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 Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Amood AL-Kamarany ◽  
Lina Al-Areqi ◽  
Abulatif Mujally ◽  
Fawzya Alkarshy ◽  
Arwa Nasser ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
Rotavirus Vaccine ◽  
Diarrheal Diseases ◽  
Predominant Genotype ◽  
Fecal Samples ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Before And After ◽  
Rotavirus Diarrhea ◽  
The Impact

The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH) in Taiz, Yemen. Prevaccination covered January 2009–July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013–December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA). The incidence ofrotavirushospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%), followed by G1P[8] (15.0%), while in postvaccination period G1P[8] (31%) was the predominant genotype, followed by G9P[8] (27.5%). In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.

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 93. Trends in the Laboratory Detection of Rotavirus Before and After Implementation of Routine Rotavirus Vaccination: the United States, 2000–2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S8-S8
Author(s):  
Benjamin D Hallowell ◽  
Umesh D Parashar ◽  
Aaron Curns ◽  
Nicholas DeGroote ◽  
Jacqueline Tate
Keyword(s):  
United States ◽  
Disease Burden ◽  
National Laboratory ◽  
The United States ◽  
Rotavirus Vaccine ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Annual Peak ◽  
Before And After ◽  
Long Term Impact

Abstract Background Before the introduction of rotavirus vaccine in the United States in 2006, rotavirus infection was the leading cause of severe gastroenteritis among US children. Methods To evaluate the long-term impact of rotavirus vaccination on disease burden in the United States, CDC analyzed national laboratory testing data for rotavirus from laboratories participating in CDC’s National Respiratory and Enteric Viruses Surveillance System (NREVSS) during the pre- (2000–2006) and post-vaccine (2007–2018) periods. Results Nationally, the median annual percentage of positive rotavirus tests declined from 25.6% (range: 25.2–29.4%) in the pre-vaccine era to 6.1% (range: 2.6–11.1%) in the post-vaccine period. When comparing the pre- and post-vaccine era, the annual peak in rotavirus positivity declined from a median of 43.1% (range: 43.8–56.3%) to a median 14.0% (range: 4.8–27.3%) while the season duration was reduced from a median of 26 weeks (range: 23–27 weeks) to 9 weeks (range: 0–18 weeks). In the post-vaccine period, a biennial pattern emerged with alternating years of low and high rotavirus activity. Conclusion The implementation of rotavirus vaccine has dramatically reduced the disease burden and altered seasonal patterns of rotavirus in the United States; these changes have been sustained over 11 post-vaccine introduction seasons. Disclosures All Authors: No reported Disclosures.

Intussusception Rates Before and After the Introduction of Rotavirus Vaccine

2018 ◽  
pp. 61-67
Author(s):  
Jacqueline E. Tate ◽  
Catherine Yen ◽  
Claudia A. Steiner ◽  
Margaret M. Cortese ◽  
Umesh D. Parashar
Keyword(s):  
Age Groups ◽  
Population Level ◽  
Hospitalization Rate ◽  
Rotavirus Vaccine ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Before And After ◽  
Increase Risk ◽  
Consistent Change ◽  
Rate Ratios

BACKGROUND Recent US studies have identified a small increased risk of intussusception after rotavirus vaccination, mainly after the first dose. We examined trends in intussusception hospitalizations before (2000–2005) and after (2007–2013) rotavirus vaccine introduction to assess whether this observed temporal risk translates into more hospitalized cases at the population level. METHODS Intussusception hospitalizations in children &lt;12 months of age were abstracted from the State Inpatient Database maintained by the Healthcare Cost and Utilization Project for 26 states that provided data from 2000 to 2013. Rates were calculated using bridged-race postcensal population estimates. Trends were analyzed by age groups (6–14 weeks, 15–24 weeks, and 25–34 weeks) based on the recommended ages for vaccine administration as well as 8–11 weeks when the majority of first doses are given. Rate ratios were calculated by using Poisson regression. RESULTS No consistent change in intussusception hospitalization rates was observed among all children &lt;12 months of age and among children 15 to 24 weeks and 25 to 34 weeks of age. The intussusception hospitalization rate for children aged 8 to 11 weeks was significantly elevated by 46% to 101% (range: 16.7–22.9 per 100 000) in all postvaccine years except 2011 and 2013 compared with the prevaccine baseline (11.7 per 100 000). CONCLUSIONS The increase in the intussusception hospitalization rate in children 8 to 11 weeks when the majority of first doses of vaccine are given is consistent with recent US postlicensure studies. Given the magnitude of declines in rotavirus disease compared with this small increase in intussusception, the benefits of rotavirus vaccination outweigh the increase risk of intussusception.

