Peb suav nrog kev txhaj tshuaj tiv thaiv. Ntu 6. Tsis muaj tshuaj tiv thaiv

2024 Tus sau: Seth Attwood | [email protected]. Kawg hloov kho: 2023-12-16 16:06

1. Tsis yog CDC (Tebchaws Meskas Lub Chaw Tiv Thaiv thiab Tiv Thaiv Kab Mob), lossis FDA (Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Tib Neeg ntawm Tebchaws Meskas), thiab ntau dua, cov tuam txhab tshuaj tsis ua cov kev tshawb fawb piv rau cov menyuam yaus uas tau txhaj tshuaj thiab tsis tau txhaj tshuaj. Ntawm no, tus thawj coj ntawm CDC, tom qab raug thawb tawm ntawm phab ntsa, lees paub qhov tseeb no hauv Congressional lub rooj sib hais (20 vib nas this). (full version)

2. Txawm li cas los xij, muaj qee qhov kev tshawb fawb sib piv cov tshuaj tiv thaiv thiab tsis muaj tshuaj tiv thaiv. Cov kev tshawb fawb no me me, lawv txhua tus muaj qhov tsis zoo, tab sis tsis muaj dab tsi zoo dua tam sim no. Tsuas yog cov kev tshawb fawb sib piv cov tshuaj tiv thaiv thiab cov tsis muaj tshuaj tiv thaiv tuaj yeem muab cov duab txaus ntawm cov txiaj ntsig thiab kev puas tsuaj ntawm kev txhaj tshuaj, thiab yog li ntawd, rau tag nrho lawv qhov tsis zoo, cov no yog cov kev tshawb fawb tseem ceeb tshaj plaws ntawm txhua tus.

3. Pilot kev sib piv txoj kev tshawb fawb txog kev noj qab haus huv ntawm cov tshuaj tiv thaiv thiab tsis tau txhaj tshuaj tiv thaiv kab mob 6- txog 12 xyoo hauv Teb Chaws Asmeskas. menyuam. (Mawson, 2017, JTS)

Txoj kev tshawb no piv cov menyuam kawm ntawv hauv tsev hauv 4 lub xeev hauv Tebchaws Meskas. 405 tau txhaj tshuaj thiab 261 tsis tau txhaj tshuaj.

Cov tshuaj tiv thaiv yog 4 zaug tsis tshua muaj kab mob khaub thuas, 3 zaug tsawg dua los ntawm hnoos hawb pob, thiab 10 zaug tsawg dua los ntawm rubella. Los ntawm qhov peb tuaj yeem txiav txim siab tias qhov ua tau zoo ntawm kev txhaj tshuaj tiv thaiv yog me ntsis exaggerated. Tab sis dab tsi yog tus nqi rau qhov ntawd?

Cov tshuaj tiv thaiv tau 4 npaug ntau dua yuav muaj otitis media, thiab 6 zaug ntxiv los ntawm kev mob ntsws.

Cov tshuaj tiv thaiv muaj 30 npaug ntau dua cov kab mob rhinitis, 4 zaug ua xua ntau dua, 4 zaug ntxiv autism, 4 zaug ntau ADHD, 3 zaug ntau dua eczema, 5 npaug ntau dua kev kawm tsis taus, 4 npaug ntau dua neurological ntshawv siab, thiab lawv muaj 2.5 npaug ntau dua. txhua yam mob ntev.

Cov tshuaj tiv thaiv yog 21 npaug ntau dua yuav siv tshuaj rau kev ua xua, 4.5 npaug ntau dua - tshuaj tua kab mob, 8 zaug ntau dua siv cov pob ntseg pob ntseg, 3 zaug ntau dua mus rau kws kho mob vim muaj mob, thiab tau mus pw hauv tsev kho mob 1.8 zaug ntau zaus.

Kuj tseem muaj cov txiaj ntsig zoo los ntawm qhov ntawd: kev pheej hmoo ntawm cov kab mob hauv lub paj hlwb nce 2.3 npaug los ntawm kev siv tshuaj tua kab mob thaum cev xeeb tub, 2.5 npaug ntawm cov tshuaj thaum cev xeeb tub, ntxov ntxov nce 5 zaug, ultrasound los ntawm 1.7 zaug, thiab ultrasound ntau dua 3 zaug. thaum cev xeeb tub 3.2 npaug.

Tus naj npawb ntawm cov kab mob neurological nyob rau hauv cov tshuaj tiv thaiv (14.4%) coincides nrog CDC cov kev tshawb fawb (15%). Tus lej ntawm kev xiam oob qhab kev kawm kuj tshwm sim (5.6% ntawm cov tshuaj tiv thaiv hauv qhov kev tshawb fawb no, thiab 5% raws li kev txheeb cais muaj).

