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Britoh Mlan A, Burke RM, Koné H, Boni-Cisse C, N'Guessan R, Zaba F, Aka LN, N'Zue K, Adom SK, Kouadio SK, Bhérat Kouadio A, Meité S, Koffi S, Faye-Kette H, Shaba K, Ntsama B, Biey J, Aliabadi N, Mwenda JM, Parashar UD, Tate JE. Impact of rotavirus vaccine introduction in Abidjan, Côte d'Ivoire. Hum Vaccin Immunother 2023; 19:2156231. [PMID: 36719054 PMCID: PMC9980462 DOI: 10.1080/21645515.2022.2156231] [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] [Indexed: 02/01/2023] Open
Abstract
Côte d'Ivoire introduced rotavirus vaccine in March 2017. Rotavirus surveillance is conducted at Centre Hospitalier Universitaire de Yopougon in Abidjan, the capital city. Children <5 years of age are enrolled in rotavirus surveillance if admitted to the hospital with acute gastroenteritis. We used sentinel surveillance data from 2014 through mid-2019 to compare trends in rotavirus pediatric gastroenteritis hospitalizations before and after rotavirus vaccine introduction. We used Poisson regression to analyze changes in rotavirus prevalence, adjusting for calendar month and accounting for total monthly admissions; January 2014 - December 2016 was considered "pre-vaccine," and January 2017 - June 2019 was considered "post-vaccine." Age distribution and severity were compared between periods using the Mann-Whitney U test. Rotavirus-positive admissions declined 51% (95% CI: 28%-67%), from 31.5% pre-vaccine to 14.9% afterward. The median age of rotavirus-positive children increased from 7 months (interquartile range [IQR]: 5-11) in the pre-vaccine period to 11 months (IQR: 7-18, p = .005) in the post-vaccine period. The median severity score decreased from 11 to 9 (p = .008) among all children, and from 12 pre- to 10.5 post-vaccine (p = .35) among rotavirus-positive children. Our findings suggest that rotavirus vaccine introduction contributed to reduced rotavirus hospitalization in Abidjan and possibly more broadly.
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Affiliation(s)
- Alice Britoh Mlan
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Rachel M Burke
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hamidou Koné
- Direction de Programme Elargi de Vaccination, Abidjan, Côte d'Ivoire
| | | | - Rebecca N'Guessan
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Flore Zaba
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Lepri Nicaise Aka
- Direction de Programme Elargi de Vaccination, Abidjan, Côte d'Ivoire
| | - Kofi N'Zue
- Country Office for Côte d'Ivoire, World Health Organization, Abidjan, Côte d'Ivoire
| | - San Koffi Adom
- Country Office for Côte d'Ivoire, World Health Organization, Abidjan, Côte d'Ivoire
| | - Sié Kabran Kouadio
- Country Office for Côte d'Ivoire, World Health Organization, Abidjan, Côte d'Ivoire
| | | | - Syndou Meité
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire.,Institut Pasteur, Abidjan, Côte d'Ivoire
| | | | | | - Keith Shaba
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Bernard Ntsama
- World Health Organization Regional Office for Africa, Inter-Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Joseph Biey
- World Health Organization Regional Office for Africa, Inter-Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Negar Aliabadi
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Umesh D Parashar
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E Tate
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ma W, Wei Z, Guo J, Lu L, Li J, Cai J, Wang X, Chang H, Huang Z, Guo X, Zhu Q, Xu J, Zeng M. Effectiveness of Pentavalent Rotavirus Vaccine in Shanghai, China: A Test-Negative Design Study. J Pediatr 2023; 259:113461. [PMID: 37172809 DOI: 10.1016/j.jpeds.2023.113461] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/13/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To evaluate vaccine effectiveness (VE) of a live oral pentavalent rotavirus vaccine (RotaTeq, RV5) among young children in Shanghai, China, via a test-negative design study. STUDY DESIGN We consecutively recruited children visiting a tertiary children's hospital for acute diarrhea from November 2021 to February 2022. Information on clinical data and rotavirus vaccination was collected. Fresh fecal samples were obtained for rotavirus detection and genotyping. To evaluate VE of RV5 against rotavirus gastroenteritis among young children, unconditional logistic regression models were conducted to compare ORs for vaccination between rotavirus-positive cases and test-negative controls. RESULTS A total of 390 eligible children with acute diarrhea were enrolled, including 45 (11.54%) rotavirus-positive cases and 345 (88.46%) test-negative controls. After excluding 4 cases (8.89%) and 55 controls (15.94%) who had received the Lanzhou lamb rotavirus vaccine, 41 cases (12.39%) and 290 controls (87.61%) were included for the evaluation of RV5 VE. After adjustment for potential confounders, the 3-dose RV5 vaccination showed 85% (95% CI, 50%-95%) VE against mild to moderate rotavirus gastroenteritis among children aged 14 weeks to ≤4 years and 97% (95% CI, 83%-100%) VE among children aged 14 weeks to ≤2 years with genotypes G8P8, G9P8, and G2P4 represented 78.95%, 18.42%, and 2.63% of circulation strains, respectively. CONCLUSIONS A 3-dose vaccination of RV5 is highly protective against rotavirus gastroenteritis among young children in Shanghai. The G8P8 genotype prevailled in Shanghai after RV5 introduction.
