Impact of rotavirus vaccine on diarrheal hospitalization and outpatient consultations in the Philippines: First evidence from a middle-income Asian country

Lopez, Anna Lena; Raguindin, Peter Francis; Esparagoza, Joel; Fox, Kimberley; Nyambat, Batmunkh; Bonifacio, Joseph; Parashar, Umesh D.; Tate, Jacqueline E.; Ducusin, Maria Joyce

doi:10.1016/j.vaccine.2018.04.058

Cited by 8 publications

(9 citation statements)

References 12 publications

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“…Further, we found that the monovalent RVV is effective against RV diarrhea in the Philippines, a lower middle income country in Asia. This supports our earlier findings of the substantial decline of RV diarrheal diseases in Agusan del Sur, where RVV was introduced 10 . Although lower VE was identified in older children in our study and may suggest waning effectiveness, it is also possible that unvaccinated children acquire infection earlier and are no longer susceptible to clinically significant infection because of natural acquired immunity 11 .…”

Section: Discussionsupporting

confidence: 92%

“…Few deaths were identified in the study; all occurred among RV negative cases. A previous records review that we conducted was unable to quantify diarrheal deaths due to limitations in civil registration in the area where the study was conducted 10 . Lastly, observational studies are subject to limitations primarily due to the non-random allocation of vaccines resulting in possible differences in the health-care seeking behavior of the cases from the controls 15 .…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of monovalent rotavirus vaccine in the Philippines

Lopez

Daag

Esparagoza³

et al. 2018

Sci Rep

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Rotavirus (RV) is an important cause of diarrheal disease particularly in children aged under 5 years. Monovalent RV vaccine (RVV) was selectively introduced in 2012 in the Philippines and in July 2014 was introduced in the public health program of a province. Two RVV doses are recommended at 6 and 10 weeks of age. We conducted a test negative case-control evaluation to assess the effectiveness of RVV when given in a routine public health program in the Philippines. From September 2014 to August 2017, 967 children aged <5 years were hospitalized with diarrhea and of these, we enrolled 600 who were eligible to have received RVV and provided stool specimens for testing. Among children ≥8 months of age who were age-eligible to have received RVV, at least one dose of RVV had an adjusted vaccine effectiveness (VE) against RV hospitalization of 60% (95% confidence interval, CI: 24%, 79%), and against severe rotavirus diarrhea, VE was 64% (95% CI: 11%, 85%). These findings support the introduction of RVV into routine public health use in the Philippines. However, other factors such as costs, cost-effectiveness and operational issues must be considered prior to adoption of the vaccine into the countries’ public immunization program.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Effectiveness of monovalent rotavirus vaccine in the Philippines

Lopez

Daag

Esparagoza³

et al. 2018

Sci Rep

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“…Despite the potential differences in health-care–seeking behavior over time, our results are similar to the RCT and CRT conducted in Matlab, Bangladesh, with the greatest impact of rotavirus vaccine on children 0 to <12 months of age. To our knowledge, no other population-level impact analyses have been reported in Asia with rotavirus diarrhea as the outcome, though a study in the Philippines saw a 60% (95% CI 55–64%) reduction in all-cause diarrhea hospitalizations within 4 years after rotavirus vaccine introduction [23]. Similar time-series analyses conducted 2–3 years after rotavirus introduction found a 49% (95% CI 32–63%) decrease in rotavirus diarrhea in <5-year-old children in Ghana [12], a 54% (95% CI 33–69%) decrease in rotavirus diarrhea in <1-year-old children in Malawi [11], a 33% (95% CI 25–41%) reduction in rotavirus diarrhea in <5-year-old children in Botswana [14], and a 38% reduction in rotavirus positivity among children <5 years old in Zambia [10].…”

Section: Discussionmentioning

confidence: 99%

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

Schwartz

Zaman

Yunus

et al. 2019

Clinical Infectious Diseases

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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.

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“…Nevertheless, rotavirus vaccination resulted in a 63.0% decline in all-cause diarrhea hospitalizations in 2015 [46]. Among the countries where the vaccine is available via the private market, data on the impact of vaccination is available from China (n=1), Japan (n=4), and South Korea (n=1); overall the findings are diverse (Supplementary Table 2).…”

Section: Overview Of Rotavirus Vaccination Implementation In the Regionmentioning

confidence: 99%

A review of rotavirus vaccine use in Asia and the Pacific regions: challenges and future prospects

Buchy¹,

Chen²,

Zhang³

et al. 2021

Expert Review of Vaccines

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Impact of rotavirus vaccine on diarrheal hospitalization and outpatient consultations in the Philippines: First evidence from a middle-income Asian country

Cited by 8 publications

References 12 publications

Effectiveness of monovalent rotavirus vaccine in the Philippines

Effectiveness of monovalent rotavirus vaccine in the Philippines

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

A review of rotavirus vaccine use in Asia and the Pacific regions: challenges and future prospects

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