Txawm li cas los xij, kev txiav txim los ntawm qhov kev tshawb fawb no ntawm cov kws kho mob, 3.3% ntawm cov tshuaj tiv thaiv twb tau txhaj tshuaj lawm, piv txwv li. 1 ntawm 30 tus menyuam. Tab sis tej zaum qhov no yog ib qho overestimation, vim nws zoo li cov neeg autistic tseem nyob hauv tsev ntau dua. (Raws li CDC, autism yog 2.24%, piv txwv li 1 ntawm 45 xyoo 2015).

4. Kev Taw Qhia Txog Kab Mob Diphtheria-Tetanus-Pertussis thiab Tshuaj Tiv Thaiv Kab Mob Hauv Qhov Ncauj Ntawm Cov Menyuam Yaus hauv Ib Lub Nroog African Zej Zog: Kev Sim Ua Ntuj. (Mogensen, 2017, EBioMedicine)

Vim qhov tseeb tias hauv Guinea-Bissau, cov menyuam yaus tau txhaj tshuaj txhua txhua peb lub hlis, nws tau dhau los ua ib qho kev sim ntawm ntuj. Qee tus me nyuam twb tau txhaj tshuaj tiv thaiv thaum 3-5 lub hlis, thiab qee qhov tsis tau.

Qhov kev pheej hmoo ntawm kev tuag ntawm cov menyuam yaus uas tau txhaj tshuaj tiv thaiv kab mob diphtheria / tetanus / pertussis (DTP) yog 10 npaug ntau dua li cov menyuam tsis tau txhaj tshuaj. Cov menyuam yaus uas tau txhaj tshuaj tiv thaiv kab mob polio (OPV) tsuas yog 5 npaug ntau dua li cov uas tsis tau txhaj tshuaj.

Tom qab txhaj tshuaj tiv thaiv, tus menyuam mos tuag saum 3 lub hlis ntawm hnub nyoog tau nce ob npaug.

Cov kws tshawb fawb tau txiav txim siab tias cov tshuaj tiv thaiv kab mob diphtheria / tetanus / pertussis tua cov menyuam yaus ntau dua li nws cawm.

Nws yog ib qho nyuaj rau xav tias cov kws sau ntawv ntawm kev txhaj tshuaj tiv thaiv. Peter Aaby, ib tus kws sau ntawv ntawm txoj kev tshawb no, tsim Bandim Health Project hauv Guinea-Bissau, yog ib lub hom phiaj tseem ceeb ntawm kev txhaj tshuaj tiv thaiv menyuam yaus.

5. Puas yog kev txhaj tshuaj tiv thaiv menyuam mos yog qhov muaj feem cuam tshuam rau menyuam yaus mob hawb pob lossis ua xua? (Kemp, 1997, Epidemiology)

New Zealand, 23 tsis tau txhaj tshuaj tiv thaiv (los ntawm DTP thiab polio) tawm ntawm 1265 10 xyoo. Ntawm cov kws txhaj tshuaj, 23% muaj mob hawb pob, 22% tau sab laj txog kev mob hawb pob, thiab 30% muaj kev ua xua.

Ntawm cov tsis txhaj tshuaj tiv thaiv tsis muaj ib kis mob hawb pob, tsis muaj kev sab laj txog kev mob ntsws asthma, tsis muaj kev ua xua.

6. Kev Tshawb Fawb Txog Pej Xeem Raws Li Kev Tshawb Fawb Txog Kev Txhaum Cai Hauv 8 Lub Koom Haum Saib Xyuas Kev Tswj Xyuas Hauv Tebchaws Meskas (Glanz, 2013, JAMA Pediatr.)

Txoj kev tshawb no piv cov tshuaj tiv thaiv thiab tsis muaj tshuaj tiv thaiv hauv Tebchaws Meskas. Cov menyuam yaus uas tsis tau txhaj tshuaj yog cov menyuam yaus uas tsis tau txais tsawg kawg ib qho tshuaj tiv thaiv, lossis tau txais tsawg kawg ib qho tshuaj tiv thaiv txawm tias ib hnub tom qab hnub kawg.

Cov uas tau txhaj tshuaj tiv thaiv tsis zoo ntawm lawv niam lawv txiv tau siv 9% tsawg dua kev saib xyuas xwm txheej ceev, 5% tsawg dua mus ntsib kws kho mob, thiab 11% tsawg dua tus mob pharyngitis thiab ARVI.

Kuv zoo siab tias cov neeg tsis tau txhaj tshuaj tiv thaiv tau nce zuj zus (los ntawm 42% hauv 2004 txog 54% hauv 2008).

7. Kev cuam tshuam ntawm cov tshuaj tiv thaiv menyuam yaus rau kev loj hlob ntawm amygdala thiab opioid ligand khi hauv cov menyuam mos rhesus macaque: Kev tshawb nrhiav. (Hewitson, 2010, Acta Neurobiol Exp (Wars).)

