Preparing for Safety Monitoring After Rotavirus Vaccine Implementation

Ngendahayo, Edouard; Bonane, Alex; Ntakiyiruta, Georges; Munyanshongore, Aline; Muganga, Narcisse; Bikoroti, Joel B; Mwenda, Jason M.; Tate, Jacqueline E.; Ngabo, Fidèle

doi:10.1097/inf.0000000000000093

Cited by 19 publications

(4 citation statements)

References 10 publications

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“…We describe the results of over four years of active hospital-based surveillance for intussusception in all 7 seven divisions in Bangladesh. The proportion of males diagnosed with intussusception was higher than that of females, which is consistent with other reported data on intussusception cases occurring in the absence of rotavirus vaccine administration from both high and low income settings [17–22]. The reasons for this male predominance are unclear but may reflect greater healthcare seeking for male children with intussusception, genetic factors or both.…”

Section: Discussionsupporting

confidence: 88%

Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012–2016

Satter

Aliabadi

Yen

et al. 2018

Vaccine

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Confirmed cases of intussusception represented nearly 2% of pediatric surgical admissions at tertiary referral centers in Bangladesh during the study period and 7% of children with intussusception died. Given the high burden of rotavirus disease in Bangladesh, vaccine introduction is warranted, however, further studies after introduction of rotavirus vaccine are necessary to determine any association between vaccine and intussusception in this setting.

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Section: Discussionsupporting

confidence: 88%

Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012–2016

Satter

Aliabadi

Yen

et al. 2018

Vaccine

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“…In Rwanda, findings from retrospective study on HAI conducted at University Teaching Hospital of Kigali indicated that SSI account for 76.8% of all HAIs in surgical department and that 35% of children with SSI experienced complications [13]. However, data are lacking the incidences of SSI until 30 days-post operation including discharged patients before that period making difficult to estimate the really burden of SSI.…”

Section: Introductionmentioning

confidence: 99%

Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study

et al. 2019

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Background Surgical Site Infections (SSI) are the most reported health acquired infection and common surgical complication in both developed and developing countries. In developing countries such as Rwanda, there is a paucity of published reports on the pattern of SSI, therefore this study aimed at assessing the incidence, risk factors and the antibiotic profile of pathogens responsible of SSI. Methods This prospective study included 294 patients admitted between October 10, 2017 and February 12, 2018 to the surgical department of the University Teaching Hospital of Kigali. Patients data were collected using a structured and pretested questionnaire in English version. Regular follow-up was maintained until at least 30 days postoperatively. Samples were collected from suspected wounds and identified using different bacteria culture media. Data were analyzed using Statistical Package for the Social Sciences (SPSS) software word version 20.0. P -value < 0.05 was considered statistically significant. Results The overall incidence of SSI was 10.9%. The associated risk factors were found to be an increased age, ASA class, wound classification, skills and experience of the surgeon, longer duration of surgery (> 2 h), prolonged duration of hospital stay, blood transfusion and emergency surgery. The most common pathogens isolated were Klebsiella ssp (55%), followed by Escherichia coli (15%) and Proteus ssp (12%), Acinectobacter (9%), Staphylococcus aureus (6%) and coagulase-negative staphylococc i (3%).The pathogens revealed different levels of antibiotic resistance; amoxy-clavilinic acid (98.8%), gentamicin (92.6%), ciprofloxacin (78.1%) and ceftriaxone (53.3%). On the other hand, Amikacin and imipinem were the only two most effective antibiotics for all isolated pathogens with 100% sensitivity. Conclusion SSI incidence rate was revealed to be within acceptable international ranges. However, multi drug resistance was seen in half of the isolates leaving clinicians with few choices of drugs for the treatment of patients with SSI. Periodic surveillance of bacteria and antibiotic susceptibility coupled with the implementation of strict protocol for antibiotic administration and operative room regulations are important to minimize the burden of SSI with resistant bacteria pathogens.

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“…A review of Zambian hospitals of IS in children <24 months old showed a high CFR of 33.7% 28 . In Rwanda, delays in presentation and treatment of IS resulted in the 28% mortality rate 29 . Overall, in African countries, the delayed presentation was common and 87% of cases required surgical intervention with a high CFR of 10 to 33.7% 30 , 31 .…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of intussusception before and after rotavirus vaccine introduction in Fiji

Ratu

Reyburn

Tuivaga

et al. 2018

Sci Rep

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In 2012, Fiji introduced rotavirus vaccine (Rotarix, GSK) into the national immunisation schedule. We describe the intussusception epidemiology prior to rotavirus vaccine, temporal association of intussusception cases to administration of rotavirus vaccine, and estimate the additional number of intussusception cases that may be associated with rotavirus vaccine. A retrospective review of intussusception cases for children aged <24 months old was undertaken between January 2007 and October 2012 pre-vaccine. All admissions and deaths with a discharge diagnosis of intussusception, bowel obstruction, paralytic ileus, or intussusception ICD10-AM codes were extracted from national databases and hospital records. Nationwide active intussusception surveillance was established for three years post-vaccine (2013–2015). There were 24 definite intussusception cases in the pre-rotavirus vaccine period, 96% were confirmed by surgery. The median age was 6.5 months. The incidence rate was 22.2 (95% CI: 13.9–33.7) per 100,000 infants. There were no deaths. Active surveillance identified 25 definite intussusception cases, 96% of which were among children who were age-eligible for rotavirus vaccine. None were potentially vaccine related. We estimated one to five additional cases of intussusception every five years. The incidence of intussusception pre-rotavirus vaccine in Fiji is low. Intussusception associated with rotavirus vaccine is likely a rare event in Fiji.

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Preparing for Safety Monitoring After Rotavirus Vaccine Implementation

Cited by 19 publications

References 10 publications

Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012–2016

Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012–2016

Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study

Epidemiology of intussusception before and after rotavirus vaccine introduction in Fiji

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