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老年人中四种疫苗可预防疾病的负担

Burden of four vaccine preventable diseases in older adults.

作者信息

Kristensen Maartje, van Lier Alies, Eilers Renske, McDonald Scott A, Opstelten Wim, van der Maas Nicoline, van der Hoek Wim, Kretzschmar Mirjam E, Nielen Mark M, de Melker Hester E

机构信息

Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.

Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, The Netherlands.

出版信息

Vaccine. 2016 Feb 10;34(7):942-9. doi: 10.1016/j.vaccine.2015.12.052. Epub 2016 Jan 3.

Abstract

BACKGROUND

Implementation of additional targeted vaccinations to prevent infectious diseases in the older adults is under discussion in different countries. When considering the added value of such preventive measures, insight into the current disease burden will assist in prioritization. The aim of this study was derive the first estimates of the disease burden in adults aged 50 years or over in the Netherlands for influenza, pertussis, pneumococcal disease and herpes zoster.

METHODS

The average annual disease burden for these four diseases in the Netherlands was calculated for the period 2010-2013 using the disability-adjusted life years (DALY) measure. Disease models and parameters were obtained from previous research. Where possible we adapted these models specifically for older adults and applied age-specific parameters derived from literature. The disease burden based on these adapted models and parameters was compared with the disease burden based on the general population models.

RESULTS

The estimated average annual disease burden was from high to low: pneumococcal disease (37,223 DALYs/year), influenza (7941 DALYs/year), herpes zoster (942 DALYs/year), and pertussis (812 DALYs/year). The adaptation of models and parameters specifically for the elderly resulted in a higher disease burden compared to the use of general population models.

CONCLUSIONS

Among older adults, the disease burden in the period 2010-2013 was highest for pneumococcal disease, mostly because of high mortality, followed by influenza. Disease burden of herpes zoster and pertussis was relatively low and consisted mostly of years lived with disability. Better information on the course of infectious diseases and long-term consequences would enable more accurate estimation of disease burden in older adults.

摘要

背景

不同国家正在讨论实施额外的针对性疫苗接种以预防老年人的传染病。在考虑此类预防措施的附加价值时,了解当前的疾病负担将有助于确定优先次序。本研究的目的是得出荷兰50岁及以上成年人流感、百日咳、肺炎球菌病和带状疱疹疾病负担的首次估计值。

方法

使用伤残调整生命年(DALY)指标计算了2010 - 2013年期间荷兰这四种疾病的年均疾病负担。疾病模型和参数来自先前的研究。我们尽可能针对老年人对这些模型进行了调整,并应用了从文献中得出的特定年龄参数。将基于这些调整后的模型和参数得出的疾病负担与基于一般人群模型的疾病负担进行了比较。

结果

估计的年均疾病负担从高到低依次为:肺炎球菌病(每年37,223个DALY)、流感(每年7941个DALY)、带状疱疹(每年942个DALY)和百日咳(每年812个DALY)。与使用一般人群模型相比,专门针对老年人调整模型和参数导致了更高的疾病负担。

结论

在老年人中,2010 - 2013年期间疾病负担最高的是肺炎球菌病,主要是因为死亡率高,其次是流感。带状疱疹和百日咳的疾病负担相对较低,主要由残疾生存年数构成。关于传染病病程和长期后果的更好信息将能够更准确地估计老年人的疾病负担。

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