Lancet：免疫接种可减少麻疹致死病例

4月24日，世界卫生组织与美国疾病控制和预防中心、联合国儿童基金会联合宣布一项旨在消除麻疹致死病例以及先天性风疹的全球计划。

最新一期英国《柳叶刀》（Lancet）杂志刊登报告称，免疫接种可减少麻疹致死病例。该研究显示，随着免疫接种的不断推广，全球因麻疹致死的人数从2000年的约53.53万下降到了2010年的13.93万，减少了74%。

这一全球计划希望通过五大措施实现以下目标：2015年将全球麻疹致死病例在2000年基础上减少至少95%，到2020年在世卫组织至少5个大区彻底消除麻疹和风疹病例。

具体措施包括提高免疫接种覆盖率，通过实验室支持的监控手段监测疾病传播，加强疾病暴发准备和应对措施，提高知识普及和社区参与度以及进一步加强医学研究等。

这项全球计划还鼓励62个目前没有进行风疹疫苗注射的国家利用它们的麻疹接种系统，将风疹免疫接种也纳入其国家免疫计划，通过一针联合疫苗就可以使个人和家庭同时免受两种疾病的威胁。

doi:10.1016/S0140-6736(12)60522-4
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Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data

Emily Simons MPH, Matthew Ferrari PhD , John Fricks PhD, Kathleen Wannemuehler PhD, Abhijeet Anand MBBS , Anthony Burton BS, Dr Peter Strebel MBChB

Background

In 2008 all WHO member states endorsed a target of 90% reduction in measles mortality by 2010 over 2000 levels. We developed a model to estimate progress made towards this goal.

Methods

We constructed a state-space model with population and immunisation coverage estimates and reported surveillance data to estimate annual national measles cases, distributed across age classes. We estimated deaths by applying age-specific and country-specific case-fatality ratios to estimated cases in each age-country class.

Findings

Estimated global measles mortality decreased 74% from 535 300 deaths (95% CI 347 200—976 400) in 2000 to 139 300 (71 200—447 800) in 2010. Measles mortality was reduced by more than three-quarters in all WHO regions except the WHO southeast Asia region. India accounted for 47% of estimated measles mortality in 2010, and the WHO African region accounted for 36%.

Interpretation

Despite rapid progress in measles control from 2000 to 2007, delayed implementation of accelerated disease control in India and continued outbreaks in Africa stalled momentum towards the 2010 global measles mortality reduction goal. Intensified control measures and renewed political and financial commitment are needed to achieve mortality reduction targets and lay the foundation for future global eradication of measles.

Funding

US Centers for Disease Control and Prevention (PMS 5U66/IP000161).