Effects of Community-Wide Vaccination with PCV-7 on Pneumococcal Nasopharyngeal Carriage in The Gambia A Cluster-Randomized Trial 英文参考文献.docVIP

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Effects of Community-Wide Vaccination with PCV-7 on Pneumococcal Nasopharyngeal Carriage in The Gambia A Cluster-Randomized Trial 英文参考文献.doc

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Effects of Community-Wide Vaccination with PCV-7 on Pneumococcal Nasopharyngeal Carriage in The Gambia A Cluster-Randomized Trial 英文参考文献

EffectsofCommunity-WideVaccinationwithPCV-7on PneumococcalNasopharyngealCarriageinTheGambia: ACluster-RandomizedTrial AnnaRoca1,2*,PhilipC.Hill1,3,JohnTownend1,UzoEgere1,MartinAntonio1,AbdoulieBojang1 ,Abiodun Akisanya1,TeresaLitchfield1,DavidE.Nsekpong1,ClaireOluwalana1,StephenR.C.Howie1 ,Brian Greenwood4,RichardA.Adegbola1,5 1MedicalResearchCouncilUnit,TheGambia,2BarcelonaCenterforInternationalHealthResearch(CRESIB),Institutd’InvestigacionsBiomediquesAugustPiiSunyer, UniversitatdeBarcelona,Barcelona,Spain,3CentreforInternationalHealth,SchoolofMedicine,UniversityofOtago,Dunedin,NewZealand,4FacultyofInfectiousand TropicalDiseases, London SchoolofHygieneTropicalMedicine,London,UnitedKingdom,5BillMelindaGatesFoundation,Seattle,Washington,United Statesof America Abstract Background:Introductionofpneumococcalconjugatevaccines(PCVs)oflimitedvalencyisjustifiedinAfricabythehigh burden of pneumococcal disease. Long-term beneficial effects of PCVs may be countered by serotype replacement. We aimedtodeterminetheimpactofPCV-7vaccinationonpneumococcalcarriageinruralGambia. MethodsandFindings:Acluster-randomized(byvillage)trialoftheimpactofPCV-7onpneumococcalnasopharyngeal carriagewasconductedin21GambianvillagesbetweenDecember2003toJune2008(5,441inhabitantsin2006).Analysis wascomplementedwithdataobtainedbeforevaccination.BecauseefficacyofPCV-9inyoungGambianchildrenhadbeen shown, it was considered unethical not to give PCV-7 to young children in all of the study villages. PCV-7 was given to childrenbelow30moofageandtothosebornduringthetrialinallstudyvillages.Villageswererandomized(olderchildren and adults) to receive one dose of PCV-7 (11 vaccinated villages) or meningococcal serogroup C conjugate vaccine (10 controlvillages).Cross-sectionalsurveys(CSSs)tocollectnasopharyngealswabswereconductedbeforevaccination(2,094 samplesinthebaselineCSS),and4–6,12,and22moaftervaccination(1,168,1,210,and446samplesinCSS-1,-2,and-3, respectively). Atimetrendanalysisshowedamarkedfallin