#11
|
|||
|
|||
Öèòàòà:
Diphtheria Toxoid Vaccine Effectiveness: A Case-Control Study in Russia Kristine M. Bisgard, Philip Rhodes, Iain R. B. Hardy, Irina L. Litkina, Nikolai N. Filatov, Anatoly A. Monisov, and Melinda Wharton The Journal of Infectious Diseases, volume 181 (2000), pages S184–S187 Prior to the completion of this and other studies, low effectiveness of diphtheria toxoidcontaining vaccine was suspected to be a major contributing factor to the diphtheria epidemic that began in the Russian Federation in 1990. A vaccine effectiveness study was done in Moscow by enrolling physician-diagnosed cases and 10 control subjects per case. Controls were matched to cases by age (±3 months) and clinic registration. Vaccination history was abstracted from a standardized form for case-patients and from clinic vaccination records for control subjects. Two hundred seventeen case-patients and 2169 matched controls were included in the study. Most controls (92%) had received three or more doses of a diphtheria toxoid vaccine, compared with 72% of case-patients. The vaccine effectiveness for three or more doses was 97% (95% confidence interval: 94.3-98.4) [âûäåëåíèå ìîå]. Low vaccine effectiveness was not a contributing factor to the diphtheria epidemic in the Russian Federation. To control and prevent diphtheria epidemics, it is necessary to achieve and maintain high vaccination coverage with three or more doses of diphtheria toxoid among adults and children. Ïîëíûé òåêñò ñòàòüè äîñòóïåí áåñïëàòíî ïî àäðåñó: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Ñõîäíûå äàííûå ïîëó÷åíû ïðè èññëåäîâàíèè â Óêðàèíå (ñì. â òîì æå íîìåðå æóðíàëà ïî òîé æå ññûëêå). Èëè ïîñìîòðèòå òàì æå äàííûå ïî Ãðóçèè, ãäå îòñóòñòâèå âàêöèíàöèè ïðîòèâ äèôòåðèè óâåëè÷èâàëî ðèñê çàáîëåâàíèÿ áîëåå ÷åì â 19 ðàç (S121), à ðèñê ëåòàëüíîãî èñõîäà áîëåå ÷åì â 2 ðàçà (S80). Äàííûå î âûñîêîé ýôôåêòèâíîñòè âàêöèíû ïðîòèâ äèôòåðèè ïîëó÷åíû è â õîäå èññëåäîâàíèé, ïðîâåäåííûõ â ñòðàíàõ Àìåðèêè è Åâðîïû. Êñòàòè, âåñü ýòîò íîìåð æóðíàëà The Journal of Infectious Diseases, íà êîòîðûé ÿ ññûëàþñü, ïîñâÿùåí ñèòóàöèè ïî äèôòåðèè â ñòðàíàõ áûâøåãî ÑÑÑÐ â ïåðèîä íà÷àëà 1990-õ. Ïîëþáîïûòñòâóéòå. Íà ìîé âçãëÿä, ïðè ðåøåíèè âîïðîñîâ íà ñòîëü âàæíóþ (â ðÿäå ñëó÷àåâ, æèçíåííî âàæíóþ) òåìó îá ýôôåêòèâíîñòè/íåýôôåêòèâíîñòè âàêöèíîïðîôèëàêòèêè íå ñòîèò ïîëàãàòüñÿ ëèøü íà ñâîþ ñîáñòâåííóþ, ïóñòü è âåñüìà ðàçâèòóþ, ñïîñîáíîñòü ê àíàëèçó. Âåäü åñòü âåðîÿòíîñòü òîãî, ÷òî Âû ìîæåòå ÷òî-òî íå ó÷èòûâàòü. Ïîäîáíûé àíàëèç ìîæåò ïðèâåñòè ê ëîæíûì âûâîäàì, êîòîðûå, áóäó÷è ðàñïðîñòðàíÿåìû â èíòåðíåòå, ìîãóò ââåñòè â çàáëóæäåíèå è äðóãèõ ëþäåé è, êàê ñëåäñòâèå, ïðèâåñòè ê óùåðáó äëÿ èõ çäîðîâüÿ è çäîðîâüÿ èõ äåòåé. Ïîýòîìó, íà ìîé âçãëÿä, ïðåæäå ÷åì ïóáëèêîâàòü òàêèå âûâîäû, èõ íàäî íåîäíîêðàòíî ïåðåïðîâåðèòü, à òàêæå ñîîòíåñòè ñ âûâîäàìè, ñäåëàííûìè äðóãèìè èññëåäîâàòåëÿìè, â òîì ÷èñëå ïðîôåññèîíàëüíûìè, ìîæåò áûòü îáñóäèòü Âàøè ðåçóëüòàòû ñ íèìè. Óâèäåâ, ÷òî Âàøè âûâîäû êàðäèíàëüíî ðàñõîäÿòñÿ ñ èõ âûâîäàìè (à òàê îíî è åñòü), ñëåäîâàëî áû î÷åíü òùàòåëüíî âçâåñèòü - ñòîèò ëè èõ ïóáëèêîâàòü. Ðå÷ü èäåò î çäîðîâüå è æèçíè äðóãèõ ëþäåé. Ýòî âñå-òàêè íåñêîëüêî ñåðüåçíåå, ÷åì òóðïîõîäû. |