A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia

Beres, Laura K.; Tate, Jacqueline E.; Njobvu, Lungowe; Chibwe, Bertha; Rudd, Cheryl; Guffey, M. Brad; Stringer, Jeffrey S. A.; Parashar, Umesh D.; Chilengi, Roma

doi:10.1093/cid/civ1206

Cited by 45 publications

(41 citation statements)

References 15 publications

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“…The design of the original study was described in detail elsewhere [2]. Briefly, children were eligible if they were aged 0-59 months; admitted to the inpatient department or under care in the outpatient department; and caregiver verbal confirmation of child presenting with diarrhoea (defined as the passing of ≥3 abnormally loose stools in the past 24 hrs).…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…Following the World Health Organisation recommendation, several countries have introduced rotavirus vaccines (RVs) into their national immunisation schedules with an observed significant impact on reduction of rotavirus associated morbidity and mortality [1]. Zambia implemented RVs in the national expanded programme on immunisation starting in Lusaka province in 2012 and scaling up to countrywide by end of 2013; becoming the 17 th GAVI eligible country to do so [2]. Over the period, significant reduction in acute gastroenteritis-associated in hospital morbidity and mortality has been recorded with the greatest reduction observed among children aged <1 year [3].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

vAetiology of Diarrhoea in Children Under Five in Zambia Detected Using Luminex xTAG Gastrointestinal Pathogen Panel

Chisenga¹,

Bosomprah²,

Laban³

et al. 2018

Pediatric Infect Dis

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Section: Study Design and Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

vAetiology of Diarrhoea in Children Under Five in Zambia Detected Using Luminex xTAG Gastrointestinal Pathogen Panel

Chisenga¹,

Bosomprah²,

Laban³

et al. 2018

Pediatric Infect Dis

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“…However, there is consistent evidence from clinical trials that RV have lower efficacies in low-and middle-income countries (LMIC): vaccine efficacies are 80 to 90% in high-income countries (HIC) and 40 to 60% in LMIC (3)(4)(5)(6)(7)(8). Indeed, there is growing evidence from vaccine effectiveness studies emerging from the field that in real-life use, vaccine effectiveness is also consistently lower in LMIC (9)(10)(11)(12).…”

mentioning

confidence: 99%

Contribution of Maternal Immunity to Decreased Rotavirus Vaccine Performance in Low- and Middle-Income Countries

Mwila

Chilengi

Simuyandi

et al. 2017

Clin Vaccine Immunol

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The role of maternal immunity, received by infants either transplacentally or orally from breast milk, in rotavirus vaccine (RV) performance is evaluated here. Breastfeeding withholding has no effect on vaccine responses, but higher levels of transplacental rotavirus-specific IgG antibody contribute to reduced vaccine seroconversion. The gaps in knowledge on the factors associated with low RV efficacy in low-and middle-income countries (LMIC) remain, and further research is needed to shed more light on these issues. KEYWORDS immunization, low-and middle-income countries, maternal, rotavirus D espite the progress seen with the global introduction of rotavirus vaccines (RV), diarrhea is still a leading cause of death in children under the age of 5 years, and a substantial proportion of disease cases are still attributable to rotavirus infection. The latest estimates show that approximately 215,000 children die each year from rotavirusassociated diarrhea, and approximately 56% of these deaths are in sub-Saharan Africa (1). The World Health Organization (WHO) recommended the introduction of oral RV into national immunization programs (2), and many countries have heeded this call. As of September 2016, the WHO lists 86 countries as having included RV in their national immunization programs, and 6 more are in the course of doing so in 2016 (www.who.int/immunization/monitoring_surveillance/VaccineIntroStatus.pptx). Approximately 50% of the countries in Africa and Asia, over 80% of those in North America, South America, and Australia, and approximately 40% of those in Europe have introduced RV. Following RV introduction, there was a notable reduction in the number of deaths due to diarrhea (1). However, there is consistent evidence from clinical trials that RV have lower efficacies in low-and middle-income countries (LMIC): vaccine efficacies are 80 to 90% in high-income countries (HIC) and 40 to 60% in LMIC (3-8). Indeed, there is growing evidence from vaccine effectiveness studies emerging from the field that in real-life use, vaccine effectiveness is also consistently lower in LMIC (9-12).In addition to the differences in observed vaccine efficacy and effectiveness, there are also marked differences in vaccine-elicited immunity as reported by various vaccine-elicited antibody titers following rotavirus immunization (13)(14)(15)(16)(17)(18). A number of hypotheses have been put forward to explain the differences in efficacy and vaccineelicited immunity between HIC and LMIC. The hypotheses include (i) maternal factors (such as interference from transplacental antibodies and antibody and nonantibody breast milk components [13,[19][20][21][22][23] [38,39]). A better understanding of these factors which decrease the efficacy of RV in LMIC may help to inform interventions to improve efficacy and to further reduce the number of child deaths due to rotavirus disease. This review examines the correlations between maternal immune factors and RV responses and their potential effect on vaccine efficacy. NATURAL ROTAVIRUS...

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“…Although subsequent trials from low and middle income countries (LMICs) showed much lower efficacy rates between 40 and 60% [7][8][9][10], the public health impact in these high burden settings was still compelling enough to continue the immunization campaigns. Several other vaccines are in the developmental and licensure phase such as Rotavin ™ and RotaVac ™ which have partial or restricted licensure in China, Vietnam and India [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…LMICs researchers are now also beginning to generate more information on vaccine effectiveness in their respective locations that has shown that vaccine responses have continued to be sub-optimal [7][8][9][10][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Effectiveness of Rotavirus Vaccine on Incidence of Diarrhoea among Children: A Meta-analysis

Mwila-Kazimbaya¹,

Bosomprah²,

Simuy³

et al. 2018

Pediatric Infect Dis

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A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia

Abstract: We observed a higher point estimate for VE against increased severity of illness compared with milder disease, but were not powered to detect a low level of VE against milder disease.

Cited by 45 publications

References 15 publications

vAetiology of Diarrhoea in Children Under Five in Zambia Detected Using Luminex xTAG Gastrointestinal Pathogen Panel

vAetiology of Diarrhoea in Children Under Five in Zambia Detected Using Luminex xTAG Gastrointestinal Pathogen Panel

Contribution of Maternal Immunity to Decreased Rotavirus Vaccine Performance in Low- and Middle-Income Countries

Efficacy and Effectiveness of Rotavirus Vaccine on Incidence of Diarrhoea among Children: A Meta-analysis

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