The impact of rotavirus vaccination in the prevalence of gastroenteritis and comorbidities among children after suboptimal rotavirus vaccines implementation in Taiwan

Using nationwide data from the Health Insurance Review and Assessment service, we assessed the impact of rotavirus vaccines, introduced in South Korea, in 2007, on changes in the prevalence of factors (age, sex, and geographic location) associated with rotavirus gastroenteritis (RVGE) and rotavirus-associated benign convulsions with mild gastroenteritis (RaCwG). We analyzed health records of children younger than 3 years who visited clinical facilities and were diagnosed with RVGE or RaCwG between 2007 and 2019. The annual mid-year population (MYP) was obtained from the Korean Statistical Information Service. The annual prevalence of RVGE, RaCwG and associated factors were statistically analyzed. Overall, 219,686, and 4032, children were confirmed to have RVGE and RaCwG, respectively. Although the annual prevalence of RVGE decreased significantly, that of RaCwG did not. The annual ratio of RaCwG to RVGE was significantly high. Compared to the prevalence of RVGE, the prevalence of RaCwG was significantly lower in rural areas. The age of RaCwG patients was significantly lower than that of the MYP and that of RVGE patients. The decrease in the number of RaCwG patients after rotavirus vaccination was not as pronounced as the decrease in the number of RVGE patients.

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Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel

Eurosurveillance ◽

10.2807/1560-7917.es.2015.20.42.30045 ◽

2015 ◽

Vol 20 (42) ◽

Cited By ~ 8

Author(s):

Khitam Muhsen ◽

Gabriel Chodick ◽

Sophy Goren ◽

Emilia Anis ◽

Tomer Ziv-Baran ◽

...

Keyword(s):

Age Groups ◽

Real World Data ◽

Health Maintenance ◽

Rotavirus Vaccination ◽

Rotavirus Gastroenteritis ◽

Rotavirus Vaccines ◽

Laboratory Surveillance ◽

Antigen Tests ◽

The Impact ◽

Clinic Visits

Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited. We used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n = 302,445) before (2005–10) and after (2011–13) the introduction of universal rotavirus immunisation in Israel. We retrieved laboratory results of rotavirus antigen tests (n = 18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5–16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8–62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes.

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The paediatric burden of rotavirus disease in Europe

Epidemiology and Infection ◽

10.1017/s0950268806006091 ◽

2006 ◽

Vol 134 (5) ◽

pp. 908-916 ◽

Cited By ~ 64

Keyword(s):

Developed Countries ◽

Epidemiological Studies ◽

Incidence Rates ◽

The European Union ◽

Rotavirus Vaccination ◽

Medical Visits ◽

Rotavirus Vaccines ◽

Median Proportion ◽

Hospital Acquired ◽

The Impact

Rotaviruses are a major cause of hospitalizations for acute gastroenteritis in developed countries. This review shows the burden of rotavirus disease in <5-year-old children in Europe. An estimated 72000–77000 hospitalizations for community-acquired rotavirus disease occur annually in the 23 million under-fives living in the European Union (EU-25), with a median cost of €1417 per case. Annual hospitalization incidence rates range from 0·3 to 11·9/1000 children <5 years old (median 3/1000). The median proportion of hospital-acquired rotavirus disease among all cases of hospitalization for rotavirus disease is estimated to be 21%. Countries of the EU-25 require information on the burden of rotavirus disease to support introduction of rotavirus vaccines. Data on cases treated at home, medical visits, and emergency wards as well as rotavirus-associated deaths are limited. To fully evaluate the impact and effectiveness of rotavirus vaccination programmes in Europe, additional epidemiological studies will be critical and desirable.

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Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays

BMC Infectious Diseases ◽

10.1186/s12879-021-06318-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rahinatou N. Ghapoutsa ◽

Maurice Boda ◽

Rashi Gautam ◽

Valantine Ngum Ndze ◽

Akongnwi E. Mugyia ◽

...

Keyword(s):

