背景:麻疹在巴基斯坦一直是一个重要的公共卫生问题,特别是在开伯尔-普赫图赫瓦省,零星和无声的流行病继续挑战现有的控制措施。本研究旨在评估KPK中麻疹病毒(MeV)的流行情况并调查其分子流行病学,并探讨可疑个体的疫苗接种状况。
方法:在2021年2月至10月之间进行了一项横断面研究。使用酶联免疫吸附测定(ELISA)分析了来自研究人群的336例疑似麻疹病例的IgM抗体。从阳性病例的子集随机收集咽拭子进行分子分析。使用邻居连接方法进行MeV分离株的系统发育分析。还记录了个体的疫苗接种状况。
结果:在可疑参与者中,61.0%(205/336)的IgM抗体ELISA阳性,男性(64.17%)的患病率高于女性(57.04%)。大多数病例(36.0%)在婴儿和幼儿中观察到,与以前的报告一致。大多数IgM阳性病例(71.7%)没有接种任何剂量的麻疹疫苗,强调疫苗覆盖率的差距和改进免疫计划的必要性。遗传分析表明,所有MeV分离株都属于B3基因型,与该地区以前报道的变异有微小的遗传变异。
结论:这项研究为KPK中MeV的遗传流行病学提供了有价值的见解,巴基斯坦。未接种疫苗的人中麻疹感染的高发率凸显了提高对疫苗重要性的认识和加强常规免疫计划的紧迫性。
BACKGROUND: Measles has been a significant public health concern in Pakistan, especially in the Khyber Pakhtunkhwa (KPK) province, where sporadic and silent epidemics continue to challenge existing control measures. This study aimed to estimate the prevalence and investigate the molecular epidemiology of the measles virus (MeV) in KPK and explore the vaccination status among the suspected individuals.
METHODS: A cross-sectional study was conducted between February and October 2021. A total of 336 suspected measles cases from the study population were analyzed for IgM antibodies using Enzyme-Linked Immunosorbent Assay (ELISA). Throat swabs were randomly collected from a subset of positive cases for molecular analysis. Phylogenetic analysis of MeV isolates was performed using the neighbor-joining method. The vaccination status of individuals was also recorded.
RESULTS: Among the suspected participants, 61.0% (205/336) were ELISA positive for IgM antibodies, with a higher prevalence in males (64.17%) compared to females (57.04%). The majority of cases (36.0%) were observed in infants and toddlers, consistent with previous reports. The majority of IgM-positive cases (71.7%) had not received any dose of measles vaccine, highlighting gaps in vaccine coverage and the need for improved immunization programs. Genetic analysis revealed that all MeV isolates belonged to the B3 genotype, with minor genetic variations from previously reported variants in the region.
CONCLUSIONS: This study provides valuable insights into the genetic epidemiology of the MeV in KPK, Pakistan. The high incidence of measles infection among unvaccinated individuals highlights the urgency of raising awareness about vaccine importance and strengthening routine immunization programs.