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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02852-8

摘要内容如下：

霍乱弧菌O1的系统检测很少，这意味着世界上有限的口服霍乱疫苗（OCVs）供应可能无法运送到真正霍乱负担最高的地区。在这里，我们使用了一个具有次国家地理定位和精细规模疫苗效果的现象学模型来模拟扩大霍乱弧菌检测如何影响35个非洲国家不同细菌学确认和疫苗定位假设的预防性疫苗接种活动的影响和成本效益。与针对疑似霍乱的现状情景相比，系统检测后根据确诊霍乱进行OCV靶向产生了更高的效率和成本效益，避免的病例也略少。针对年发病率大于10/10，000的人群接种疫苗，测试情景避免了每1，000名完全接种疫苗的人中有10.8例（95%预测区间（PI）9.4-12.6），而现状情景避免了每1，000名完全接种疫苗的人中有6.9例（95%PI 6.0-7.8）。在检测方案中，与现状相比，每个避免病例的检测成本增加了31美元（95%PI 25-39），而疫苗接种成本减少了248美元（95%PI 176-326）。在霍乱监测中引入系统检测可以提高全球预防性疫苗接种OCV供应的效率和范围。

英文原文如下：

Abstracts

Systematic testing for Vibrio cholerae O1 is rare, which means that the world's limited supply of oral cholera vaccines (OCVs) may not be delivered to areas with the highest true cholera burden. Here we used a phenomenological model with subnational geographic targeting and fine-scale vaccine effects to model how expanding V. cholerae testing affected impact and cost-effectiveness for preventive vaccination campaigns across different bacteriological confirmation and vaccine targeting assumptions in 35 African countries. Systematic testing followed by OCV targeting based on confirmed cholera yielded higher efficiency and cost-effectiveness and slightly fewer averted cases than status quo scenarios targeting suspected cholera. Targeting vaccine to populations with an annual incidence rate greater than 10 per 10,000, the testing scenario averted 10.8 (95% prediction interval (PI) 9.4-12.6) cases per 1,000 fully vaccinated persons while the status quo scenario averted 6.9 (95% PI 6.0-7.8) cases per 1,000 fully vaccinated persons. In the testing scenario, testing costs increased by US$31 (95% PI 25-39) while vaccination costs reduced by US$248 (95% PI 176-326) per averted case compared to the status quo. Introduction of systematic testing into cholera surveillance could improve efficiency and reach of global OCV supply for preventive vaccination.

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