The Effectiveness ofCoxiella burnetiiVaccines in Occupationally Exposed Populations: A Systematic Review and Meta-Analysis
| Autor: | Tyler J. O’Neill, Zvonimir Poljak, Jan M. Sargeant |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Epidemiology
Population law.invention Randomized controlled trial law Occupational Exposure Environmental health Animals Humans Medicine education education.field_of_study General Veterinary General Immunology and Microbiology biology business.industry Vaccination Public Health Environmental and Occupational Health Coxiella burnetii biology.organism_classification Occupational Diseases Infectious Diseases Systematic review Meta-analysis Bacterial Vaccines Cohort Immunology Observational study Public Health Q Fever business Abattoirs |
| Zdroj: | Zoonoses and Public Health. 61:81-96 |
| ISSN: | 1863-1959 |
| Popis: | Summary To estimate the effect of vaccination in preventing acute Q fever in individuals occupationally exposed to Coxiella burnetii, a systematic review and meta-analysis were undertaken in controlled trials and observational studies. Publications were obtained through a scoping study of English and non-English articles, and those reporting a commercially licensed or licensable vaccine compared with an unvaccinated or placebo control group were included in the review. Two authors performed independent assessment of risk of systematic error and data extraction. One controlled trial and five cohort publications met the inclusion criteria. All trials used a Henzerling phase I vaccine. A random-effects meta-analysis estimated significant protection in abattoir workers (RR = 0.07; 95% confidence interval [CI] 0.02–0.22) compared with the control individuals. In individuals with rare or sporadic contact with the abattoir, a significant benefit of vaccination was also found (RR = 0.06; 95% CI 0–0.93). Overall, the vaccine effectively prevented acute Q fever in individuals responsible for handling animals or their products and those working in the abattoir but not directly exposed to animals (RR = 0.06; 95% CI 0.02–0.18). Caution must be taken when interpreting the effect of C. burnetii vaccination as significant heterogeneity amongst publications was observed. A meta-regression found no significant univariate associations. This may reflect the uncertainty provided by reported data in the cohort publications. Potential systematic biases were present in the publications, and evidence included may not be sufficiently robust to extrapolate the effect of vaccination on occupationally exposed groups beyond the population of abattoir employees in Australia where all included studies occurred. |
| Databáze: | OpenAIRE |
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