scholarly journals Rotavirus Genotypes in Hospitalized Children With Acute Gastroenteritis Before and After Rotavirus Vaccine Introduction in Blantyre, Malawi, 1997–2019

2020 ◽  
Author(s):  
Chimwemwe Mhango ◽  
Jonathan J Mandolo ◽  
End Chinyama ◽  
Richard Wachepa ◽  
Oscar Kanjerwa ◽  
...  
Keyword(s):  
Rotavirus Vaccine ◽  
Predominant Genotype ◽  
Vaccine Introduction ◽  
Strain Diversity ◽  
Positive Stool ◽  
Genotype Variation ◽  
Before And After ◽  
Polymerase Chain ◽  
The Impact ◽  
Genotype G3

Abstract Background Rotavirus vaccine (Rotarix [RV1]) has reduced diarrhea-associated hospitalizations and deaths in Malawi. We examined the trends in circulating rotavirus genotypes in Malawi over a 22-year period to assess the impact of RV1 introduction on strain distribution. Methods Data on rotavirus-positive stool specimens among children aged &lt;5 years hospitalized with diarrhea in Blantyre, Malawi before (July 1997–October 2012, n = 1765) and after (November 2012–October 2019, n = 934) RV1 introduction were analyzed. Rotavirus G and P genotypes were assigned using reverse-transcription polymerase chain reaction. Results A rich rotavirus strain diversity circulated throughout the 22-year period; Shannon (H′) and Simpson diversity (D′) indices did not differ between the pre- and postvaccine periods (H′ P &lt; .149; D′ P &lt; .287). Overall, G1 (n = 268/924 [28.7%]), G2 (n = 308/924 [33.0%]), G3 (n = 72/924 [7.7%]), and G12 (n = 109/924 [11.8%]) were the most prevalent genotypes identified following RV1 introduction. The prevalence of G1P[8] and G2P[4] genotypes declined each successive year following RV1 introduction, and were not detected after 2018. Genotype G3 reemerged and became the predominant genotype from 2017 onward. No evidence of genotype selection was observed 7 years post–RV1 introduction. Conclusions Rotavirus strain diversity and genotype variation in Malawi are likely driven by natural mechanisms rather than vaccine pressure.

scholarly journals The impact of teaching on the duration of common urological operations

2016 ◽  
Vol 10 (5-6) ◽  
pp. 172 ◽  
Author(s):  
Blayne Welk ◽  
Jennifer Winick-Ng ◽  
Andrew McClure ◽  
Chris Vinden ◽  
Sumit Dave ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Potential Effect ◽  
Sensitivity Analyses ◽  
Teaching Hospitals ◽  
Operative Duration ◽  
Open Radical Prostatectomy ◽  
Academic Hospitals ◽  
The Impact

Introduction: The ability of academic (teaching) hospitals to offer the same level of efficiency as non-teaching hospitals in a publicly funded healthcare system is unknown. Our objective was to compare the operative duration of general urology procedures between teaching and non-teaching hospitals. Methods: We used administrative data from the province of Ontario to conduct a retrospective cohort study of all adults who underwent a specified elective urology procedure (2002–2013). Primary outcome was duration of surgical procedure. Primary exposure was hospital type (academic or non-teaching). Negative binomial regression was used to adjust relative time estimates for age, comorbidity, obesity, anesthetic, and surgeon and hospital case volume.Results: 114 225 procedures were included (circumcision n=12 280; hydrocelectomy n=7221; open radical prostatectomy n=22 951; transurethral prostatectomy n=56 066; or mid-urethral sling n=15 707). These procedures were performed in an academic hospital in 14.8%, 13.3%, 28.6%, 17.1%, and 21.3% of cases, respectively. The mean operative duration across all procedures was higher in academic centres; the additional operative time ranged from 8.3 minutes (circumcision) to 29.2 minutes (radical prostatectomy). In adjusted analysis, patients treated in academic hospitals were still found to have procedures that were significantly longer (by 10‒21%). These results were similar in sensitivity analyses that accounted for the potential effect of more complex patients being referred to tertiary academic centres.Conclusions: Five common general urology operations take significantly longer to perform in academic hospitals. The reason for this may be due to the combined effect of teaching students and residents or due to inherent systematic inefficiencies within large academic hospitals.

scholarly journals Epidemiology of intussusception before and after rotavirus vaccine introduction in Fiji