Cov macaques tau txhaj tshuaj tiv thaiv li menyuam yaus raws li 1999 US lub sijhawm txhaj tshuaj tiv thaiv thiab piv rau cov liab uas tsis tau txhaj tshuaj.

Cov tshuaj tiv thaiv muaj lub hlwb loj dua (qhov no tau pom hauv cov kws kho mob).

Lub amygdala (tej thaj tsam ntawm lub hlwb lub luag haujlwm rau kev xav) yog qhov loj dua hauv cov tshuaj tiv thaiv ntau dua li qhov tsis tau txhaj tshuaj. (Qhov no kuj pom nyob rau hauv cov neeg autistic.)

8. Cov menyuam mos tuag cov nqi rov qab los ntawm cov koob tshuaj tiv thaiv ib txwm muab: Puas muaj tshuaj lom neeg lossis cov tshuaj lom neeg sib xyaw ua ke? (Miller, 2011, Hum Exp Toxicol.)

Cov kws sau ntawv piv cov menyuam mos tuag hauv 30 lub teb chaws thiab cov naj npawb ntawm cov tshuaj tiv thaiv hauv cov hnub nyoog txog 12 lub hlis. Ib txoj kev sib raug zoo yog tau ntawm lawv.

Kev txhaj tshuaj ntau dua, qhov kev tuag ntawm tus menyuam mos ntau dua.

9. Cov menyuam yaus uas tsis tau txhaj tshuaj tiv thaiv zoo dua.

Kev xaiv tsa hauv New Zealand. 226 tus menyuam tau txhaj tshuaj tiv thaiv thiab 269 tsis tau txhaj tshuaj.

Cov tshuaj tiv thaiv kab mob hawb pob 5 zaug ntau zaus, angina 10 zaug ntau zaus, eczema 2 zaug ntau zaus, apnea 4 zaug ntau zaus, hyperactivity 4 zaug ntau zaus, otitis 4 zaug ntau zaus, thiab lawv muaj lub pob ntseg tso dej tso 8 zaug ntxiv. feem ntau.

Hauv 5% ntawm cov tshuaj tiv thaiv, tonsils raug tshem tawm. Ntawm cov tsis tau txhaj tshuaj, tsis muaj kev tshem tawm ntawm migdalin.

1.7% ntawm cov neeg txhaj tshuaj tiv thaiv kab mob vwm. Tsis muaj ib tus neeg mob qaug dab peg ntawm cov tsis tau txhaj tshuaj.

10. Kev txhaj tshuaj tiv thaiv kab mob thiab ua xua: Kev Tshawb Fawb Txog Kev yug me nyuam. (McKeever, 2004, Am J Public Health)

Kawm txog 30 txhiab tus menyuam los ntawm UK.

Cov txhaj tshuaj tiv thaiv kab mob diphtheria / tetanus / hnoos hawb pob / polio muaj 14 npaug ntau dua yuav muaj mob hawb pob thiab 9 zaug ntau dua yuav muaj eczema.

Cov tshuaj tiv thaiv kab mob qhua pias / mumps / rubella yog 3.5 npaug ntau dua yuav muaj mob hawb pob, thiab 4.5 npaug ntau dua yuav muaj eczema.

Cov lej zoo li hais rau lawv tus kheej, puas yog? Tab sis cov kws sau ntawv tsis haum rau cov lej no, lawv xav tau kev txhaj tshuaj tiv thaiv. Yog li ntawd lawv ua ob feints nrog lawv pob ntseg.

Thaum xub thawj, lawv pom tias cov tsis tau txhaj tshuaj mus rau tus kws kho mob tsawg dua. Qhov no, hauv lawv txoj kev xav, tsis tau txhais hais tias cov neeg tsis tau txhaj tshuaj tiv thaiv mob tsawg dua, tab sis hais tias lawv txoj kev kuaj mob tsawg dua li cov tshuaj tiv thaiv! Yog li ntawd lawv hloov kho. Tab sis qhov no tsis txaus.

Lawv mus ntxiv, thiab rau qee qhov laj thawj faib tag nrho cov menyuam yaus ua 4 pawg hnub nyoog, thiab tom qab ntawd txheeb xyuas txhua pab pawg sib cais. Thiab, saib thiab saib seb, qhov tseem ceeb ntawm kev txheeb cais ploj mus! Zoo, tsis yog nyob rau hauv txhua pab pawg, ntawm chav kawm, nyob rau hauv cov pab pawg neeg ntawm cov menyuam yaus hnub nyoog qis dua 6 xyoo, cov tshuaj tiv thaiv tseem raug kev txom nyem los ntawm mob hawb pob thiab eczema 10-15 zaug ntau dua li cov tsis tau txhaj tshuaj. Tab sis nyob rau hauv cov menyuam yaus, qhov tseem ceeb ntawm cov hnub nyoog hauv qee pawg (tab sis tsis yog tag nrho) tau ploj mus, txawm hais tias ntawm lawv cov tshuaj tiv thaiv tau mob ntau dua.

