Evaluating the health impact of a public-private partnership

Khawaja, Shazia; Cardellino, Anna; Klotz, Diana; Kuter, Barbara J.; Feinberg, Mark B.; Colatrella, Brenda; Mast, T. Christopher

doi:10.4161/hv.19757

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…The effectiveness estimates demonstrated in this analysis and those reported in subsequent studies for Latin American and the Caribbean countries [56–58] are high and similar to the efficacy values previously observed in clinical trials. However, they are somewhat lower than those reported for developed countries, including the United States [59] and Finland [60].…”

Section: Discussionsupporting

confidence: 86%

Efficacy, safety and effectiveness of licensed rotavirus vaccines: a systematic review and meta-analysis for Latin America and the Caribbean

et al. 2017

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Background RotaTeq™ (RV5; Merck & Co. Inc., USA) and Rotarix™ (RV1, GlaxoSmithKline, Belgium) vaccines, developed to prevent rotavirus diarrhea in children under five years old, were both introduced into national immunization programs in 2006. As many countries in Latin America and the Caribbean have included either RV5 or RV1 in their routine childhood vaccination programs, we conducted a systematic review and meta-analysis to analyze efficacy, safety and effectiveness data from the region.MethodsWe conducted a systematic search in PubMed, EMBASE, Scielo, Lilacs and the Cochrane Central Register, for controlled efficacy, safety and effectiveness studies published between January 2000 until December 2011, on RV5 and RV1 across Latin America (where both vaccines are available since 2006). The primary outcome measures were: rotavirus-related gastroenteritis of any severity; rotavirus emergency department visits and hospitalization; and severe adverse events.ResultsThe results of the meta-analysis for efficacy show that RV1 reduced the risk of any-severity rotavirus-related gastroenteritis by 65% (relative risk (RR) 0.35, 95% confidence interval (CI) 0.25; 0.50), and of severe gastroenteritis by 82% (RR 0.18, 95%CI 0.12; 0.26) versus placebo. In trials, both vaccines significantly reduced the risk of hospitalization and emergency visits by 85% (RR 0.15, 95%CI 0.09; 0.25) for RV1 and by 90% (RR 0.099, 95%CI 0.012; 0.77) for RV5. Vaccination with RV5 or RV1 did not increase the risk of death, intussusception, or other severe adverse events which were previously associated with the first licensed rotavirus vaccine. Real-world effectiveness studies showed that both vaccines reduced rotavirus hospitalization in the region by around 45–50% for RV5 (for 1 to 3 doses, respectively), and, by around 50–80% for RV1 (for 1 to 2 doses, respectively). For RV1, effectiveness against hospitalization was highest (around 80–96%) for children vaccinated before 12 months of age, compared with 5–60% effectiveness in older children. Both vaccines were most effective in preventing more severe gastroenteritis (70% for RV5 and 80–90% for RV1) and severe gastroenteritis (50% for RV5 and 70–80% for RV1).ConclusionThis systematic literature review confirms rotavirus vaccination has been proven effective and well tolerated in protecting children in Latin America and the Caribbean.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0771-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

Efficacy, safety and effectiveness of licensed rotavirus vaccines: a systematic review and meta-analysis for Latin America and the Caribbean

et al. 2017

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“…In October 2006, the Nicaraguan Expanded Program of Immunization (EPI) initiated universal RV vaccination with the pentavalent RV vaccine from Merck (RotaTeq), which is orally administrated in a 3-dose regimen to children at 2, 4, and 6 months of age. Vaccine coverage rapidly reached over > 90% in eligible Nicaraguan children [11]. A case control study evaluating RotaTeq in 2007–2008 in Nicaragua showed that vaccination was associated with a lower risk of RVGE in children younger than 2 years [12], but to a lesser extent than observed in clinical trials in Europe and USA [13].…”

