1
|
Sadiq A, Khan J. Rotavirus in developing countries: molecular diversity, epidemiological insights, and strategies for effective vaccination. Front Microbiol 2024; 14:1297269. [PMID: 38249482 PMCID: PMC10797100 DOI: 10.3389/fmicb.2023.1297269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
Rotavirus (RV) causes the loss of numerous children's lives worldwide each year, and this burden is particularly heavy in low- and lower-middle-income countries where access to healthcare is limited. RV epidemiology exhibits a diverse range of genotypes, which can vary in prevalence and impact across different regions. The human genotypes that are most commonly recognized are G1P[8], G2P[4], G3P[8], G4P[8], G8P[8], G9P[8], and G12P[8]. The diversity of rotavirus genotypes presents a challenge in understanding its global distribution and developing effective vaccines. Oral, live-attenuated rotavirus vaccines have undergone evaluation in various contexts, encompassing both low-income and high-income populations, demonstrating their safety and effectiveness. Rotavirus vaccines have been introduced and implemented in over 120 countries, offering an opportunity to assess their effectiveness in diverse settings. However, these vaccines were less effective in areas with more rotavirus-related deaths and lower economic status compared to wealthier regions with fewer rotavirus-related deaths. Despite their lower efficacy, rotavirus vaccines significantly decrease the occurrence of diarrheal diseases and related mortality. They also prove to be cost-effective in regions with a high burden of such diseases. Regularly evaluating the impact, influence, and cost-effectiveness of rotavirus vaccines, especially the newly approved ones for worldwide use, is essential for deciding if these vaccines should be introduced in countries. This is especially important in places with limited resources to determine if a switch to a different vaccine is necessary. Future research in rotavirus epidemiology should focus on a comprehensive understanding of genotype diversity and its implications for vaccine effectiveness. It is crucial to monitor shifts in genotype prevalence and their association with disease severity, especially in high-risk populations. Policymakers should invest in robust surveillance systems to monitor rotavirus genotypes. This data can guide vaccine development and public health interventions. International collaboration and data sharing are vital to understand genotype diversity on a global scale and facilitate the development of more effective vaccines.
Collapse
Affiliation(s)
- Asma Sadiq
- Department of Microbiology, University of Jhang, Jhang, Pakistan
| | - Jadoon Khan
- Department of Allied and Health Sciences, IQRA University, Chak Shahzad Campus, Islamabad, Pakistan
| |
Collapse
|
2
|
Ligero-López J, García-Rodríguez J, Ruiz-Carrascoso G. Diagnosis of gastrointestinal infections: comparison between traditional microbiology and a commercial syndromic molecular-based panel. FEMS Microbiol Lett 2023; 370:fnad122. [PMID: 37960927 DOI: 10.1093/femsle/fnad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/26/2023] [Accepted: 11/11/2023] [Indexed: 11/15/2023] Open
Abstract
Traditional diagnosis of infectious gastroenteritis is based on culture, microscopy and antigen detection. The development of gastrointestinal syndromic panels based on molecular techniques have allowed rapid and simultaneous identification of multiple pathogens. The objective was to evaluate the implementation of Allplex™ Gastrointestinal Panel Assays (AGPA): Allplex™ GI-Virus, Allplex™ GI-Bacteria (I) and Allplex™ GI-Parasite by comparing with traditional diagnosis. A retrospective comparative study was conducted at Hospital Universitario La Paz, between the first year of implementation of the AGPA (April 1, 2018 to March 31, 2019) and the results obtained during the previous year with traditional methods (April 1, 2017 to March 31, 2018). With the implementation of AGPA we obtained an increase in the detection of rotavirus and adenovirus, being statistically significant for rotavirus ([CI95%:3.60-6.79]; P < 0.05) and an increase in the positivity rates of all the bacteria tested, with the exception of Salmonella spp. ([CI95%:3.60-6.79]; P < 0.05). Comparing the bacteria recovered by culture, we obtained an increase in the case of Shigella spp. cultivation during the AGPA period. Regarding protozoa, we achieved a significant increase in the positivity rates for Cryptosporidium spp. ([CI95%:1.98-3.01] P < 0.05), Giardia intestinalis ([CI95%:3.94-5.25]; P < 0.05) and Blastocystis spp. ([CI95%:9.44-11.36]; P < 0.05). There was an improvement in report turnaround time when comparing molecular diagnosis to bacterial culture and concentration plus microscopy for parasites; but not compared with antigen detection. The molecular diagnosis approach with AGPA were more sensitive and had a faster turnaround time for some targets, and in our setting, enabled an increased diagnostic capacity for viruses and protozoa.