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Affiliation(s)
- Wenjie Ma
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zhongqiu Wei
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Jiayin Guo
- Department of Microbiology, Changning District Center for Disease Control and Prevention, Shanghai, China
| | - Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Jingjing Li
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Jiehao Cai
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Xiangshi Wang
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Hailing Chang
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zhuoying Huang
- Institute of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai, China
| | - Xiang Guo
- Institute of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai, China
| | - Qirong Zhu
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Mei Zeng
- Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
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Nazurdinov A, Azizov Z, Mullojonova M, Sadykova U, Mosina L, Singh S, Suleymonova S, Tishkova F, Videbaek D, Cortese MM, Daniels DS, Burke RM. Impact and effectiveness of monovalent rotavirus vaccine in Tajik children. Vaccine 2022; 40:3705-3712. [PMID: 35581101 DOI: 10.1016/j.vaccine.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/04/2022] [Accepted: 05/05/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND In 2015, Tajikistan became the second country in Central Asia to introduce rotavirus vaccine into its national immunization program. Before vaccine introduction, rotavirus was estimated to cause > 40% of pediatric diarrhea hospitalizations in Tajikistan. We aimed to assess the impact of rotavirus vaccine introduction on rotavirus disease burden and estimate rotavirus vaccine effectiveness (VE). METHODS Using surveillance data from 2013 through 2019, we examined trends in monthly hospital admissions among children < 5 years old, before and after rotavirus vaccine introduction. Poisson regression was used to quantify decreases. VE was estimated using a test-negative case control design, with data from admissions during 2017 - 2019. Immunization records were obtained from clinics. RESULTS Among enrolled children, rotavirus positivity declined from 42% to 25% in the post-vaccine introduction period, a decrease of 41% (95% Confidence Interval [CI]: 36 - 45%). Declines were greatest in children < 12 months of age. Estimated VE of a complete course of rotavirus vaccine was 55% (95% CI: 21 - 73%) among children 5 - 59 months of age and 64% (95% CI: 36 - 80%) among children 5 - 23 months of age. VE point estimates were higher among children receiving both doses of rotavirus vaccine non-concurrently with OPV and among children receiving their first dose of rotavirus vaccine at 4 - 11 months of age, but CIs were wide and overlapping. CONCLUSIONS Our data demonstrate that rotavirus vaccine introduction was associated with a substantial reduction in pediatric rotavirus hospitalization burden in Tajikistan, and that rotavirus vaccination is effective in Tajik children.
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Affiliation(s)
- Anvar Nazurdinov
- State Institution "Republican Center of Immunoprophylaxis", Dushanbe, Tajikistan; Department of Epidemiology of the State Educational Institution "Avicenna Tajik State Medical University", Dushanbe, Tajikistan.
| | - Zafarjon Azizov
- State Institution "Republican Center of Immunoprophylaxis", Dushanbe, Tajikistan
| | - Manija Mullojonova
- Virology Laboratory of Tajik Research Institute of Preventive Medicine, Dushanbe, Tajikistan
| | - Umeda Sadykova
- Tajikistan Country Office, World Health Organization, Dushanbe, Tajikistan
| | - Liudmila Mosina
- Vaccine-preventable Diseases and Immunization, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Simarjit Singh
- Vaccine-preventable Diseases and Immunization, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Sudoba Suleymonova
- State Institution "Republican Center of Immunoprophylaxis", Dushanbe, Tajikistan
| | - Farida Tishkova
- Virology Laboratory of Tajik Research Institute of Preventive Medicine, Dushanbe, Tajikistan
| | - Dovile Videbaek
- Vaccine-preventable Diseases and Immunization, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Margaret M Cortese
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Danni S Daniels
- Vaccine-preventable Diseases and Immunization, World Health Organization Regional Office for Europe, Copenhagen, Denmark; Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachel M Burke
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Meki CD, Ncube EJ, Voyi K. Community-level interventions for mitigating the risk of waterborne diarrheal diseases: a systematic review. Syst Rev 2022; 11:73. [PMID: 35436979 PMCID: PMC9016942 DOI: 10.1186/s13643-022-01947-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterborne diarrhea diseases are among the leading causes of morbidity and mortality globally. These diseases can be mitigated by implementing various interventions. We reviewed the literature to identify available interventions to mitigate the risk of waterborne diarrheal diseases. METHODS We conducted a systematic database review of CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, Web of Science Core Collection, Cochrane library, Scopus, African Index Medicus (AIM), and LILACS (Latin American and Caribbean Health Sciences Literature). Our search was limited to articles published between 2009 and 2020. We conducted the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement checklist. The identified studies were qualitatively synthesized. RESULTS Our initial search returned 28 773 articles of which 56 studies met the inclusion criteria. The included studies reported interventions, including vaccines for rotavirus disease (monovalent, pentavalent, and Lanzhou lamb vaccine); enhanced water filtration for preventing cryptosporidiosis, Vi polysaccharide for typhoid; cholera 2-dose vaccines, water supply, water treatment and safe storage, household disinfection, and hygiene promotion for controlling cholera outbreaks. CONCLUSION We retrieved few studies on interventions against waterborne diarrheal diseases in low-income countries. Interventions must be specific to each type of waterborne diarrheal disease to be effective. Stakeholders must ensure collaboration in providing and implementing multiple interventions for the best outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020190411 .
