Impact of Rotavirus Vaccine Introduction in Children Less Than 2 Years of Age Presenting for Medical Care With Diarrhea in Rural Matlab, Bangladesh

Abstract

BackgroundFollowing the conclusion of a human rotavirus vaccine (HRV) cluster-randomized, controlled trial (CRT) in Matlab, Bangladesh, HRV was included in Matlab’s routine immunization program. We describe the population-level impact of programmatic rotavirus vaccination in Bangladesh in children <2 years of age.MethodsInterrupted time series were used to estimate the impact of HRV introduction. We used diarrheal surveillance collected between 2000 and 2014 within the 2 service delivery areas (International Centre for Diarrhoeal Disease Research, Bangladesh [icddr,b] service area [ISA] and government service area [GSA]) of the Matlab Health and Demographic Surveillance System, administered by icddr,b. Age group–specific incidence rates were calculated for both rotavirus-positive (RV+) and rotavirus-negative (RV–) diarrhea diagnoses of any severity presenting to the hospital. We used 2 models to assess the impact within each service area: Model 1 used the pre-vaccine time period in all villages (HRV– and control-only) and Model 2 combined the pre-vaccine time period and the CRT time period, using outcomes from control-only villages.ResultsBoth models demonstrated a downward trend in RV+ diarrheal incidences in the ISA villages during 3.5 years of routine HRV use, though only Model 2 was statistically significant. Significant impacts of HRV on RV+ diarrhea incidences in GSA villages were not observed in either model. Differences in population-level impacts between the 2 delivery areas may be due to the varied rotavirus vaccine coverage and presentation rates to the hospital.ConclusionsThis study provides initial evidence of the population-level impact of rotavirus vaccines in children <2 years of age in Matlab, Bangladesh. Further studies are needed of the rotavirus vaccine impact after the nationwide introduction in Bangladesh.

Impact of rotavirus vaccine on admissions due to acute gastroenteritis and rotavirus gastroenteritis in Israel

“…The main finding of this study was a significant reduction in the proportion of hospital admissions due to overall AGE (41% reduction) and, specifically, due to RVGE (43% reduction) after the introduction of the RVV to the vaccination programme in Israel. These findings were similar to data from other surveillance studies of RVGE from other countries 6,7 . Substantial reductions (30%‐40%) in the incidence rates of all‐cause AGE hospitalisations of young children were documented in other studies from Israel following the introduction of RVV into the NIP 6,8‐11 .…”

Occurrence of Diarrhea and Feeding Practices among Children below Two Years of Age in Southwestern Saudi Arabia

“…Variable effects of vaccination on occurrences of diarrhea have been reported in previous literature. For example, a study in Bangladesh reported no significant impact of rotavirus vaccination on incidence of rotavirus-induced diarrhea [36], while another study in Mozambique reported a decrease in rotavirus positivity and diarrhea hospitalizations after the introduction of the vaccine [37]. In this study, most of the children had received rotavirus vaccination as part of the expanded program of immunization in Saudi Arabia.…”

Comparative Analysis of G1P[8] Rotaviruses Identified Prior to Vaccine Implementation in Pakistan With Rotarix™ and RotaTeq™ Vaccine Strains

“…Rotavirus-related gastroenteritis (RVGE) is a significant global health concern contributing to 128,500 deaths among children younger than 5 years worldwide in 2016, as of the most recent data ( 1 ). While the rate of diarrhea-associated mortality has decreased globally over the last decade, the burden of rotavirus diarrhea remains significant in low-income settings ( 2 ). According to estimates from the WHO, approximately half of all rotavirus-associated deaths occurred in India, Nigeria, Pakistan and the Democratic Republic of Congo in 2013 ( 3 ).…”