Collapse
Affiliation(s)
- Jorge Ligero-López
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, 28046 - Madrid, Spain
| | - Julio García-Rodríguez
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, 28046 - Madrid, Spain
| | - Guillermo Ruiz-Carrascoso
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, 28046 - Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, 28029 -Madrid, Spain
| |
Collapse
|
3
|
Cohen R, Martinón-Torres F, Posiuniene I, Benninghoff B, Oh KB, Poelaert D. The Value of Rotavirus Vaccination in Europe: A Call for Action. Infect Dis Ther 2023; 12:9-29. [PMID: 36355309 PMCID: PMC9647247 DOI: 10.1007/s40121-022-00697-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/08/2022] [Indexed: 11/12/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has pushed many healthcare systems into crisis. High vaccine coverage amongst children reduces emergency room presentations, hospital admissions and deaths due to vaccine-preventable diseases, freeing up healthcare resources including polymerase chain reaction testing for patients with SARS-CoV-2. In Europe, rotavirus gastroenteritis leads to 75,000-150,000 hospitalisations and up to 600,000 medical encounters annually. Nevertheless, in 2022, only 18 countries in Europe (out of 38) have a publicly funded routine universal mass immunisation programme against rotavirus gastroenteritis. Evidence available in the last few years re-emphasises that rotavirus vaccines currently available in Europe are highly effective, preventing up to 96% of rotavirus-related hospitalisations in children less than 1 year of age (potentially 72,000-144,000 hospitalisations Europe-wide). Long-term surveillance indicates that rotavirus vaccination does not result in an overall increase in intussusception. On the contrary, increasing evidence suggests an overall reduction in intussusception in the first 12 months of life when early, high rotavirus vaccine coverage is achieved. Prevention of rotavirus gastroenteritis has marked positive impacts on parental wages and government tax revenue, with benefits extending across the whole economy. In the SARS-CoV-2 pandemic setting there is a new imperative to achieve high levels of paediatric vaccination against vaccine-preventable diseases, including rotavirus gastroenteritis. The introduction of rotavirus universal mass vaccination can be expected to reduce the number of preventable illnesses, hospitalisations and deaths caused by rotavirus gastroenteritis. Reducing vaccine-preventable diseases is particularly urgent at this time when healthcare systems are preoccupied and overwhelmed with SARS-CoV-2. Graphical abstract available for this article.