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Affiliation(s)
- Chisala D. Meki
- University of Zambia, School of Public Health, University of Zambia, P O. BOX 50110, Lusaka, Zambia
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Esper J. Ncube
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- Rand Water, Johannesburg, South Africa
| | - Kuku Voyi
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Varghese T, Kang G, Steele AD. Understanding Rotavirus Vaccine Efficacy and Effectiveness in Countries with High Child Mortality. Vaccines (Basel) 2022; 10:346. [PMID: 35334978 PMCID: PMC8948967 DOI: 10.3390/vaccines10030346] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/16/2022] [Accepted: 02/19/2022] [Indexed: 02/01/2023] Open
Abstract
Rotavirus claims thousands of lives of children globally every year with a disproportionately high burden in low- and lower-middle income countries where access to health care is limited. Oral, live-attenuated rotavirus vaccines have been evaluated in multiple settings in both low- and high-income populations and have been shown to be safe and efficacious. However, the vaccine efficacy observed in low-income settings with high rotavirus and diarrheal mortality was significantly lower than that seen in high-income populations where rotavirus mortality is less common. Rotavirus vaccines have been introduced and rolled out in more than 112 countries, providing the opportunity to assess effectiveness of the vaccines in these different settings. We provide an overview of the efficacy, effectiveness, and impact of rotavirus vaccines, focusing on high-mortality settings and identify the knowledge gaps for future research. Despite lower efficacy, rotavirus vaccines substantially reduce diarrheal disease and mortality and are cost-effective in countries with high burden. Continued evaluation of the effectiveness, impact, and cost-benefit of rotavirus vaccines, especially the new candidates that have been recently approved for global use, is a key factor for new vaccine introductions in countries, or for a switch of vaccine product in countries with limited resources.
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Affiliation(s)
- Tintu Varghese
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, India; (T.V.); (G.K.)
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, India; (T.V.); (G.K.)
| | - Andrew Duncan Steele
- Enteric and Diarrheal Disease, Bill & Melinda Gates Foundation, Seattle, WA 98102, USA
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Omatola CA, Ogunsakin RE, Olaniran AO. Prevalence, Pattern and Genetic Diversity of Rotaviruses among Children under 5 Years of Age with Acute Gastroenteritis in South Africa: A Systematic Review and Meta-Analysis. Viruses 2021; 13:1905. [PMID: 34696335 PMCID: PMC8538439 DOI: 10.3390/v13101905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 12/26/2022] Open
Abstract
Rotavirus is the most significant cause of severe acute gastroenteritis among children under 5 years of age, worldwide. Sub-Saharan Africa particularly bears the brunt of the diarrheal deaths. A meta-analysis was conducted on 43 eligible studies published between 1982 and 2020 to estimate the pooled prevalence of rotavirus infection and changes in the main rotavirus strains circulating before and after vaccine introduction among under-five children in South Africa. The pooled national prevalence of rotavirus infection was estimated at 24% (95% CI: 21-27%) for the pre-vaccination period and decreased to 23% (95% CI: 21-25%) in the post-vaccination period. However, an increased number of cases was observed in the KwaZulu-Natal (21-28%) and Western Cape (18-24%) regions post-vaccination. The most dominant genotype combinations in the pre-vaccine era was G1P[8], followed by G2P[4], G3P[8], and G1P[6]. After vaccine introduction, a greater genotype diversity was observed, with G9P[8] emerging as the predominant genotype combination, followed by G2P[4], G12P[8], and G1P[8]. The introduction of the rotavirus vaccine was associated with a reduction in the burden of rotavirus-associated diarrhea in South Africa, although not without regional fluctuation. The observed changing patterns of genotype distribution highlights the need for ongoing surveillance to monitor the disease trend and to identify any potential effects associated with the dynamics of genotype changes on vaccine pressure/failure.
