Evidence of reduction of rotavirus diarrheal disease after rotavirus vaccine introduction in national immunization programs in the African countries: Report of the 11th African rotavirus symposium held in Lilongwe, Malawi

Vaccine ◽  
2019 ◽  
Vol 37 (23) ◽  
pp. 2975-2981 ◽  
Author(s):  
Jason M. Mwenda ◽  
Inácio Mandomando ◽  
Khuzwayo C. Jere ◽  
Nigel A. Cunliffe ◽  
A. Duncan Steele
Keyword(s):  
Diarrheal Disease ◽  
Rotavirus Vaccine ◽  
Immunization Programs ◽  
African Countries ◽  
Vaccine Introduction ◽  
National Immunization

scholarly journals Global Impact of Rotavirus Vaccination on Diarrhea Hospitalizations and Deaths Among Children <5 Years Old: 2006–2019

2020 ◽  
Vol 222 (10) ◽  
pp. 1731-1739 ◽  
Author(s):  
Eleanor Burnett ◽  
Umesh D Parashar ◽  
Jacqueline E Tate
Keyword(s):  
Age Groups ◽  
Published Data ◽  
Rotavirus Vaccine ◽  
Immunization Programs ◽  
Median Percentage ◽  
Global Impact ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Younger Age ◽  
Before And After

Abstract Background Since 2006, more than 100 countries have introduced rotavirus vaccine into their immunization programs. We reviewed published data on relative reductions of rotavirus hospitalizations, acute gastroenteritis (AGE) hospitalizations, and AGE deaths among children &lt;5 years old. Methods Articles published from January 1, 2006 to December 31, 2019 with at least 12 months of data before and after rotavirus vaccine introduction were included. Relative reductions were abstracted into a standardized form. Descriptive statistics are presented as medians and interquartile ranges (IQRs). Results We reviewed 1827 total records and included 105 articles from 49 countries. Among children &lt;5 years old, there was a median reduction of 59% (IQR, 46–74) in rotavirus hospitalizations, 36% (IQR, 23–47) in AGE hospitalizations, and 36% (IQR, 28–46) AGE mortality. Reductions were larger in countries with low child mortality, among younger age groups, and in countries with higher coverage. The median percentage of specimens that tested positive for rotavirus among children &lt;5 years old hospitalized for diarrhea was 40% (IQR, 28–45) before rotavirus vaccine introduction and 20% (IQR, 20–20) 4 years after introduction. Conclusions Overall, we found sustained impact on rotavirus and AGE hospitalizations and deaths. These results should encourage countries still considering rotavirus vaccine implementation.

scholarly journals Emergence of Double- and Triple-Gene Reassortant G1P[8] Rotaviruses Possessing a DS-1-Like Backbone after Rotavirus Vaccine Introduction in Malawi

2017 ◽  
Vol 92 (3) ◽  
Author(s):  
Khuzwayo C. Jere ◽  
Chrispin Chaguza ◽  
Naor Bar-Zeev ◽  
Jenna Lowe ◽  
Chikondi Peno ◽  
...  
Keyword(s):  
Amino Acid ◽  
Vaccine Effectiveness ◽  
Recent Common Ancestor ◽  
Rotavirus Vaccine ◽  
Careful Evaluation ◽  
African Countries ◽  
Vaccine Introduction ◽  
Rotavirus Gastroenteritis ◽  
Structural Conformation ◽  
Rotavirus Vaccines

ABSTRACT To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced rotavirus vaccines into their childhood immunization programs. Malawi incorporated a G1P[8] rotavirus vaccine (Rotarix) into its immunization schedule in 2012. Utilizing a surveillance platform of hospitalized rotavirus gastroenteritis cases, we examined the phylodynamics of G1P[8] rotavirus strains that circulated in Malawi before (1998 to 2012) and after (2013 to 2014) vaccine introduction. Analysis of whole genomes obtained through next-generation sequencing revealed that all randomly selected prevaccine G1P[8] strains sequenced ( n = 32) possessed a Wa-like genetic constellation, whereas postvaccine G1P[8] strains ( n = 18) had a DS-1-like constellation. Phylodynamic analyses indicated that postvaccine G1P[8] strains emerged through reassortment events between human Wa- and DS-1-like rotaviruses that circulated in Malawi from the 1990s and hence were classified as atypical DS-1-like reassortants. The time to the most recent common ancestor for G1P[8] strains was from 1981 to 1994; their evolutionary rates ranged from 9.7 × 10 −4 to 4.1 × 10 −3 nucleotide substitutions/site/year. Three distinct G1P[8] lineages chronologically replaced each other between 1998 and 2014. Genetic drift was the likely driver for lineage turnover in 2005, whereas replacement in 2013 was due to reassortment. Amino acid substitution within the outer glycoprotein VP7 of G1P[8] strains had no impact on the structural conformation of the antigenic regions, suggesting that it is unlikely that they would affect recognition by vaccine-induced neutralizing antibodies. While the emergence of DS-1-like G1P[8] rotavirus reassortants in Malawi was therefore likely due to natural genotype variation, vaccine effectiveness against such strains needs careful evaluation. IMPORTANCE The error-prone RNA-dependent RNA polymerase and the segmented RNA genome predispose rotaviruses to genetic mutation and genome reassortment, respectively. These evolutionary mechanisms generate novel strains and have the potential to lead to the emergence of vaccine escape mutants. While multiple African countries have introduced a rotavirus vaccine, there are few data describing the evolution of rotaviruses that circulated before and after vaccine introduction. We report the emergence of atypical DS-1-like G1P[8] strains during the postvaccine era in Malawi. Three distinct G1P[8] lineages circulated chronologically from 1998 to 2014; mutation and reassortment drove lineage turnover in 2005 and 2013, respectively. Amino acid substitutions within the outer capsid VP7 glycoprotein did not affect the structural conformation of mapped antigenic sites, suggesting a limited effect on the recognition of G1-specific vaccine-derived antibodies. The genes that constitute the remaining genetic backbone may play important roles in immune evasion, and vaccine effectiveness against such atypical strains needs careful evaluation.