Collapse
Affiliation(s)
- Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France ,Groupe de Pathologie Infectieuse Pédiatrique, Paris, France ,Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France ,Université Paris Est, Mondor Institute of Biomedical Research-Groupement de Recherche Clinique Groupe d’étude de Maladies Infectieuses Néonatales Et Infantiles, Créteil, France ,Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and Universidad de Santiago de Compostela (USC), Galicia, Spain ,Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Hospital Clínico Universitario and Universidad de Santiago de Compostela (USC), Galicia, Spain ,Centro de Investigación Biomédica en Enfermedades Respiratorias (CIBERES), Instituto Carlos III, Madrid, Spain
| | | | | | | | | |
Collapse
|
4
|
Arístegui J, Alfayate-Miguelez S, Carazo-Gallego B, Garrote E, Díaz-Munilla L, Mendizabal M, Méndez-Hernández M, Doménech E, Ferrer-Lorente B, Unsaín-Mancisidor M, Ramos-Amador JT, Illán-Ramos M, Croche-Santander B, Centeno Malfaz F, Rodríguez-Suárez J, Cotarelo Suárez M, San-Martín M, Ruiz-Contreras J. Clinical characteristics, health care resource utilization and direct medical costs of Rotavirus hospitalizations in Spain (2013-2018). Hum Vaccin Immunother 2022; 18:2046961. [PMID: 35435807 PMCID: PMC9196715 DOI: 10.1080/21645515.2022.2046961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rotavirus (RV) is the most common cause of severe gastroenteritis (GE) in infants and young children worldwide and is associated with a significant clinical and economic burden. The objective of this study was to analyze the characteristics, healthcare resource utilization and the direct medical costs related to RVGE hospitalizations in Spain. An observational, multicenter, cross-sectional study was conducted from June 2013 to May 2018 at the pediatric departments of 12 hospitals from different Spanish regions. Children under 5 years of age admitted to the hospital with a confirmed diagnosis of RVGE were selected. Data on clinical characteristics, healthcare resource use and costs were collected from patient records and hospital databases. Most children hospitalized for RVGE did not have any previous medical condition or chronic disease. Forty-seven percent had previously visited the Emergency Room (ER), 27% had visited a primary care pediatrician, and 15% had received pharmacological treatment prior to hospital admission due to an RVGE episode. The average length of a hospital stay for RVGE was 5.6 days, and the mean medical costs of RVGE hospitalizations per episode ranged from 3,940€ to 4,100€. The highest direct medical cost was due to the hospital stay. This study showed a high burden of health resource utilization and costs related to the management of cases of RVGE requiring hospitalization. RV vaccination with high coverage rates should be considered to minimize the clinical and economic impacts of this disease on the health-care system.
Collapse
Affiliation(s)
| | | | | | - Elisa Garrote
- Pediatrics, Hospital Universitario de Basurto, Bilbao, Spain
| | | | | | | | - Elia Doménech
- Paediatrics, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Belén Ferrer-Lorente
- Paediatrics, Hospital Germans Trias i Pujol, Badalona, Spain.,Paediatrics, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - María Unsaín-Mancisidor
- Paediatrics, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,Paediatrics, Hospital Universitario de Donostia, San Sebastián, Spain
| | - José Tomás Ramos-Amador
- Paediatrics, Hospital Universitario de Donostia, San Sebastián, Spain.,Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Marta Illán-Ramos
- Paediatrics, Hospital Universitario de Donostia, San Sebastián, Spain.,Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Borja Croche-Santander
- Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain.,Paediatrics, Hospital Juan Ramón Jiménez, Huelva, Spain
| | - Fernando Centeno Malfaz
- Paediatrics, Hospital Juan Ramón Jiménez, Huelva, Spain.,Paediatrics, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Julián Rodríguez-Suárez
- Paediatrics, Hospital Universitario Río Hortega, Valladolid, Spain.,Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Manuel Cotarelo Suárez
- Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain.,Medical Affairs Department, MSD, Madrid, Spain
| | - María San-Martín
- Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain.,Medical Affairs Department, MSD, Madrid, Spain
| | - Jesús Ruiz-Contreras
- Medical Affairs Department, MSD, Madrid, Spain.,Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| |
Collapse
|
5
|
Bencina G, Costantino C, Mameli C, Sabale U, Murtagh J, Newman R, Ahern A, Bhaila R, Sanchez AO, Martinon-Torres F, Carias C. Real-world impact of rotavirus vaccination in European healthcare settings: a systematic literature review. Expert Rev Vaccines 2022; 21:1121-1136. [PMID: 35708263 DOI: 10.1080/14760584.2022.2075851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Rotavirus is one of the most common pathogens causing diarrhea in children <5 years and has a major impact on childhood morbidity and mortality. Since the implementation of rotavirus vaccines into childhood immunization programs across Europe, there has been a reduction in rotavirus burden, including hospitalizations, outpatient cases, costs, and deaths. AREAS COVERED A systematic literature review identified publications describing the clinical and economic impact of rotavirus vaccinations across Europe, from their introduction in 2006 to the end of 2020. A total of 3,137 articles were identified, of which 46 were included in the review. Included articles reported the impact of rotavirus vaccination on disease in any age group. EXPERT OPINION Rotavirus vaccination has resulted in substantial reductions in hospitalizations and rotavirus-associated costs across Europe, particularly in children <5 years. There is some evidence of herd protection afforded to older age groups where vaccine uptake is high among infants, highlighting the potential for vaccination to confer a greater societal benefit as programs become more established. Increasing vaccination coverage and continuing investment in widespread rotavirus vaccination programs across countries will likely increase the substantial public health benefits associated with vaccination and further reduce the clinical and economic burden of disease.