Cov kws sau ntawv xaus lus hauv lub siab zoo tias kev txhaj tshuaj tiv thaiv tsis ua rau muaj kev pheej hmoo mob hawb pob thiab eczema.

Cov kws kho mob uas tau nyeem tsuas yog paub daws teeb meem (uas yog, hais txog txhua yam, vim tias tsawg tus neeg nyeem cov ntawv no tag nrho), kawm tsuas yog qhov xaus, thiab nrog lub siab mos siab muag lawv mus txhaj tshuaj tiv thaiv menyuam yaus.

Pob ntseg tricks zoo li no muaj ntau heev nyob rau hauv cov kev tshawb fawb supposedly ua pov thawj kev nyab xeeb ntawm kev txhaj tshuaj.

Kev sib xyaw ntawm cov tshuaj tiv thaiv:

11. Cov txheeb ze sib txawv hauv kev mus pw hauv tsev kho mob thiab kev tuag ntawm cov me nyuam mos los ntawm tus naj npawb ntawm cov tshuaj tiv thaiv thiab hnub nyoog, raws li Vaccine Adverse Event Reporting System (VAERS), 1990-2010. (Goldman, 2012, Hum Exp Toxicol.)

Qhov txhaj tshuaj tiv thaiv ntau dua nyob rau ib zaug, qhov kev pheej hmoo ntawm kev mus pw hauv tsev kho mob thiab tuag ntau dua. Qhov kev tuag ntawm cov neeg uas tau txais 5-8 koob tshuaj tiv thaiv yog 1.5 npaug ntau dua li ntawm cov neeg tau txhaj tshuaj 1-4.

12. DTP nrog lossis tom qab txhaj tshuaj tiv thaiv kab mob qhua pias yog txuam nrog kev tuag hauv tsev kho mob hauv Guinea-Bissau. (Aaby, 2007, Vaccine)

Cov menyuam yaus hauv Guinea-Bissau uas tau txais cov tshuaj tiv thaiv kab mob diphtheria / tetanus / pertussis nrog rau cov tshuaj tiv thaiv qhua pias tau tuag ob zaug ntau npaum li cov neeg tau txais cov tshuaj tiv thaiv qhua pias ib leeg.

Cov kws sau ntawv hais txog ntau yam kev tshawb fawb nrog cov txiaj ntsig zoo sib xws hauv Gambia, Malawi, Congo, Ghana thiab Senegal.

UPD:

13. Kev siv tshuaj tiv thaiv kab mob qhua pias thiab kab mob daj daj thiab cov tshuaj tiv thaiv kab mob pentavalent inactivated yog txuam nrog kev tuag ntau dua piv rau cov tshuaj tiv thaiv kab mob qhua pias thiab daj daj xwb. Kev tshawb fawb soj ntsuam los ntawm Guinea-Bissau (Fisker, 2014, Vaccine)

Cov menyuam yaus uas tau txais cov tshuaj tiv thaiv pentavalent (diphtheria / tetanus / pertussis / Hib / hepatitis B) ntxiv rau cov tshuaj tiv thaiv kab mob qhua pias thiab daj daj tuag 7.7 npaug ntau dua li cov menyuam yaus uas tsis tau txais cov tshuaj tiv thaiv pentavalent.

Hauv zaj lus qhuab qhia no, Susan Humphries piav qhia vim li cas kev sib xyaw tshuaj tiv thaiv nyob thiab tuag muaj qhov cuam tshuam zoo li no.

14. Kev cuam tshuam ntawm diphtheria-tetanus-pertussis lossis txhaj tshuaj tiv thaiv kab mob tetanus rau kev ua xua thiab ua xua cuam tshuam txog kev ua pa ntawm cov menyuam yaus thiab cov tub ntxhais hluas hauv Tebchaws Meskas. (Hurwitz, 2000, J Manipulative Physiol Ther.)

Cov tshuaj tiv thaiv kab mob tetanus lossis DTP tshuaj tiv thaiv yog ob zaug yuav muaj mob hawb pob, 63% kev ua xua ntxiv, thiab 81% ntau dua sinusitis.

15. Cov nyhuv ntawm DPT thiab BCG txhaj tshuaj tiv thaiv kab mob atopic (Yoneyama, 2000, Arerugi)

Ntawm cov tshuaj tiv thaiv DTP, 56% muaj mob hawb pob, mob rhinitis lossis dermatitis. Ntawm cov tsis tau txhaj tshuaj, 9% tau mob.