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Affiliation(s)
- Cornelius A. Omatola
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa;
| | - Ropo E. Ogunsakin
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa;
| | - Ademola O. Olaniran
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa;
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Sun ZW, Fu Y, Lu HL, Yang RX, Goyal H, Jiang Y, Xu HG. Association of Rotavirus Vaccines With Reduction in Rotavirus Gastroenteritis in Children Younger Than 5 Years: A Systematic Review and Meta-analysis of Randomized Clinical Trials and Observational Studies. JAMA Pediatr 2021; 175:e210347. [PMID: 33970192 PMCID: PMC8111566 DOI: 10.1001/jamapediatrics.2021.0347] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Rotavirus vaccines have been introduced worldwide, and the clinical association of different rotavirus vaccines with reduction in rotavirus gastroenteritis (RVGE) after introduction are noteworthy. OBJECTIVE To evaluate the comparative benefit, risk, and immunogenicity of different rotavirus vaccines by synthesizing randomized clinical trials (RCTs) and observational studies. DATA SOURCES Relevant studies published in 4 databases: Embase, PubMed, the Cochrane Library, and Web of Science were searched until July 1, 2020, using search terms including "rotavirus" and "vaccin*." STUDY SELECTION Randomized clinical trials and cohort and case-control studies involving more than 100 children younger than 5 years that reported the effectiveness, safety, or immunogenicity of rotavirus vaccines were included. DATA EXTRACTION AND SYNTHESIS A random-effects model was used to calculate relative risks (RRs), odds ratios (ORs), risk differences, and 95% CIs. Adjusted indirect treatment comparison was performed to assess the differences in the protection of Rotarix and RotaTeq. MAIN OUTCOMES AND MEASURES The primary outcomes were RVGE, severe RVGE, and RVGE hospitalization. Safety-associated outcomes involved serious adverse events, intussusception, and mortality. RESULTS A meta-analysis of 20 RCTs and 38 case-control studies revealed that Rotarix (RV1) significantly reduced RVGE (RR, 0.316 [95% CI, 0.224-0.345]) and RVGE hospitalization risk (OR, 0.347 [95% CI, 0.279-0.432]) among children fully vaccinated; RotaTeq (RV5) had similar outcomes (RVGE: RR, 0.350 [95% CI, 0.275-0.445]; RVGE hospitalization risk: OR, 0.272 [95% CI, 0.197-0.376]). Rotavirus vaccines also demonstrated higher protection against severe RVGE. Additionally, no significant differences in the protection of RV1 and RV5 against rotavirus disease were noted in adjusted indirect comparisons. Moderate associations were found between reduced RVGE risk and Rotavac (RR, 0.664 [95% CI, 0.548-0.804]), Rotasiil (RR, 0.705 [95% CI, 0.605-0.821]), and Lanzhou lamb rotavirus vaccine (RR, 0.407 [95% CI, 0.332-0.499]). All rotavirus vaccines demonstrated no risk of serious adverse events. A positive correlation was also found between immunogenicity and vaccine protection (eg, association of RVGE with RV1: coefficient, -1.599; adjusted R2, 99.7%). CONCLUSIONS AND RELEVANCE The high protection and low risk of serious adverse events for rotavirus vaccines in children who were fully vaccinated emphasized the importance of worldwide introduction of rotavirus vaccination. Similar protection provided by Rotarix and RotaTeq relieves the pressure of vaccines selection for health care authorities.
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Affiliation(s)
- Zi-Wei Sun
- Department of Laboratory Medicine, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yu Fu
- Department of Pathology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hai-Ling Lu
- Department of Laboratory Medicine, Yancheng Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Yancheng, China
| | - Rui-Xia Yang
- Department of Laboratory Medicine, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hemant Goyal
- The Wright Center of Graduate Medical Education, Scranton, Pennsylvania
| | - Ye Jiang
- Department of Laboratory Medicine, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hua-Guo Xu
- Department of Laboratory Medicine, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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8
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Wang Y, Li J, Dai P, Liu P, Zhu F. Effectiveness of the oral human attenuated pentavalent rotavirus vaccine (RotaTeq™) postlicensure: a meta-analysis-2006-2020. Expert Rev Vaccines 2021; 20:437-448. [PMID: 33709863 DOI: 10.1080/14760584.2021.1902808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Rotavirus (RV), which causes RV-associated gastroenteritis (RVGE), has accounted for considerable morbidity. We aimed to assess the effectiveness (VE) of the oral pentavalent RV vaccine (RotaTeq™) in real-world settings in children and infants with gastroenteritis. METHODS We performed a systematic search for peer-reviewed studies published between 1 January 2006 and 1 May 2020 and a meta-analysis to calculate the VE of RotaTeq™ vaccine. The primary outcome was the pooled three-dose vaccine VE. Stratified analysis of the vaccine VEs was performed according to dosages, study design, population age, socioeconomic status (SES), introduction condition, control group types, outcomes of RV disease, and RV strains. RESULTS After screening 2359 unique records, 28 studies were included and meta-analyzed. The overall VE estimate was 84% (95% confidence interval [CI], 80-87%). Stratified analyses revealed a nonnegligible impact of factors such as study design and SES. Other factors did not show great impart to VE with no significant differences between groups. CONCLUSIONS RotaTeq™ is effective against RV infection, especially in high-income countries. Adopting suitable study methods and expansion of RV surveillance in low-income regions is crucial to assess VE in real-life settings and provide feasible vaccine regimens to improve vaccine VE.
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Affiliation(s)
- Yuxiao Wang
- School of Public Health, Southeast University, Nanjing, China
| | - Jingxin Li
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Pinyuan Dai
- School of Public Health, Southeast University, Nanjing, China
| | - Pei Liu
- School of Public Health, Southeast University, Nanjing, China
| | - Fengcai Zhu
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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9
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Sharma P, Katewa S, Meel SK, Katewa V, Bishnoi A, Verma VK, Nair NP, Thiyagarajan V. Clinicoepidemiological Profile and Genetic Characterization of Circulating Rotavirus Strain among Children < 5 Years Hospitalized for Acute Gastroenteritis in Western Rajasthan, India. Indian J Pediatr 2021; 88:97-104. [PMID: 33555569 DOI: 10.1007/s12098-020-03628-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the clinical and epidemiological profile and circulating strains of rotavirus among children less than 5 y of age hospitalized for diarrhea in a tertiary care center of western Rajasthan. METHOD Children < 5 y of age admitted for acute gastroenteritis were recruited in this hospital-based surveillance study. Detailed clinical history and sociodemographic information was collected for all enrolled children. Severity of the gastroenteritis was assessed using the 20-point Vesikari Clinical Severity Scoring System. Rotavirus positivity was tested in the stool samples collected from children by commercially available techniques and further molecular characterization done as per defined protocol. RESULTS Out of 1055 enrolled children, overall positivity rate of typable rotavirus was 18.95% (169/892). Among children who were less than 24 mo of age, positivity due to rotavirus diarrhea was maximum (24.4%). Distinct seasonality was observed as maximum cases of rotavirus diarrhea were detected in the months of December to February. Commonest G type was G3 (54%) followed by G1 (19%) while predominant P type was P[8] (77%) followed by P[4] (11%). G3P[8] (51.83%) was the commonest genotype observed in the study region. CONCLUSION The current study found positivity of rotavirus to be 18.95% among children aged 0-59 mo admitted due to acute gastroenteritis is a tertiary care setting in northern part of India. Emergence of newer predominant strains emphasizes the need of continued surveillance to determine the changing trends.
