scholarly journals Do hospital pressures change following rotavirus vaccine introduction? A retrospective database analysis in a large paediatric hospital in the UK

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027739 ◽  
Author(s):  
Ellen Heinsbroek ◽  
Daniel Hungerford ◽  
Richard P D Cooke ◽  
Margaret Chowdhury ◽  
James S Cargill ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Unmet Need ◽  
Rotavirus Vaccine ◽  
Bed Occupancy ◽  
Database Analysis ◽  
Paediatric Hospital ◽  
Vaccine Introduction ◽  
The Uk

ObjectiveHospitals in the UK are under increasing clinical and financial pressures. Following introduction of childhood rotavirus vaccination in the UK in 2013, rotavirus gastroenteritis (RVGE) hospitalisations reduced significantly. We evaluated changes in ‘hospital pressures’ (demand on healthcare resources and staff) following rotavirus vaccine introduction in a paediatric setting in the UK.DesignRetrospective hospital database analysis between July 2007 and June 2015.SettingA large paediatric hospital providing primary, secondary and tertiary care in Merseyside, UK.ParticipantsHospital admissions aged <15 years. Outcomes were calculated for four different patient groups identified through diagnosis coding (International Classification of Disease, 10th edition) and/or laboratory confirmation: all admissions; any infection, acute gastroenteritis and RVGE.MethodsHospital pressures were compared before and after rotavirus vaccine introduction: these included bed occupancy, hospital-acquired infection rate, unplanned readmission rate and outlier rate (medical patients admitted to surgical wards due to lack of medical beds). Interrupted time-series analysis was used to evaluate changes in bed occupancy.ResultsThere were 116 871 admissions during the study period. Lower bed occupancy in the rotavirus season in the postvaccination period was observed for RVGE (−89%, 95% CI 73% to 95%), acute gastroenteritis (−63%, 95% CI 39% to 78%) and any infection (−23%, 95% CI 15% to 31%). No significant overall reduction in bed occupancy was observed (−4%, 95% CI −1% to 9%). No changes were observed for the other outcomes.ConclusionsRotavirus vaccine introduction was not associated with reduced hospital pressures. A reduction in RVGE hospitalisation without change in overall bed occupancy suggests that beds available were used for a different patient population, possibly reflecting a previously unmet need.Trials registration numberNCT03271593

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

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.

scholarly journals Rates of hospitalization and death for all-cause and rotavirus acute gastroenteritis before rotavirus vaccine introduction in Kenya, 2010–2013

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Richard Omore ◽  
Sammy Khagayi ◽  
Billy Ogwel ◽  
Reuben Onkoba ◽  
John B. Ochieng ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Rotavirus Vaccine ◽  
Vaccine Introduction

scholarly journals Epidemiology of rotavirus diarrhea among children less than 5 years hospitalized with acute gastroenteritis prior to rotavirus vaccine introduction in India

Vaccine ◽  
2020 ◽  
Vol 38 (51) ◽  
pp. 8154-8160
Author(s):  
C.P. Girish Kumar ◽  
Sidhartha Giri ◽  
Mamta Chawla-Sarkar ◽  
Varanasi Gopalkrishna ◽  
Shobha D. Chitambar ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Rotavirus Vaccine ◽  
Vaccine Introduction ◽  
Rotavirus Diarrhea

scholarly journals Home Albumin Infusion Therapy, Another Alternative Treatment in Patients With Congenital Nephrotic Syndrome of the Finnish Type

2021 ◽  
Vol 8 ◽  
Author(s):  
Eugènia Serramontmany ◽  
Marina Muñoz ◽  
Aurora Fernández-Polo ◽  
María Morillo ◽  
Laura Gómez-Ganda ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Congenital Nephrotic Syndrome ◽  
Infusion Therapy ◽  
Complication Rates ◽  
Assistance Program ◽  
Paediatric Hospital ◽  
Albumin Infusion ◽  
Finnish Type

Background: Congenital nephrotic syndrome of the Finnish type (CNF) is a rare, severe glomerular disease caused by mutations in the NPHS1 gene, which codes for nephrin. It is characterised by massive proteinuria and severe edoema. Progression to end-stage kidney failure occurs during early childhood and the only curative treatment is kidney transplantation. Nowadays, patients need aggressive medical treatment, which includes daily albumin infusions (for months) until they get clinical stability to receive transplant.Objective: In our paediatric hospital, we implemented a multidisciplinary program for the home infusion of albumin with outpatient follow-up. The aim of the study was to assess the safety and efficacy of this program for the first four years of its implementation.Material and Methods: Retrospective observational study of CNF paediatric patients treated with home albumin infusion therapy from March 2014 to July 2018 at a tertiary care paediatric hospital. Information on albumin administration was obtained from the electronic prescription assistance program and details on clinical and care-related variables from the hospital's electronic information systems.Results: Four patients with CNF received albumin infusions for 18, 21, 22 months, and 3 years. The treatment was safe, and the complication rates were to be expected considering the severity of disease. Patients required a median of two hospital admissions a year (19 in total); 47% due to catheter-related complications, but there were just three catheter infections.Conclusions: In our experience, home albumin infusion therapy is safe and effective and helps to improve children health and quality of life.

scholarly journals Trends in rotavirus from 2001 to 2015 in two paediatric hospitals in Atlanta, Georgia

2018 ◽  
Vol 146 (4) ◽  
pp. 465-467 ◽  
Author(s):  
B. K. Sederdahl ◽  
J. Yi ◽  
R. C. Jerris ◽  
S. E. Gillespie ◽  
L. F. Westblade ◽  
...  
Keyword(s):  
Emergency Department ◽  
Rotavirus Vaccine ◽  
Older Children ◽  
Paediatric Hospital ◽  
Vaccine Introduction ◽  
Antigen Testing

AbstractWe compared rotavirus detection patterns before (2001–2006) and after (2008–2015) rotavirus vaccine introduction. We also compared rotavirus detection patterns in odd (2009, 2011, 2013, 2015) and even (2008, 2010, 2012, 2014) years post-vaccine separately. Results of stool rotavirus antigen testing from inpatient, outpatient and emergency department encounters from July 2000 to July 2015 at two paediatric hospital laboratories in Atlanta, Georgia were reviewed. Post-vaccine, rotavirus detection declined (30.2% vs. 13.7% (overall 54.6% decline, P <0.001)), occurred more frequently outside the rotavirus season (19.8% vs. 3.5%; P < 0.001), and was more common among older children (26 vs. 13 median months of age; P < 0.001). During odd years post-vaccine, rotavirus detection was significantly higher than even years (20.2% vs. 6.4%; P < 0.001). Rotavirus detection declined substantially and developed a biennial pattern in the post-vaccine era. The intensity and temporality of rotavirus detection in odd years post-vaccine resembled that observed pre-vaccine, although considerably reduced in magnitude.

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