论文标题
使用社交接触数据来改善塞内加尔集群随机流感疫苗计划的总体效果估计值
Using social contact data to improve the overall effect estimate of a cluster-randomized influenza vaccination program in Senegal
论文作者
论文摘要
这项研究估计了两种流感疫苗接种计划在2009 - 2011年的两个流感季节中，在塞内加尔西部的一项集群随机试验中连续管理的两个流感疫苗接种计划的总体效果。我们采用将社会接触数据与感染数据结合在一起的尖端方法，以减少簇之间污染引起的估计偏差。我们的时变估计表明，干预措施减少了季节性流感，而H1N1大流行性流感的增加了。我们估计在研究第一年（95％CI：-2.53，1.18）中，总累积发生率（对照组为6.13％）的累加变化为-0.68个百分点。当H1N1大流行感染被排除在分析之外时，估计的变化为-1.45个百分点，并且显着（95％CI，-2.81，-0.08）。由于跨群集污染较低（大多数村庄的接触率为0-3％），因此假设没有污染的估计量仅略有减弱（-0.65个百分点）。对于精心设计的研究以最大程度地减少溢出量，这些发现令人鼓舞。在各种环境中，需要进一步的工作来估计污染及其对估计的影响。
This study estimates the overall effect of two influenza vaccination programs consecutively administered in a cluster-randomized trial in western Senegal over the course of two influenza seasons from 2009-2011. We apply cutting-edge methodology combining social contact data with infection data to reduce bias in estimation arising from contamination between clusters. Our time-varying estimates reveal a reduction in seasonal influenza from the intervention and a nonsignificant increase in H1N1 pandemic influenza. We estimate an additive change in overall cumulative incidence (which was 6.13% in the control arm) of -0.68 percentage points during Year 1 of the study (95% CI: -2.53, 1.18). When H1N1 pandemic infections were excluded from analysis, the estimated change was -1.45 percentage points and was significant (95% CI, -2.81, -0.08). Because cross-cluster contamination was low (0-3% of contacts for most villages), an estimator assuming no contamination was only slightly attenuated (-0.65 percentage points). These findings are encouraging for studies carefully designed to minimize spillover. Further work is needed to estimate contamination, and its effect on estimation, in a variety of settings.
