Trends in Hospitalizations From All-Cause Gastroenteritis in Children Younger Than 5 Years of Age in Brazil Before and After Human Rotavirus Vaccine Introduction, 1998–2007

Abstract

Rotavirus vaccination was introduced in Brazil in March 2006. We describe trends in hospitalizations from all-cause gastroenteritis in children younger than 5 years during pre- and postvaccination periods using hospital discharge data from Brazil Hospital Information System (SIH-SUS). A reduction in gastroenteritis hospitalizations of 26% and 48% in 2006 and in 2007, respectively, was observed among children younger than 1 year compared with prevaccination period (1998-2005). The largest reduction rates among children younger than 1 year were noted in the South and Southeast regions, approximately 56% in 2007, where vaccine coverage was the highest.

Impacto da vacina oral de rotavírus Humano nas taxas de hospitalizações em crianças

“…In southern Brazil, the risk of children under one year being ill was 3.59 times higher than in children one to four years old. (6) It was observed that the risk for two-year-old children changed a little, with a small reduction in the year 2009, and that the pre-and post-vaccination periods remain virtually unchanged (Table 2) although they present a variation rate of (-25.8%).…”

“…(11) The study conducted in Brazil, in 2006 and 2007, found a 14% reduction in the hospitalization rates for acute diarrhea by region, with a mean hospitalization rate of 115.74 cases per 10,000 children before the introduction of the vaccine, 85.84 in 2006 and 59.94 in 2007 (a reduction of 25.8% and 48%, respectively). (6) Meanwhile,in the city of São Paulo, a reduction of 29% in hospitalizations for diarrhea of any cause was found after oral human rotavirus vaccine. (5) Identifying the causes of diarrhea is essential,-so that appropriate measures are instituted for its prevention.…”

“…In the natural history of rotavirus infections, 90% of children up to the second year of life would present an infection (6) of greater severity that would require hospital care and the availability of the vaccine for all children, according to the age group. This would also reduce the risk of bias in the analysis of admission rates, suggesting that the introduction of the vaccine has reduced the percentages of hospitalization rates for some age groups.…”

“…(3,4) Younger children with rotavirus infection tend to have significantly higher risks of complications, as most cases of severe diarrhea and dehydration occur between three to 35 months. (2,5,6) In the United States, 17% of hospitalizations occurred during the first six months of life, and 40% in children up to one year of age. It is estimated that each year the rotavirus infections in children under five years of age total 27 million episodes, and result in 410,000 consultations, with 205,000 -272,000 emergency room visits, and 20-60 deaths.…”

“…After its introduction, there was a 14% reduction in hospitalization rates for acute diarrhea, with a mean hospitalization of 115.74 cases before the introduction, 85.84 cases in 2006 and 59.94 cases in 2007, a reduction of 25.8% and 48.0% respectively. (6) Given the above, this study aimed to evaluate the risk of hospitalization for acute diarrhea in children under five,in the state of Paraná, from 2000 -2009, comparing the periods before and after the introduction of oral human rotavirus vaccine.…”