Section: Introductionmentioning

confidence: 99%

Predominance of Norovirus and Sapovirus in Nicaragua after Implementation of Universal Rotavirus Vaccination

et al. 2014

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BackgroundDespite significant reduction of rotavirus (RV) infections following implementation of RotaTeq vaccination in Nicaragua, a large burden of patients with diarrhea persists.MethodsWe conducted a community- and hospital-based study of the burden of RV, norovirus (NV) and sapovirus (SV) infections as cause of sporadic acute gastroenteritis (GE) among 330 children ≤ 5 years of age between September 2009 and October 2010 in two major cities of Nicaragua with a RotaTeq coverage rate of 95%.ResultsWe found that NV, SV and RV infections altogether accounted for 45% of cases of GE. Notably, NV was found in 24% (79/330) of the children, followed by SV (17%, 57/330) and RV (8%, 25/330). The detection rate in the hospital setting was 27%, 15% and 14% for NV, SV and RV respectively, whereas in the community setting the detection rate of RV was < 1%. Among each of the investigated viruses one particular genogroup or genotype was dominant; GII.4 (82%) for NV, GI (46%) for SV and G1P[8] (64%) in RV. These variants were also found in higher proportions in the hospital setting compared to the community setting. The GII.4.2006 Minerva strain circulating globally since 2006 was the most common among genotyped NV in this study, with the GII.4-2010 New Orleans emerging in 2010.ConclusionsThis study shows that NV has become the leading viral cause of gastroenteritis at hospital and community settings in Nicaragua after implementation of RV vaccination.

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“…1 Because of the large number of children experiencing severe rotavirus gastroenteritis, the rates of severe gastroenteritis were expected to decline dramatically after the introduction of rotavirus vaccines in 2006. 2 However, despite the nearly 90% coverage of rotavirus vaccines, 3 rates of acute gastroenteritis remain high in Nicaragua. [4][5][6] Norovirus is now the leading cause of medically attended pediatric viral gastroenteritis.…”

Section: Introductionmentioning

confidence: 99%

“…Coverage of the vaccine is high with more than 90% of children receiving at least one dose of the vaccine. 3 This country is tropical and typically has annual peaks of norovirus infections during the beginning of the rainy season (May-August). 5,8 Our objective was to investigate the distribution, clinical features, and risk factors for medically attended norovirus gastroenteritis among children < 5 years of age living in León.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Norovirus Gastroenteritis among Nicaraguan Children

Gruber

Bowman

Becker‐Dreps

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Norovirus is a leading cause of pediatric gastroenteritis. Understanding norovirus epidemiology is essential for reducing disease burden. We conducted a case-control study to describe the distribution, clinical features, and risk factors of norovirus gastroenteritis among children < 5 years of age in León, Nicaragua. Cases were children testing positive for norovirus and controls were children living in the cases' communities. Study staff interviewed mothers of enrolled cases and controls to obtain detailed exposure information including food, water, and sanitation sources; recent exposures; household characteristics; and handwashing practices. In addition, study staff requested stool samples to be tested for norovirus from select household members. We used descriptive statistics to understand the epidemiologic and clinical features of gastroenteritis episodes. To analyze potential risk factors, we used Firth's penalized logistic regression to estimate crude and adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs). There were 102 children with gastroenteritis, 18 cases of norovirus and 31 controls. Norovirus cases occurred later in the year, corresponding to a delay in the rainy season. Cases were more likely to have a household member with norovirus in their stool as compared with controls [crude OR: 13.3 (95% CI: 2.5, 136.2) and adjusted OR: 11.5 (95% CI: 1.6, 223.2)]. In addition, alcohol-based hand sanitizer use among household members was reported for 10 (32%) of controls and but never for cases. Further research is needed to understand household transmission of norovirus in low- and middle-income countries and the potential impact of hand sanitizer use.

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Evaluating the health impact of a public-private partnership

Cited by 6 publications

References 11 publications

Efficacy, safety and effectiveness of licensed rotavirus vaccines: a systematic review and meta-analysis for Latin America and the Caribbean

Efficacy, safety and effectiveness of licensed rotavirus vaccines: a systematic review and meta-analysis for Latin America and the Caribbean

Predominance of Norovirus and Sapovirus in Nicaragua after Implementation of Universal Rotavirus Vaccination

Risk Factors for Norovirus Gastroenteritis among Nicaraguan Children

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