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1、會(huì)計(jì)學(xué)1b型流感嗜血桿菌英文型流感嗜血桿菌英文第1頁/共30頁第2頁/共30頁第3頁/共30頁Gambia slides courtesy of Kim Mulholland, MD University of Melbourne第4頁/共30頁DTP + PRP-TDTP + placeboat 2, 3 and 4 months of age5 numbers5 numbers第5頁/共30頁第6頁/共30頁 PRP-T controls vaccine efficacy episodes prevented WHO pneumonia* 526 570 8% 44 radiologica

2、l pneumonia 132 170 22% 38 *cough + fast breathing or lower chest wall indrawing第7頁/共30頁第8頁/共30頁第9頁/共30頁第10頁/共30頁第11頁/共30頁第12頁/共30頁第13頁/共30頁第14頁/共30頁第15頁/共30頁第16頁/共30頁第17頁/共30頁第18頁/共30頁第19頁/共30頁OutcomePrevented proportionControl group incidenceHib Vaccine group incidencePrevented Hib incidence (95%

3、CI)-43 (-185 to 98)52 (-194 to 298)174 (-153 to 500)264 (-101 to 629)1561 (270 to 2,853)1+ vaccine dosesRadiologically confirmed-4.90%893936Any infiltrate on chest radiology1.90%2,6772,625Hospitalized severe pneumonia3.80%4,5184,345Any severe pneumonia4.80%5,4605,196Clinical pneumonia4.00%39,51637,9

4、54All incidences are per 100,000 child-yearsPneumonia Outcomes第20頁/共30頁OutcomePrevented proportionControl group incidenceHib Vaccine group incidencePrevented Hib incidence (95% CI)-89 (-248 to 71)-36 (-322 to 249)-49 (-416 to 318)6.9 (-401 to 415)1,467 (-60 to 2,994)3 vaccine dosesRadiologically con

5、firmed-12.0%770859Any infiltrate on chest radiology-1.5%2,4682,504Hospitalized severe pneumonia-1.3%3,9063,955Any severe pneumonia0.15%4,7124,705Clinical pneumonia3.8%38,22636,759All incidences are per 100,000 child-yearsPneumonia Outcomes第21頁/共30頁OutcomePrevented proportionControl group incidenceHi

6、b vaccine group incidencePrevented Hib incidence (95% CI)16 (1.4 to 31)47 (13 to 81)67 (22 to 112)89 (10 to 167)158 (42 to 273)Meningitis admission or clinic evaluation for seizures22%701543Lumbar punctures26%346258Possible bacterial (incl. conf. Hib)50%13467Probable bacterial (incl. conf. Hib)55%86

7、391+ vaccine dosesMicrobiologically confirmed Hib86%192.6All incidences are per 100,000 child-yearsMeningitis Outcomes第22頁/共30頁OutcomePrevented proportionControl group incidenceHib vaccine group incidencePrevented Hib incidence (95% CI)20 (-0.42 to 40)45 (3.9 to 86)74 (19 to 128)52 (-41 to 144)129 (

8、-6.7 to 265)3 vaccine dosesMicrobiologically confirmed Hib84%233.7Probable bacterial (incl. conf. Hib)57%7834Possible bacterial (incl. conf. Hib)54%13764Lumbar punctures16%317265Meningitis admission or clinic evaluation for seizures20%656527All incidences are per 100,000 child-yearsMeningitis Outcom

9、es第23頁/共30頁RegionCountryRateNorth AmericaU.S.11 - 64South AmericaBrazil5 - 44EuropeIceland43Bulgaria6.1AfricaGambia57 - 60South Africa34Middle EastSaudi Arabia45Kuwait15AsiaChina8Hong Kong, Taiwan1Lombok (Based on under 2 rates, 1+ doses)63Published rates of Hib meningitis(Children under 5 years per

10、 100K person-years)第24頁/共30頁第25頁/共30頁59 (-249 to 367)-4.9 (-136 to 126)-4.5 (-147 to 138)66 (-126 to 259)40 (-17 to 97)Preventable Hib mortality (95% CI)Meningitis admission or seen at health center for seizures25.0%161121Clinical or verbal autopsy-defined pneumonia6.5%1,020954Clinical pneumonia-0.7

11、%601606WHO-defined severe pneumonia-0.9%526531All deaths3.0%1,9361,877OutcomePrevented proportionControl group mortalityHib Vaccine group mortalityMortality rates are per 100,000 child-yearsMortality after at least 1 dose第26頁/共30頁30 (-201 to 261)-4.8 (-109 to 99)-14 (-124 to 96)19 (-126 to 164)75 (8

12、.1 to 141)Preventable Hib mortality (95% CI)Meningitis admission or seen at health center for seizures46.0%16186Clinical or verbal autopsy-defined pneumonia3.3%583564Clinical pneumonia-4.2%341355WHO-defined severe pneumonia-1.6%305310All deaths2.6%1,1551,125OutcomePrevented proportionControl group mortalityHib Vaccine group mortalityMortality rates are per 100,000 child-yearsMortality after 3 doses第27頁/共30頁第28頁/共30頁GambiaLombok第29頁/共30頁