Impact of Rotavirus Vaccine on Childhood Diarrheal Hospitalization After Introduction Into the South African Public Immunization Program

Msimang, Veerle; Page, Nicola; Groome, Michelle; Moyes, Jocelyn; Cortese, Margaret M.; Seheri, Mapaseka; Kahn, Kathleen; Chagan, Meera; Madhi, Shabir А.; Cohen, Cheryl

doi:10.1097/inf.0b013e3182a72fc0

Cited by 71 publications

(56 citation statements)

References 27 publications

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“…First, declines were concentrated during the rotavirus season months, with the great majority of annual reductions occurring in May through October, as has been described in other settings after introduction of rotavirus vaccination [13][14][15]22]. Second, declines in deaths and hospitalizations were most pronounced among infants, which correlated with the higher burden of severe rotavirus in this age group [20], as well as with the higher vaccine coverage among infants during the study period.…”

Section: Discussionmentioning

confidence: 60%

Impact of Rotavirus Vaccination on Hospitalizations and Deaths From Childhood Gastroenteritis in Botswana

et al. 2016

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Background. A monovalent human rotavirus vaccine (RV1) was introduced in Botswana in July 2012. We assessed the impact of RV1 vaccination on childhood gastroenteritis-related hospitalizations and deaths in 2013 and 2014.Methods. We obtained data from registers of 4 hospitals in Botswana on hospitalizations and deaths from gastroenteritis, regardless of cause, among children <5 years of age. Gastroenteritis hospitalizations and deaths during the prevaccine period (January 2009-December 2012) were compared to the postvaccine period (January 2013-December 2014). Vaccine coverage was estimated from data collected through a concurrent vaccine effectiveness study at the same hospitals.Results. By December 2014, coverage with ≥1 dose of RV1 was an estimated 90% among infants <1 year of age and 76% among children 12-23 months of age. In the prevaccine period, the annual median number of gastroenteritis-related hospitalizations in children <5 years of age was 1212, and of gastroenteritis-related deaths in children <2 years of age was 77. In the postvaccine period, gastroenteritis-related hospitalizations decreased by 23% (95% confidence interval [CI], 16%-29%) to 937, and gastroenteritis-related deaths decreased by 22% (95% CI, −9% to 44%) to 60. Declines were most prominent during the rotavirus season (May-October) and among infants <1 year of age, with reductions of 43% (95% CI, 34%-51%) in gastroenteritis hospitalizations and 48% (95% CI, 11%-69%) in gastroenteritis deaths.Conclusions. Following introduction of RV1 into the national immunization program, significant declines in hospitalizations and deaths from gastroenteritis were observed among children in Botswana, suggestive of the beneficial public health impact of rotavirus vaccination.

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Section: Discussionmentioning

confidence: 60%

Impact of Rotavirus Vaccination on Hospitalizations and Deaths From Childhood Gastroenteritis in Botswana

et al. 2016

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“…[25] Subsequent studies of the public health impact of these vaccines have shown a beneficial effect. [25][26][27] These data demonstrate a similar trend in the incidence and mortality of severe diarrhoea and pneumonia in under-5 children, which coincides with the introduction of new vaccines and may be due to an actual decline in population incidence and reduced severity of disease. However, other contributing factors, such as improvements in access to and treatment at lower levels of care, and improvements in access to …”

Section: Researchmentioning

confidence: 56%

Trends in admissions, morbidity and outcomes at Red Cross War Memorial Children’s Hospital, Cape Town, 2004 - 2013