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Felisita Tupou Ratu ◽  
Rita Reyburn ◽  
Evelyn Tuivaga ◽  
Asena Tuiketei ◽  
Kylie Jenkins ◽  
...  
Keyword(s):  
Rotavirus Vaccine ◽  
Vaccine Introduction ◽  
Before And After

scholarly journals 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

2019 ◽  
Vol 73 (11) ◽  
pp. 1020-1025 ◽  
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.

scholarly journals Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas

2018 ◽  
Vol 46 (8) ◽  
pp. 3172-3182 ◽  
Author(s):  
Vijay Agusala ◽  
Priyanka Vij ◽  
Veena Agusala ◽  
Vivekanand Dasari ◽  
Bhargavi Kola
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Parental Education ◽  
Pediatric Patients ◽  
Hospital Admissions ◽  
Care Utilization ◽  
Asthma Education ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Objective It is well known that parent/patient education helps to reduce the burden of asthma in urban areas, but data are scarce for rural areas. This study explored the impact of asthma education in Ector County, a rural part of Health Services Region 9 in Texas, which has one of the highest prevalence rates of asthma in the state. Methods This prospective study investigated an interactive asthma education intervention in pediatric patients aged 2–18 years and their caregivers. Change in parental/caregiver knowledge about their child’s asthma along with frequency of missed school days, emergency department (ED) visits and hospital admissions was obtained via telephone surveys before and after the educational intervention was delivered. Results The study enrolled 102 pediatric patients and their parents/caregivers. Asthma education was associated with significantly fewer school absences, ED visits and hospitalizations. Parents/caregivers reported feeling better educated, knowing what triggers an asthma exacerbation, identifying the signs of a severe asthma attack in their child, feeling confident about managing asthma and feeling that the asthma was under control. Conclusion Asthma education of caregivers and children was associated with better symptom management and fewer acute exacerbations, pointing to the relevance and importance of asthma education among pediatric patients in rural areas.

scholarly journals 1491. Active Norovirus Surveillance in Children Under 5 Years with Diarrhea after Rotavirus Vaccine Introduction in Argentina (2017–2019)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S543-S543
Author(s):  
Angela Gentile ◽  
Juan Stupka ◽  
Juan I Degiuseppe ◽  
María del Valle Juárez ◽  
Maria Florencia Lucion ◽  
...  
Keyword(s):  
Acute Diarrhea ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Epidemiological Surveillance ◽  
Watery Diarrhea ◽  
Rotavirus Vaccine ◽  
Cross Sectional ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Children Under 5

Abstract Background Acute diarrhea is one of the leading causes of infant morbidity and mortality. Argentina introduced massive rotavirus vaccination in 2015. In several countries, this introduction has changed the distribution of enteropathogens. The decrease in the prevalence of rotavirus has been described at the expense of an increase in Norovirus (NoV) activity worldwide. The aim of this study was to analyze the role of NoV in acute diarrhea cases in outpatient children under 5 years of age and their epidemiological profile. Methods A prospective and cross-sectional study in <5 years outpatients attended for acute diarrhea in Children’s Hospital “Dr. Ricardo Gutiérrez” in Buenos Aires, Argentina, between July 2017 and March 2019 was conducted. Active epidemiological surveillance was performed with a specific case reporting form. Stool samples were tested for NoV (RT-qPCR). Clinical and epidemiological data were recorded. Results A total of 252 patients were enrolled and 235 stools samples were tested. Median of age was 22.3 months (IQR: 11–30), 58.7% were male. The most frequent symptoms were fever and vomiting in 63.1% and 53%, respectively; 52% had watery diarrhea, 45.2% had moderate diarrhea according to Vesikari Scale, 95.6% were normohydrated and 22% had a household member with diarrhea. There were no immunocompromised children. A 72% had received rotavirus vaccine, 86% of them with full scheme. From samples tested, 27% (n = 63) were NoV positive. NoV was found throughout the year and the frequency of detection was higher in January and June (summer and winter in Argentina). Regarding genetic diversity the most frequent genogroup was GII (65%; 41/63) and genotype GII.P16-GII.4 Sydney (48%; 20/41). Bacterial co-infection was observed in 35%. Compared with negative cases, NoV were younger (18 vs. 20 months; P < 0.001) and were associated with higher prevalence of rotavirus vaccination (88% vs. 66%; P = 0.001). No statistically difference was found regarding to gender, clinical outcome and severity. Conclusion NoV was detected at high frequency (27%) in children presenting moderate acute diarrhea, mainly in those who received rotavirus vaccine. Regarding sporadic acute diarrhea cases in children, it is important to consider NoV as a frequent etiological agent. Disclosures All authors: No reported disclosures.

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