Collapse
Affiliation(s)
- Goran Bencina
- Center for Observational and Real-World Evidence (CORE), MSD, Madrid, Spain
| | - Claudio Costantino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Excellence Specialties "G. D'Alessandro," University of Palermo, Palermo, Italy.,Department of Science for Health Promotion and Mother Child Care, University of Palermo, Palermo, Italy
| | - Chiara Mameli
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Ugne Sabale
- Center for Observational and Real-World Evidence (CORE), MSD, Stockholm, Sweden
| | - Janice Murtagh
- Medical Affairs Vaccines, Merck & Co., Inc, Kenilworth, NJ, USA
| | | | | | | | - Alejandro Orrico Sanchez
- Department of Vaccine Research, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Valencia, Spain
| | - Federico Martinon-Torres
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, University of Santiago, Santiago de Compostela, Spain.,Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | - Cristina Carias
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc, Kenilworth, NJ, USA
| |
Collapse
|
6
|
Ruiz-Contreras J, Alfayate-Miguelez S, Carazo-Gallego B, Onís E, Díaz-Munilla L, Mendizabal M, Méndez Hernández M, Ferrer-Lorente B, Unsaín-Mancisidor M, Ramos-Amador JT, Croche-Santander B, Centeno Malfaz F, Rodríguez-Suárez J, Cotarelo M, San-Martín M, Arístegui J. Rotavirus gastroenteritis hospitalizations in provinces with different vaccination coverage rates in Spain, 2013-2018. BMC Infect Dis 2021; 21:1138. [PMID: 34742235 PMCID: PMC8572461 DOI: 10.1186/s12879-021-06841-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/29/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Rotavirus (RV) vaccines are available in Spain since 2006 but are not included in the National Immunization Program. RV vaccination has reached an intermediate vaccination coverage rate (VCR) but with substantial differences between provinces. The aim of this study was to assess the ratio of RV gastroenteritis (RVGE) admissions to all-cause hospitalizations in children under 5 years of age in areas with different VCR. METHODS Observational, multicenter, cross-sectional, medical record-based study. All children admitted to the study hospitals with a RVGE confirmed diagnosis during a 5-year period were selected. The annual ratio of RVGE to the total number of all-cause hospitalizations in children < 5 years of age were calculated. The proportion of RVGE hospitalizations were compared in areas with low (< 30%), intermediate (31-59%) and high (> 60%) VCR. RESULTS From June 2013 to May 2018, data from 1731 RVGE hospitalizations (16.47% of which were nosocomial) were collected from the 12 study hospitals. RVGE hospital admissions accounted for 2.82% (95 CI 2.72-3.00) and 43.84% (95% CI 40.53-47.21) of all-cause and Acute Gastroenteritis (AGE) hospitalizations in children under 5 years of age, respectively. The likelihood of hospitalization due to RVGE was 56% (IC95%, 51-61%) and 27% (IC95%, 18-35%) lower in areas with high and intermediate VCR, respectively, compared to the low VCR areas. CONCLUSIONS RVGE hospitalization ratios are highly dependent on the RV VCR. Increasing VCR in areas with intermediate and low coverage rates would significantly reduce the severe burden of RVGE that requires hospital management in Spain. Clinical trial registration Not applicable.