Demographic Data ◽

Laboratory Diagnosis ◽

Epidemiological Studies ◽

Sub Saharan Africa ◽

Rt Pcr ◽

Mortality And Morbidity ◽

Vaccine Introduction ◽

Littoral Region ◽

Rotavirus Vaccines ◽

The Impact

Abstract Background Despite the global roll-out of rotavirus vaccines (RotaTeq/Rotarix / ROTAVAC/Rotasiil), mortality and morbidity due to group A rotavirus (RVA) remains high in sub-Saharan Africa, causing 104,000 deaths and 600,000 hospitalizations yearly. In Cameroon, Rotarix™ was introduced in March 2014, but, routine laboratory diagnosis of rotavirus infection is not yet a common practice, and vaccine effectiveness studies to determine the impact of vaccine introduction have not been done. Thus, studies examining RVA prevalence post vaccine introduction are needed. The study aim was to determine RVA prevalence in severe diarrhoea cases in Littoral region, Cameroon and investigate the role of other diarrheagenic pathogens in RVA-positive cases. Methods We carried out a study among hospitalized children < 5 years of age, presenting with acute gastroenteritis in selected hospitals of the Littoral region of Cameroon, from May 2015 to April 2016. Diarrheic stool samples and socio-demographic data including immunization and breastfeeding status were collected from these participating children. Samples were screened by ELISA (ProSpecT™ Rotavirus) for detection of RVA antigen and by gel-based RT-PCR for detection of the VP6 gene. Co-infection was assessed by multiplexed molecular detection of diarrheal pathogens using the Luminex xTAG GPP assay. Results The ELISA assay detected RVA antigen in 54.6% (71/130) of specimens, with 45, positive by VP6 RT-PCR and 54, positive using Luminex xTAG GPP. Luminex GPP was able to detect all 45 VP6 RT-PCR positive samples. Co-infections were found in 63.0% (34/54) of Luminex positive RVA infections, with Shigella (35.3%; 12/34) and ETEC (29.4%; 10/34) detected frequently. Of the 71 ELISA positive RVA cases, 57.8% (41/71) were fully vaccinated, receiving two doses of Rotarix. Conclusion This study provides insight on RVA prevalence in Cameroon, which could be useful for post-vaccine epidemiological studies, highlights higher than expected RVA prevalence in vaccinated children hospitalized for diarrhoea and provides the trend of RVA co-infection with other enteric pathogens. RVA genotyping is needed to determine circulating rotavirus genotypes in Cameroon, including those causing disease in vaccinated children.

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Impact of Monovalent Rotavirus Vaccine on Rotavirus Hospitalizations among Children Younger Than 5 Years of Age in the Ouest and Artibonite Departments, Haiti, 2013 to 2019

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0414 ◽

2021 ◽

Author(s):

Anne-Marie Desormeaux ◽

Eleanor Burnett ◽

Gérard Joseph ◽

Mentor Ali Ber Lucien ◽

Negar Aliabadi ◽

...

Keyword(s):

Negative Binomial ◽

Hospital Admissions ◽

Absolute Number ◽

Sensitivity Analyses ◽

Rotavirus Vaccine ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Before And After ◽

Rotavirus Diarrhea ◽

The Impact

Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean. Haiti introduced the monovalent rotavirus vaccine in April 2014. The objective of this analysis is to describe the impact of the rotavirus vaccine on hospitalizations among Haitian children younger than 5 years old during the first 5 years after introduction. This analysis includes all children with diarrhea who were enrolled as part of a sentinel surveillance system at two hospitals from May 2013 to April 2019. We compare the proportion of rotavirus-positive specimens in each post-vaccine introduction year to the pre-vaccine period. To account for the potential dilution of the proportion of rotavirus-positive specimens from a waning cholera outbreak, we also analyzed annual trends in the absolute number of positive stools, fit a two-component finite-mixture model to the negative specimens, and fit a negative binomial time series model to the pre-vaccine rotavirus-positive specimens to predict the number of rotavirus diarrhea hospital admissions in the absence of rotavirus vaccination. The overall percentage of rotavirus-positive specimens declined by 22% the first year after introduction, increased by 17% the second year, and declined by 33% to 50% the subsequent 3 years. All sensitivity analyses confirmed an overall decline. We observed a clear annual rotavirus seasonality before and after vaccine introduction, with the greatest activity in December through April, and a biennial pattern, with high sharp peaks and flatter longer periods of increased rotavirus activity in alternating years, consistent with suboptimal vaccination coverage. Overall, our study shows evidence that the introduction of the rotavirus vaccine reduced the burden of severe rotavirus diarrhea.

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Emergence of Unusual Rotavirus G9p[4] and G8p[8] Strains During Post Vaccination Surveillance in Argentina, 2017-2018

10.21203/rs.3.rs-72107/v1 ◽

2020 ◽

Author(s):

Juan I Degiuseppe ◽

Juan A Stupka

Keyword(s):