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Affiliation(s)
- Pramod Sharma
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Suman Katewa
- Department of Obstetrics & Gynaecology, Dr S N Medical College, Jodhpur, Rajasthan, India
| | - Suresh Kumar Meel
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Vikash Katewa
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India.
| | - Alka Bishnoi
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Vijay Kumar Verma
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Nayana P Nair
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Varunkumar Thiyagarajan
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
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10
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Steele AD, Groome MJ. Measuring Rotavirus Vaccine Impact in Sub-Saharan Africa. Clin Infect Dis 2021; 70:2314-2316. [PMID: 31544209 PMCID: PMC7245150 DOI: 10.1093/cid/ciz918] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 09/18/2019] [Indexed: 12/21/2022] Open
Affiliation(s)
- A Duncan Steele
- Enteric and Diarrheal Disease, Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Michelle J Groome
- Respiratory and Meningeal Pathogens Research Unit, South African Medical Research Council, Johannesburg, South Africa.,Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Lee B. Update on rotavirus vaccine underperformance in low- to middle-income countries and next-generation vaccines. Hum Vaccin Immunother 2020; 17:1787-1802. [PMID: 33327868 PMCID: PMC8115752 DOI: 10.1080/21645515.2020.1844525] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In the decade since oral rotavirus vaccines (ORV) were recommended by the World Health Organization for universal inclusion in all national immunization programs, significant yet incomplete progress has been made toward reducing the burden of rotavirus in low- to middle-income countries (LMIC). ORVs continue to demonstrate effectiveness and impact in LMIC, yet numerous factors hinder optimal performance and evaluation of these vaccines. This review will provide an update on ORV performance in LMIC, the increasing body of literature regarding factors that affect ORV response, and the status of newer and next-generation rotavirus vaccines as of early 2020. Fully closing the gap in rotavirus prevention between LMIC and high-income countries will likely require a multifaceted approach accounting for biological and methodological challenges and evaluation and roll-out of newer and next-generation vaccines.
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Affiliation(s)
- Benjamin Lee
- Vaccine Testing Center and Translational Global Infectious Diseases Research Center, University of Vermont College of Medicine, Burlington, VT, USA
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12
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Norovirus and rotavirus in children hospitalised with diarrhoea after rotavirus vaccine introduction in Burkina Faso. Epidemiol Infect 2020; 148:e245. [PMID: 32998792 PMCID: PMC7592103 DOI: 10.1017/s0950268820002320] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Several studies report norovirus as the new leading cause of severe gastroenteritis in children after the global introduction of rotavirus vaccines. Burkina Faso introduced general rotavirus vaccination with the oral pentavalent vaccine RotaTeq in November 2013 and quickly reached a vaccine coverage of >90%. This study describes detection rates, clinical profiles and the molecular epidemiology of norovirus and rotavirus infections in 146 children aged <5 years with severe acute gastroenteritis in Ouagadougou, consecutively enrolled from a hospital between January 2015 and December 2015. Virus detection was performed with an antigen test or real-time polymerase chain reaction (PCR) and genotyping was performed by nucleotide sequencing or multiplex PCR. Rotavirus was found in 14% and norovirus in 20% of faecal samples. Norovirus infection was significantly more associated with severe dehydration compared to rotavirus (P < 0.001). Among genotyped norovirus samples 48% (12/25) belonged to GII.4 which caused significantly more diarrhoeal episodes than non-GII.4 genotypes (P = 0.01). The most common rotavirus genotypes were G2P[4] (30%), G12P[6] (25%) and G12P[8] (20%). Fifty percent of the rotavirus positive children were infected with fully or partly heterotypic strains. In conclusion, this study found a higher proportion of norovirus causing more severe symptoms in children with diarrhoea in Burkina Faso after the introduction of rotavirus vaccination.
