levels of intensity of polio vaccine use in routine immunization programs. Conclusions Analysis of historical cases provides important context for understanding and communicating the benefits of investments made in polio eradication. Prospective studies will need to explore the expected benefits of future investments, the outcomes of which will depend on whether and when polio is globally eradicated.
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