2017

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Background. Routinely collected patient information has the potential to yield valuable information about health systems and population health, but there have been few comprehensive analyses of paediatric admissions at South African (SA) hospitals. Objectives. To investigate trends in hospitalisation and outcomes at Red Cross War Memorial Children's Hospital (RCWMCH), a major referral hospital for children in the Western Cape and SA. Results. There were 215 536 admissions over 10 years of 129 733 patients. Admissions increased by 9.3%, with increases in the general medical wards (5%), medical specialty wards (74%), the burns unit (73%), and the intensive care unit (16%). In contrast, admissions decreased in the trauma unit (21%) and short-stay medical wards (1%). In-hospital mortality decreased by 54% (p-trend <0.001) over 10 years. Diarrhoea and lower-respiratory tract illness were the most common causes for medical admissions, although admissions and deaths due to these conditions decreased between 2008 and 2013, which coincided with the national introduction of related vaccines. Similarly, tuberculosis admissions and deaths decreased over this period. These trends could be owing to a concurrent decrease in HIV comorbidity (p-trend <0.001). Trauma was the most common reason for surgical admission. Conclusion. Paediatric in-hospital mortality decreased consistently over a decade, despite an overall increase in admissions. Pneumonia and diarrhoea admissions decreased markedly over a 6-year period, but remain the most important causes of hospitalisation.

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“…Some countries have included this vaccine in the national vaccination program and achieved very good vaccination coverage in infants. In those countries, rotavirus incidence and hospitalization rates for rotavirus gastroenteritis have decreased significantly (Buttery et al, 2011;Dennehy, 2012;Msimang et al, 2013;Payne et al, 2013;Standaert et al, 2013;Vesikari et al, 2013). The effectiveness of the two rotavirus vaccines was confirmed in large prelicensure clinical trials and they showed good protection for the most common rotavirus genotypes (Ruiz-Palacios et al, 2006;Vesikari et al, 2006).…”

Section: Introductionmentioning

confidence: 87%

Molecular characterization of rotavirus strains from pre- and post-vaccination periods in a country with low vaccination coverage: The case of Slovenia

Steyer

Sagadin

Kolenc

et al. 2014

Infection, Genetics and Evolution

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Rotavirus vaccination started in Slovenia in 2007 on a voluntarily basis. The vaccination rate is relatively low (up to 27%) and no increasing trend is observed. We present rotavirus genotype distribution among children hospitalized for rotavirus gastroenteritis in Slovenia. Eight consecutive rotavirus seasons were followed, from 2005/06 to 2012/13, and 113 strains of the most common rotavirus genotypes were randomly selected for molecular characterization of rotavirus VP7 and VP4 (VP8(∗)) genome segments. During the vaccine introduction period, from 2007 to 2013, rotavirus genotype prevalences changed, with G1P[8] decreasing from 74.1% to 8.7% between 2007/08 and 2010/11 seasons, replaced by G4P[8] and G2P[4], with up to 52.0% prevalence. Comparable analysis of VP7 and VP8(∗) genome fragments within G1P[8] genotype lineages revealed considerable differences for rotavirus strains circulating before and during the vaccination period. The G1P[8] rotavirus strains from the pre-vaccination period clustered in a phylogenetic tree within Rotarix®-like VP7 and VP8(∗) lineages. However, since 2007, the majority of G1P[8] strains have shifted to distant genetic lineages with lower nucleotide (88.1-94.0% for VP7 and 86.6-91.1% for VP8(∗)) and amino acid (93.8-95.2% for VP7 and 85.3-94.6% for VP8(∗)) identities to the vaccine Rotarix® strain. This change also resulted in a different deduced amino acid profile at the major VP7 and VP8(∗) antigenic epitopes.

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Impact of Rotavirus Vaccine on Childhood Diarrheal Hospitalization After Introduction Into the South African Public Immunization Program

Abstract: Using published estimates of rotavirus hospitalization burden, we estimate that at least 13,000 to 20,000 hospitalizations in children <2 years were prevented in the 2 years after rotavirus vaccine introduction.

Cited by 71 publications

References 27 publications

Impact of Rotavirus Vaccination on Hospitalizations and Deaths From Childhood Gastroenteritis in Botswana

Impact of Rotavirus Vaccination on Hospitalizations and Deaths From Childhood Gastroenteritis in Botswana

Trends in admissions, morbidity and outcomes at Red Cross War Memorial Children’s Hospital, Cape Town, 2004 - 2013

Molecular characterization of rotavirus strains from pre- and post-vaccination periods in a country with low vaccination coverage: The case of Slovenia

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