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Aliabadi N, Bonkoungou IJO, Pindyck T, Nikièma M, Leshem E, Seini E, Kam M, Konaté S, Ouattara M, Ouédraogo B, Gue E, Nezien D, Ouedraogo I, Parashar U, Medah I, Mwenda JM, Tate JE. Cost of pediatric hospitalizations in Burkina Faso: A cross-sectional study of children aged <5 years enrolled through an acute gastroenteritis surveillance program. Vaccine 2020; 38:6517-6523. [PMID: 32868131 DOI: 10.1016/j.vaccine.2020.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/31/2020] [Accepted: 08/12/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Diarrheal illness is a leading cause of hospitalizations among children <5 years. We estimated the costs of inpatient care for rotavirus and all-cause acute gastroenteritis (AGE) in two Burkina Faso hospitals. METHODS We conducted a cross-sectional study among children <5 years from December 2017 to June 2018 in one urban and one rural pediatric hospital. Costs were ascertained through caregiver interview and chart abstraction. Direct medical, non-medical, and indirect costs per child incurred are reported. Costs were stratified by rotavirus results. RESULTS 211 children <5 years were included. AGE hospitalizations cost 161USD (IQR 117-239); 180USD (IQR 121-242) at the urban and 154USD (IQR 116-235) at the rural site. Direct medical costs were higher in the urban compared to the rural site (140USD (IQR 102-182) vs. 90USD (IQR 71-108), respectively). Direct non-medical costs were higher at the rural versus urban site (15USD (IQR 10, 15) vs. 11USD (IQR 5-20), respectively). Indirect costs were higher at the rural versus urban site (35USD (IQR 8-91) vs. 0USD (IQR 0-26), respectively). Rotavirus hospitalizations incurred less direct medical costs as compared to non-rotavirus hospitalizations at the rural site (79USD (IQR 64-103) vs. 95USD (IQR 80-118)). No other differences by rotavirus testing status were observed. The total median cost of a hospitalization incurred by households was 24USD (IQR 12-49) compared to 75USD for government (IQR 59-97). Direct medical costs for households were higher in the urban site (median 49USD (IQR 31-81) versus rural (median 14USD (IQR 8-25)). Households in the lowest wealth quintiles at the urban site expended 149% of their monthly income on the child's hospitalization, compared to 96% at the rural site. CONCLUSIONS AGE hospitalization costs differed between the urban and rural hospitals and were most burdensome to the lowest income households. Rotavirus positivity was not associated with greater household costs.
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Affiliation(s)
- Negar Aliabadi
- US Centers for Disease Control and Prevention, Atlanta, USA.
| | | | - Talia Pindyck
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Moumouni Nikièma
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Eyal Leshem
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Emmanuel Seini
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Madibélé Kam
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | | | - Ma Ouattara
- World Health Organization, Burkina Faso Country Office, Ouagadougou, Burkina Faso
| | - Boureima Ouédraogo
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Edmond Gue
- Centre Hospitalier Regional de Gaoua, Burkina Faso
| | - Désiré Nezien
- National Public Health Laboratory, Ouagadougou, Burkina Faso
| | - Issa Ouedraogo
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Umesh Parashar
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Isaïe Medah
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Jason M Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
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Real-world effectiveness of rotavirus vaccines, 2006-19: a literature review and meta-analysis. LANCET GLOBAL HEALTH 2020; 8:e1195-e1202. [PMID: 32827481 DOI: 10.1016/s2214-109x(20)30262-x] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Since licensure in 2006, rotavirus vaccines have been introduced in more than 100 countries. The efficacy of rotavirus vaccines is variable in settings with different child mortality levels. We did an updated review of the published literature to assess the real-world effectiveness of rotavirus vaccines in a range of settings. METHODS In this literature review and meta-analysis, we included observational, post-licensure studies of rotavirus vaccines, published from Jan 1, 2006, to Dec 31, 2019, in English, with laboratory-confirmed rotavirus as the endpoint. In addition to product-specific results for Rotarix (GlaxoSmithKline Biologicals, Rixensart, Belgium) or RotaTeq (Merck, West Point, PA, USA), we included Rotarix and RotaTeq mixed series, and non-product-specific vaccine effectiveness estimates from countries where Rotarix and RotaTeq are both available. Studies of other infant rotavirus vaccines were excluded because little or no post-licensure data were available. We fitted random-effects regression models to estimate vaccine effectiveness among children younger than 12 months and aged 12-23 months. On the basis of 2017 UNICEF mortality estimates for children younger than 5 years, countries were stratified as having low (lowest quartile), medium (second quartile), or high mortality (third and fourth quartiles). FINDINGS We identified and screened 1703 articles, of which 60 studies from 32 countries were included. 31 studies were from countries with low child mortality, eight were from medium-mortality countries, and 21 were from high-mortality countries. Rotarix vaccine effectiveness against laboratory-confirmed rotavirus among children younger than 12 months old was 86% (95% CI 81-90) in low-mortality countries, 77% (66-85) in medium-mortality countries, and 63% (54-70) in high-mortality countries. Rotarix vaccine effectiveness among children aged 12-23 months was 86% (81-90) in low-mortality countries, 54% (23-73) in medium-mortality countries, and 58% (38-72) in high-mortality countries. RotaTeq vaccine effectiveness among children younger than 12 months was 86% (76-92) in low-mortality countries and 66% (51-76) in high-mortality countries. RotaTeq vaccine effectiveness among children aged 12-23 months was 84% (79-89) in low-mortality countries. There was no substantial heterogeneity (I2 range: 0-36%). Median vaccine effectiveness in low-mortality countries was similar for Rotarix (83%; IQR 78-91), RotaTeq (85%; 81-92), mixed series (86%; 70-91), and non-product-specific (89%; 75-91) vaccination. INTERPRETATION Rotavirus vaccines were effective in preventing rotavirus diarrhoea, with higher performance in countries with lower child mortality. FUNDING None.
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Abstract
As of 2019, four rotavirus vaccines have been prequalified by the WHO for use worldwide. This review highlights current knowledge regarding rotavirus vaccines available, and provides a brief summary of the rotavirus vaccine pipeline.