Early Spring ◽

High Rate ◽

Phylogenetic Study ◽

Genotype Distribution ◽

Post Vaccination ◽

Rotavirus Vaccination ◽

Immunization Strategies ◽

Monovalent Vaccine ◽

The Impact ◽

Children Under 5

Abstract Background. In 2015, Argentina included RotarixTM monovalent vaccine for universal administration and it showed a sharp decline in all-cause and rotavirus-confirmed cases as well as an immediate predominance of the G2P[4] genotype. The aim of this study was to analyze the impact of rotavirus vaccination on disease burden and genotype distribution in our country following its introduction. Methods. Prevalence and seasonality of laboratory-confirmed rotavirus cases data were assessed. Analyses of circulating genotypes were performed by conventional binary characterization (G and P typing). Phylogenetic study of VP7 gene was performed from emergent unusual strains. Results. During 2017-2018, 1183 rotavirus cases (13.2%) were detected and prevalence was uniform among different age subgroups. Weekly distribution showed a raise of confirmed cases around late July and early August. In 2017 the most frequently detected genotypes were G2P[4] and G3P[8]. However, in 2018 G12P[8] genotype increased and it was detected at a high rate. Noteworthy, the detection of uncommon G9P[4] and G8P[8] strains (bearing DS-1-like genetic backbones) was observed at moderate rates. Conclusions. Following four years of this strategy, the prevalence of rotavirus remained low in children under 5 years of age with a shift of the seasonal peak in early spring. The emergence of uncommon genotypes was due to introduction of new strains rather than to reassortment of local strains. Continuous monitoring of rotavirus burden of disease and genotype distribution provides useful evidence to evaluate existing immunization strategies and to contribute in the development of new vaccines as well.

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The impact of shared decision making with patient decision aids on the rotavirus vaccination rate in children: A randomized controlled trial

Preventive Medicine ◽

10.1016/j.ypmed.2020.106244 ◽

2020 ◽

Vol 141 ◽

pp. 106244

Author(s):

Sheng-Chieh Lin ◽

Ka-Wai Tam ◽

Jean Yu-Chun Yen ◽

Meng-Che Lu ◽

Elaine Ying-Fang Chen ◽

...

Keyword(s):

Decision Making ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Decision Aids ◽

Vaccination Rate ◽

Shared Decision ◽

Rotavirus Vaccination ◽

Randomized Controlled ◽

Patient Decision ◽

The Impact

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Reduction in hospitalisations for acute gastroenteritis-associated childhood seizures since introduction of rotavirus vaccination: a time-series and change-point analysis of hospital admissions in England

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-213055 ◽

2019 ◽

Vol 73 (11) ◽

pp. 1020-1025 ◽

Cited By ~ 4

Author(s):

Daniel James Hungerford ◽

Neil French ◽

Miren Iturriza-Gómara ◽

Jonathan M Read ◽

Nigel A Cunliffe ◽

...

Keyword(s):

Time Series ◽

Acute Gastroenteritis ◽

Change Point ◽

Hospital Admissions ◽

Population Level ◽

Febrile Seizures ◽

Change Point Analysis ◽

Rotavirus Vaccination ◽

Point Analysis ◽

The Impact

IntroductionThe incidence of severe childhood diarrhoea has fallen substantially following the introduction of rotavirus vaccine in the UK in July 2013. Since children with rotavirus infection may experience febrile and afebrile seizures, we evaluated the impact of rotavirus vaccination on seizure hospitalisations in children in England.MethodsUsing data from Hospital Episode Statistics, we employed interrupted time-series analyses to assess changes in monthly hospital admissions for seizures among children aged <5 years from July 2000 to June 2017. Outcome measures comprised all seizures and febrile seizures, with and without a co-diagnosis of acute gastroenteritis (AGE). Models were adjusted for pneumococcal conjugate vaccine (PCV) introduction. Change-point analysis was used to independently identify step-changes in the time-series.ResultsAmong hospitalised children aged <5 years, the incidence of any seizures and febrile seizures with AGE decreased post-vaccine introduction by 23% (95% CI: 11% to 33%) and 31% (95% CI: 19% to 41%), respectively. For febrile seizures with AGE, a single change-point was identified in July 2013 (95% CI: June 2013 to December 2013). Reductions in seizure incidence were higher during the rotavirus season (49%, 95% CI: 37% to 58%) compared with out-of-season (13%, 95% CI: −4 to 28%) and showed no relation to PCV introduction. There were small reductions in any seizures with any co-diagnosis (4%, 95% CI: 0% to 8%) and in febrile seizures with any co-diagnosis (10%, 95% CI: 2% to 16%).ConclusionRotavirus vaccination has reduced hospitalisations for seizures associated with AGE in England, providing additional evidence of population-level impact of rotavirus vaccination on seizure incidence in high-income countries.

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

Clinical Infectious Diseases ◽

10.1093/cid/ciz133 ◽

2019 ◽

Vol 69 (12) ◽

pp. 2059-2070 ◽

Cited By ~ 5

Author(s):

Lauren M Schwartz ◽

K Zaman ◽

Md Yunus ◽

Ahasan-ul H Basunia ◽

Abu Syed Golam Faruque ◽

...

Keyword(s):

Vaccine Coverage ◽

Controlled Trial ◽

Population Level ◽

Diarrhoeal Disease ◽

Incidence Rates ◽

Service Area ◽

Rotavirus Vaccine ◽

Rotavirus Vaccines ◽

Time Period ◽

The Impact

Abstract Background Following 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. Methods Interrupted 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. Results Both 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. Conclusions This 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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