Time series investigation of changes in seasonality of acute diarrhea hospitalizations before and after rotavirus vaccine in Southern Brazil

Masukawa, Maria de Lourdes Teixeira; Souza, Eniuce Menezes de; Gimenes, Edilson; Uchimura, Nelson Shozo; Moriwaki, Adriana Mayumi; Uchimura, Taqueco Teruya

doi:10.1590/0102-311x00080515

Cited by 6 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent studies also suggest rotavirus seasonality might be weaker in the tropics, with some evidence that it peaks during the cooler and drier seasons [4–6, 26]. Introduction of rotavirus vaccine may attenuate the annual peaks in diarrheal disease associated with rotavirus [27]. We found less consistent periodicity of other pathogens across GEMS sites; however, there is less evidence in the scientific literature on the global seasonality of diarrheal pathogens other than rotavirus.…”

Section: Discussionmentioning

confidence: 62%

The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years

et al. 2019

View full text Add to dashboard Cite

Background Pediatric diarrhea can be caused by a wide variety of pathogens, from bacteria to viruses to protozoa. Pathogen prevalence is often described as seasonal, peaking annually and associated with specific weather conditions. Although many studies have described the seasonality of diarrheal disease, these studies have occurred predominantly in temperate regions. In tropical and resource-constrained settings, where nearly all diarrhea-associated mortality occurs, the seasonality of many diarrheal pathogens has not been well characterized. As a retrospective study, we analyze the seasonal prevalence of diarrheal pathogens among children with moderate-to-severe diarrhea (MSD) over three years from the seven sites of the Global Enteric Multicenter Study (GEMS), a case–control study. Using data from this expansive study on diarrheal disease, we characterize the seasonality of different pathogens, their association with site-specific weather patterns, and consistency across study sites. Methodology/Principal findings Using traditional methodologies from signal processing, we found that certain pathogens peaked at the same time every year, but not at all sites. We also found associations between pathogen prevalence and weather or “seasons,” which are defined by applying modern machine-learning methodologies to site-specific weather data. In general, rotavirus was most prevalent during the drier “winter” months and out of phase with bacterial pathogens, which peaked during hotter and rainier times of year corresponding to “monsoon,” “rainy,” or “summer” seasons. Conclusions/Significance Identifying the seasonally-dependent prevalence for diarrheal pathogens helps characterize the local epidemiology and inform the clinical diagnosis of symptomatic children. Our multi-site, multi-continent study indicates a complex epidemiology of pathogens that does not reveal an easy generalization that is consistent across all sites. Instead, our study indicates the necessity of local data to characterizing the epidemiology of diarrheal disease. Recognition of the local associations between weather conditions and pathogen prevalence suggests transmission pathways and could inform control strategies in these settings.

show abstract

Section: Discussionmentioning

confidence: 62%

The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years

et al. 2019

View full text Add to dashboard Cite

show abstract

“…We will compare these findings with the post-vaccination variations. We expect changes in seasonal patterns after universal vaccine implementation, including delays in the start of rotavirus season, shorter duration of seasons and blunting of seasonal peaks [35,36,37,38]. The presented model for estimating the peak timing will allow us to monitor changes in disease incidence.…”

Section: Discussionmentioning

confidence: 99%

Seasonality of Rotavirus Hospitalizations at Costa Rica’s National Children’s Hospital in 2010–2015

Ureña-Castro

Ávila

Gutierrez

et al. 2019

IJERPH

View full text Add to dashboard Cite

Rotavirus is a leading cause of acute diarrhea in children worldwide. Costa Rica recently started universal rotavirus vaccinations for infants with a two-dose schedule in February 2019. We aimed to study the seasonality of rotavirus during the pre-vaccination era. We retrospectively studied a six-year period of hospital admissions due to rotavirus gastroenteritis. We estimated seasonal peak timing and relative intensities using trend-adjusted negative binomial regression models with the δ-method. We assessed the relationship between rotavirus cases and weather characteristics and estimated their effects for the current month, one-month prior and two months prior, by using Pearson correlation coefficients. A total of 798 cases were analyzed. Rotavirus cases predominated in the first five months of the year. On average, the peak of admissions occurred between late-February and early-March. During the seasonal peaks, the monthly count tended to increase 2.5–2.75 times above the seasonal nadir. We found the strongest negative association of monthly hospitalizations and joint percentiles of precipitation and minimal temperature at a lag of two months (R = −0.265, p = 0.027) and we detected correlations of −0.218, −0.223, and −0.226 (p < 0.05 for all three estimates) between monthly cases and the percentile of precipitation at lags 0, 1, and 2 months. In the warm tropical climate of Costa Rica, the increase in rotavirus hospitalizations coincided with dry and cold weather conditions with a two-month lag. The findings serve as the base for predictive modeling and estimation of the impact of a nation-wide vaccination campaign on pediatric rotaviral infection morbidity.

show abstract

“…Millions of people have suffered from diseases such as diarrhea, especially children, and this disease is one of the main causes of morbidity and mortality among children, especially in the group aged zero to four full years [ 9 , 11 , 14 ]. Most cases (50%) are caused by rotavirus in several countries [ 15 , 33 ], despite increased vaccination coverage, improved health conditions and knowledge about oral rehydration [ 5 , 9 ]. In Brazil, children aged up to 5 years are the most affected and 80% are younger than 1 year old [ 14 , 17 ], especially in the North region, where diarrheal diseases rank 8th in the causes of infant mortality [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Socio-environmental factors and diarrheal diseases in under five-year old children in the state of Tocantins, Brazil

Fontoura

Santos

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

BackgroundDiarrhea is a waterborne disease that affects children, especially those under 5 years of age. The objective of this study was to identify the spatial patterns of distribution of diarrheal disease in under 5-year-old children in the State of Tocantins, Brazil, from 2008 to 2013.MethodsGeoprocessing tools were used to carry out an epidemiological study, to prepare thematic maps in the TerraView 4.2.2 software based on secondary data. General indicators of the disease, presence of spatial dependence through the Global Moran’s Index (I) and the Spatial Association Index (LISA) were described.ResultsThere were 3,015 cases of under 5-year-old children hospitalized for diarrhea, with an average annual rate (AAR) of 4.10/1,000 inhabitants (inhab.). Among the main characteristics were: increasing rates in under 1-year-old children (6.16 to 9.66/1,000 inhabitants); children aged 1 to 4 full years (63%); males (55%); 8 deaths of under one-year-old children (75%); county of Araguaína (67%); incidence in the county of Nazaré (63.97/1,000 inhab.); prevalence and incidence in the Araguaína microregion (45%, AAR 9.38/1,000 inhab.). The presence of a cluster with spatial autocorrelation was found in the Araguaína microregion, which was statistically significant (I = 0.11, p-value < 0.03), with priority of intervention (Moran Map).ConclusionsThere was an increase in the number of hospitalizations for diarrhea in under 5–year-old children in the state of Tocantins. The spatial analysis identified clusters of priority areas for measures of maintenance and control of diarrheal diseases.

show abstract

Time series investigation of changes in seasonality of acute diarrhea hospitalizations before and after rotavirus vaccine in Southern Brazil

Cited by 6 publications

References 20 publications

The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years

The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years

Seasonality of Rotavirus Hospitalizations at Costa Rica’s National Children’s Hospital in 2010–2015

Socio-environmental factors and diarrheal diseases in under five-year old children in the state of Tocantins, Brazil

Contact Info

Product

Resources

About