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16
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Overview of the Development, Impacts, and Challenges of Live-Attenuated Oral Rotavirus Vaccines. Vaccines (Basel) 2020; 8:vaccines8030341. [PMID: 32604982 PMCID: PMC7565912 DOI: 10.3390/vaccines8030341] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 12/15/2022] Open
Abstract
Safety, efficacy, and cost-effectiveness are paramount to vaccine development. Following the isolation of rotavirus particles in 1969 and its evidence as an aetiology of severe dehydrating diarrhoea in infants and young children worldwide, the quest to find not only an acceptable and reliable but cost-effective vaccine has continued until now. Four live-attenuated oral rotavirus vaccines (LAORoVs) (Rotarix®, RotaTeq®, Rotavac®, and RotaSIIL®) have been developed and licensed to be used against all forms of rotavirus-associated infection. The efficacy of these vaccines is more obvious in the high-income countries (HIC) compared with the low- to middle-income countries (LMICs); however, the impact is far exceeding in the low-income countries (LICs). Despite the rotavirus vaccine efficacy and effectiveness, more than 90 countries (mostly Asia, America, and Europe) are yet to implement any of these vaccines. Implementation of these vaccines has continued to suffer a setback in these countries due to the vaccine cost, policy, discharging of strategic preventive measures, and infrastructures. This review reappraises the impacts and effectiveness of the current live-attenuated oral rotavirus vaccines from many representative countries of the globe. It examines the problems associated with the low efficacy of these vaccines and the way forward. Lastly, forefront efforts put forward to develop initial procedures for oral rotavirus vaccines were examined and re-connected to today vaccines.
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17
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Asare EO, Al-Mamun MA, Armah GE, Lopman BA, Parashar UD, Binka F, Pitzer VE. Modeling of rotavirus transmission dynamics and impact of vaccination in Ghana. Vaccine 2020; 38:4820-4828. [PMID: 32513513 PMCID: PMC8290434 DOI: 10.1016/j.vaccine.2020.05.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 04/26/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022]
Abstract
Background: Rotavirus incidence remains relatively high in low-income countries (LICs) compared to high-income countries (HICs) after vaccine introduction. Ghana introduced monovalent rotavirus vaccine in April 2012 and despite the high coverage, vaccine performance has been modest compared to developed countries. The predictors of low vaccine effectiveness in LICs are poorly understood, and the drivers of subnational heterogeneity in rotavirus vaccine impact are unknown. Methods: We used mathematical models to investigate variations in rotavirus incidence in children <5 years old in Ghana. We fit models to surveillance and case-control data from three different hospitals: Korle-Bu Teaching Hospital in Accra, Komfo Anokye Teaching Hospital in Kumasi, and War Memorial Hospital in Navrongo. The models were fitted to both pre- and post-vaccine data to estimate parameters describing the transmission rate, waning of maternal immunity, and vaccine response rate. Results: The seasonal pattern and age distribution of rotavirus cases varied among the three study sites in Ghana. Our model was able to capture the spatio-temporal variations in rotavirus incidence across the three sites and showed good agreement with the age distribution of observed cases. The rotavirus transmission rate was highest in Accra and lowest in Navrongo, while the estimated duration of maternal immunity was longer (∼5 months) in Accra and Kumasi and shorter (∼3 months) in Navrongo. The proportion of infants who responded to the vaccine was estimated to be high in Accra and Kumasi and low in Navrongo. Conclusions: Rotavirus vaccine impact varies within Ghana. A low vaccine response rate was estimated for Navrongo, where rotavirus is highly seasonal and incidence limited to a few months of the year. Our findings highlight the need to further explore the relationship between rotavirus seasonality, maternal immunity, and vaccine response rate to determine how they influence vaccine effectiveness and to develop strategies to improve vaccine impact.
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Affiliation(s)
- Ernest O Asare
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.
| | - Mohammad A Al-Mamun
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - George E Armah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Benjamin A Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Umesh D Parashar
- Epidemiology Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Fred Binka
- University of Health and Allied Health Sciences, Ho, Ghana
| | - Virginia E Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
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Khagayi S, Omore R, Otieno GP, Ogwel B, Ochieng JB, Juma J, Apondi E, Bigogo G, Onyango C, Ngama M, Njeru R, Owor BE, Mwanga MJ, Addo Y, Tabu C, Amwayi A, Mwenda JM, Tate JE, Parashar UD, Breiman RF, Nokes DJ, Verani JR. Effectiveness of Monovalent Rotavirus Vaccine Against Hospitalization With Acute Rotavirus Gastroenteritis in Kenyan Children. Clin Infect Dis 2020; 70:2298-2305. [PMID: 31326980 PMCID: PMC7245145 DOI: 10.1093/cid/ciz664] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/17/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Rotavirus remains a leading cause of pediatric diarrheal illness and death worldwide. Data on rotavirus vaccine effectiveness in sub-Saharan Africa are limited. Kenya introduced monovalent rotavirus vaccine (RV1) in July 2014. We assessed RV1 effectiveness against rotavirus-associated hospitalization in Kenyan children. METHODS Between July 2014 and December 2017, we conducted surveillance for acute gastroenteritis (AGE) in 3 Kenyan hospitals. From children age-eligible for ≥1 RV1 dose, with stool tested for rotavirus and confirmed vaccination history we compared RV1 coverage among rotavirus positive (cases) vs rotavirus negative (controls) using multivariable logistic regression and calculated effectiveness based on adjusted odds ratio. RESULTS Among 677 eligible children, 110 (16%) were rotavirus positive. Vaccination data were available for 91 (83%) cases; 51 (56%) had 2 RV1 doses and 33 (36%) 0 doses. Among 567 controls, 418 (74%) had vaccination data; 308 (74%) had 2 doses and 69 (16%) 0 doses. Overall 2-dose effectiveness was 64% (95% confidence interval [CI], 35%-80%); effectiveness was 67% (95% CI, 30%-84%) for children aged <12 months and 72% (95% CI, 10%-91%) for children aged ≥12 months. Significant effectiveness was seen in children with normal weight for age, length/height for age and weight for length/height; however, no protection was found among underweight, stunted, or wasted children. CONCLUSIONS RV1 in the Kenyan immunization program provides significant protection against rotavirus-associated hospitalization which persisted beyond infancy. Malnutrition appears to diminish vaccine effectiveness. Efforts to improve rotavirus uptake and nutritional status are important to maximize vaccine benefit.