scholarly journals The Burden of Acute Diarrheal Disease in Young Hospitalized Urban South African Children Five Years After Rotavirus Vaccine Introduction

2019 ◽  
Vol 38 (7) ◽  
pp. 752-756
Author(s):  
Euphrasia Makgatho ◽  
Firuzan Patel ◽  
Fatima Solomon ◽  
Michelle J. Groome ◽  
Sanjay G. Lala ◽  
...  
Keyword(s):  
South African ◽  
Diarrheal Disease ◽  
Rotavirus Vaccine ◽  
Vaccine Introduction ◽  
African Children ◽  
Urban South ◽  
South African Children

scholarly journals Trends for rotavirus acute gastroenteritis in children under 5 years old before and after vaccine introduction, Morocco, 2006–2014

2021 ◽  
Vol 27 (6) ◽  
pp. 553-562
Author(s):  
Hind Ezzine ◽  
Ahmed Rguig ◽  
Mariam Naciri ◽  
I. Jroundi
Keyword(s):  
Acute Gastroenteritis ◽  
Diarrheal Disease ◽  
Public Health Issue ◽  
Rotavirus Vaccine ◽  
Immunization Programme ◽  
National Immunization ◽  
National Immunization Programme ◽  
Before And After ◽  
The Impact ◽  
Children Under 5

Background: In Morocco, acute gastroenteritis in children is a public health issue. Since 1987, several strategies have been conducted to reduce its burden by the Moroccan Ministry of Health, including the introduction of the anti-rotavirus vaccine into the national immunization programme in 2010. Aims: To evaluate the impact of the anti-rotavirus vaccine in outpatients and inpatients with acute gastroenteritis under 5 years old. Methods: We conducted descriptive studies and a retrospective cohort study using data from the hospital’s sentinel surveillance system and the national ambulatory surveillance registry for acute gastroenteritis from 2006 to 2014. This include the period before and after the implementation of the rotavirus (RV) vaccine on children under age 5 years. Results: The decrease in acute gastroenteritis cases was about 5.2%, mainly among children aged 0–11 months. The proportion of acute RV gastroenteritis (RVGE) decreased from 37.0% to 31.1% after the vaccine’s introduction; it was statistically significant among the children aged 0–11 months (38.8% to 28.1%; P = 0.009). The proportion of RVGE among inpatients decreased from 97.0% to 91.7% (P = 0.022). Diarrheal disease cases without dehydration increased from 7.8% to 11.1% (P < 0.001); RVGE was 2.3 times more frequent among unvaccinated children. The vaccine effectiveness was estimated at 57%. The proportion of G1P[8] genotype infections decreased after the introduction of the RV vaccine (56% to 40%; P < 0.001), while the G2P[4] genotype became more frequent (13% to 21%; P = 0.015). Conclusions: The introduction of the RV vaccination into the national immunization programme in Morocco has allowed significant reduction in the incidence and severity of RVGE among children under 5 years old

scholarly journals Is rotavirus still a major cause for diarrheal illness in hospitalized pediatric patients after rotavirus vaccine introduction in the Saudi national immunization program?

Medicine ◽  
2017 ◽  
Vol 96 (15) ◽  
pp. e6574 ◽  
Author(s):  
Moustafa Abdelaal Hegazi ◽  
Mohamed Hesham Sayed ◽  
Haifa Hasan Sindi ◽  
Osama Elsayed Bekhit ◽  
Basem Salama El-Deek ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Rotavirus Vaccine ◽  
National Immunization Program ◽  
Immunization Program ◽  
Diarrheal Illness ◽  
Vaccine Introduction ◽  
National Immunization

Rapid impact of rotavirus vaccine introduction to the National Immunization Plan in Southern Israel: Comparison between 2 distinct populations

Vaccine ◽  
2015 ◽  
Vol 33 (16) ◽  
pp. 1934-1940 ◽  
Author(s):  
Noga Givon-Lavi ◽  
Shalom Ben-Shimol ◽  
Raanan Cohen ◽  
David Greenberg ◽  
Ron Dagan
Keyword(s):  
Rotavirus Vaccine ◽  
Vaccine Introduction ◽  
National Immunization
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