Collapse
Affiliation(s)
| | - S Alfayate-Miguelez
- Pediatrics, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - B Carazo-Gallego
- Pediatrics, Hospital Regional Universitario de Málaga, Malaga, Spain
| | - E Onís
- Pediatrics, Hospital Universitario de Basurto, Bilbao, Spain
| | - L Díaz-Munilla
- Pediatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Mendizabal
- Pediatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - B Ferrer-Lorente
- Pediatrics, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - J T Ramos-Amador
- Pediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - F Centeno Malfaz
- Pediatrics, Hospital Universitario Río Hortega, Valladolid, Spain
| | | | - M Cotarelo
- Medical Affairs Department, MSD Spain, C/Josefa Valcárcel, 38, 28027, Madrid, Spain
| | - M San-Martín
- Medical Affairs Department, MSD Spain, C/Josefa Valcárcel, 38, 28027, Madrid, Spain.
| | - J Arístegui
- Pediatrics, Hospital Universitario de Basurto, Bilbao, Spain
| |
Collapse
|
7
|
Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J. [Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations]. An Pediatr (Barc) 2021; 94:53.e1-53.e10. [PMID: 33419517 DOI: 10.1016/j.anpedi.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 10/22/2022] Open
Abstract
The CAV-AEP annually publishes the immunisation schedule considered optimal for all children and adolescent resident in Spain, taking into account the available evidence. The 2+1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate.A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2+1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for triple viral (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, regardless of gender, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders.
Collapse
Affiliation(s)
| | - María José Cilleruelo Ortega
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | | | - María Garcés-Sánchez
- Centro de Salud Nazaret, Valencia, España; Área de Vacunas, FISABIO, Valencia, España
| | - Nuria García Sánchez
- Centro de Salud Delicias Sur, Zaragoza, España; Departamento de Pediatría, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
| | - Elisa Garrote Llanos
- Sección de Infectología, Hospital Universitario Basurto, Bilbao, España; Facultad de Medicina, Universidad del País Vasco, UPV-EHU, Bilbao, España
| | | | | | | | - María Luisa Navarro Gómez
- Servicio de Pediatría, Hospital Universitario Gregorio Marañón, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - Jesús Ruiz-Contreras
- Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | | |
Collapse
|
8
|
Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.anpede.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
9
|
Azor-Martinez E, Garcia-Fernandez L, Strizzi JM, Cantarero-Vallejo MD, Jimenez-Lorente CP, Balaguer-Martinez JV, Torres-Alegre P, Yui-Hifume R, Sanchez-Forte M, Gimenez-Sanchez F. Effectiveness of a hand hygiene program to reduce acute gastroenteritis at child care centers: A cluster randomized trial. Am J Infect Control 2020; 48:1315-1321. [PMID: 32303373 DOI: 10.1016/j.ajic.2020.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 12/15/2022]
Abstract
We aimed to assess the effectiveness of an educational and hand hygiene program in daycare centers (DCCs) and homes on acute gastroenteritis (AGE) incidence in children attending DCCs. METHODS A randomized, controlled, and open study of 911 children aged 0-3 years attending 24 DCCs in Almería (Spain) with an 8-month follow-up was employed. Two intervention groups of DCCs families performed educational and hand hygiene measures, 1 with soap and water (soap and water group; n = 274), another with hand sanitizer (hand sanitizer group [HSG]; n = 339), and the control group (CG; n = 298) followed usual handwashing procedures. We compared AGE episode rates with Poisson regression model. RESULTS seven hundred fourteen AGE episodes were registered, significant differences between HSG and CG children were found during December and January. A multivariate model was applied and the adjusted incidence rate ratios by rotavirus vaccination found significant differences when children were previously vaccinated, the children in the soap and water group had a higher risk of AGE episodes (incidence rate ratio: 1.28, 95% confidence interval:1.0-1.64), compared with those in the HSG. CONCLUSIONS This study demonstrated that hand hygiene programs that included hand sanitizer were most effective in the winter months. Further, the largest reduction of AGE episodes occurred in the children that followed hand hygiene programs including hand sanitizer and educational measures for DCC staff, parents, and children, and were vaccinated for rotavirus.
Collapse
|
10
|
Silva-Sales M, Martínez-Puchol S, Gonzales-Gustavson E, Hundesa A, Gironès R. High Prevalence of Rotavirus A in Raw Sewage Samples from Northeast Spain. Viruses 2020; 12:v12030318. [PMID: 32188099 PMCID: PMC7150846 DOI: 10.3390/v12030318] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/08/2020] [Accepted: 03/14/2020] [Indexed: 12/20/2022] Open
Abstract
Rotavirus A (RVA) is the most common virus associated with infantile gastroenteritisworldwide, being a public health threat, as it is excreted in large amounts in stool and can persist inthe environment for extended periods. In this study, we performed the detection of RVA and humanadenovirus (HAdV) by TaqMan qPCR and assessed the circulation of RVA genotypes in threewastewater treatment plants (WWTPs) between 2015 and 2016 in Catalonia, Spain. RVA wasdetected in 90% and HAdV in 100% of the WWTP samples, with viral loads ranging between 3.96 ×104 and 3.30 × 108 RT-PCR Units/L and 9.51 × 104 and 1.16 × 106 genomic copies/L, respectively. RVAVP7 and VP4 gene analysis revealed the circulation of G2, G3, G9, G12, P[4], P[8], P[9] and P[10].Nucleotide sequencing (VP6 fragment) showed the circulation of I1 and I2 genotypes, commonlyassociated with human, bovine and porcine strains. It is important to mention that the RVA strainsisolated from the WWTPs were different from those recovered from piglets and calves living in thesame area of single sampling in 2016. These data highlight the importance of monitoring watermatrices for RVA epidemiology and may be a useful tool to evaluate and predict possibleemergence/reemergence of uncommon strains in a region.
Collapse
|
11
|
IMMUNISATION SCHEDULE OF THE SPANISH ASSOCIATION OF PAEDIATRICS: 2020 RECOMMENDATIONS. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.anpede.2019.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
|
12
|
Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Merino Moína M, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J, Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Merino Moína M, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J. Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2020. An Pediatr (Barc) 2020; 92:52.e1-52.e10. [DOI: 10.1016/j.anpedi.2019.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 12/19/2022] Open
|
13
|
Novel Human Astroviruses: Prevalence and Association with Common Enteric Viruses in Undiagnosed Gastroenteritis Cases in Spain. Viruses 2019; 11:v11070585. [PMID: 31252663 PMCID: PMC6669616 DOI: 10.3390/v11070585] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/14/2022] Open
Abstract
A remarkable percentage of acute gastroenteritis cases remain etiologically undiagnosed. The aim of the study was to determine the prevalence of common and emerging enteric viruses, such as novel human astroviruses, among undiagnosed samples from children with acute gastroenteritis. Epidemiological studies for novel human astroviruses are still scarce. Stool samples collected over two consecutive winter seasons (2016–2017) from children with gastroenteritis in Spain, which were negative for bacteria, rotavirus, and adenovirus by routine diagnostics were screened by real-time RT-PCR assays for the presence of classical and novel astrovirus, rotavirus, norovirus GI and GII, sapovirus, and adenovirus. Overall, 220/384 stool samples (57.3%) were positive for at least one virus. Co-infections were identified in 21% of cases. Among a total of 315 viruses identified, adenovirus was the most prevalent (n = 103), followed by rotavirus (n = 51), sapovirus (n = 50), classical astrovirus (n = 43), novel astroviruses (n = 42), and norovirus (n = 26). Novel astroviruses were present in 13.3% of virus-positive cases. Most novel astroviruses were found in children <2-year-old (30/39 children, 77%, p = 0.01) and were found in co-infection (66%). Only classical astroviruses demonstrated significant differences in the Cq values during mono-infections compared to co-infections. In conclusion, common enteric viruses may be frequently found in children with undiagnosed gastroenteritis, indicating the need to implement more sensitive diagnostic methods. Novel astroviruses circulate in the community and could be the cause of gastroenteritis among young children.
Collapse
|