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Affiliation(s)
- Sammy Khagayi
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Richard Omore
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Grieven P Otieno
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Billy Ogwel
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - John B Ochieng
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Jane Juma
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Evans Apondi
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Godfrey Bigogo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Clayton Onyango
- Division of Global Health Protection, Centers for Disease Control and Prevention (CDC)–Kenya, Kisumu, Kenya
| | - Mwanajuma Ngama
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Regina Njeru
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Betty E Owor
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Mike J Mwanga
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Yaw Addo
- Emory Global Health Institute, Emory University, Atlanta, Georgia
| | - Collins Tabu
- National Vaccines and Immunisations Programme, and
| | - Anyangu Amwayi
- Disease Surveillance and Response Unit, Ministry of Health, Nairobi, Kenya
| | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Jacqueline E Tate
- Viral Gastroenteritis Branch, Division of Viral Diseases, CDC, Atlanta, Georgia
| | - Umesh D Parashar
- Viral Gastroenteritis Branch, Division of Viral Diseases, CDC, Atlanta, Georgia
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia
| | - D James Nokes
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
- School of Life Sciences, and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Jennifer R Verani
- Division of Global Health Protection, CDC–Kenya, Nairobi, Kenya; and
- Division of Global Health Protection, CDC, Atlanta, Georgia
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Dama E, Nikiema A, Nichols K, Bicaba BW, Porgho S, Greco Koné R, Tarnagda Z, Cissé A, Ngendakumana I, Adjami A, Medah I, Ake F, Mirza SA. Designing and Piloting a Specimen Transport System in Burkina Faso. Health Secur 2020; 18:S98-S104. [PMID: 32004130 DOI: 10.1089/hs.2019.0068] [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] [Indexed: 02/01/2023] Open
Abstract
Efficient specimen transport systems are critical for early disease detection and reporting by laboratory networks. In Burkina Faso, centralized reference laboratories receive specimens from multiple surveillance sites for testing, but transport methods vary, resulting in potential delays and risk to specimen quality. The ministry of health and partners, under the Global Health Security Agenda implementation, piloted a specimen transport system for severe acute respiratory illness (SARI) surveillance in 4 Burkina Faso districts. A baseline assessment was conducted of the current specimen transport network structure and key stakeholders. Assessment results and guidelines for processing SARI specimens informed the pilot specimen transport system design and implementation. Monitoring and evaluation performance indicators included: proportion of packages delivered, timeliness, and quality of courier services (missed or damaged packages). Our baseline assessment found that laboratorians routinely carried specimens from the health center to reference laboratories, resulting in time away from laboratory duties and potential specimen delays or loss of quality. The pilot specimen transport system design engaged Sonapost, the national postal service, to transport specimens from SARI sites to the influenza national reference laboratory. From May 2017 to December 2018, the specimen transport system transported 557 packages containing 1,158 SARI specimens; 95% (529/557) were delivered within 24 hours of pick-up and 77% (892/1,158) within 48 hours of collection. No packages were lost. This article highlights lessons learned that may be useful for other countries considering establishment of a specimen transport system to strengthen laboratory system infrastructure in global health security implementation.
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Affiliation(s)
- Emilie Dama
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Abdoulaye Nikiema
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Kameko Nichols
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Brice Wilfried Bicaba
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Souleymane Porgho
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Rebecca Greco Koné
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Zekiba Tarnagda
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Assana Cissé
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Irene Ngendakumana
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Aimé Adjami
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Isaïe Medah
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Flavien Ake
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Sara A Mirza
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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Polio endgame: Lessons for the global rotavirus vaccination program. Vaccine 2019; 37:3040-3049. [DOI: 10.1016/j.vaccine.2019.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/19/2022]
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Mwenda JM, Parashar UD, Cohen AL, Tate JE. Impact of rotavirus vaccines in Sub-Saharan African countries. Vaccine 2018; 36:7119-7123. [PMID: 29914848 DOI: 10.1016/j.vaccine.2018.06.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/25/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
By the end of 2017, 32 (68%) of 47 countries in the World Health Organization's African Region had introduced rotavirus vaccine into their national immunization programs, including 27 countries that received financial support from the Gavi, the Vaccine Alliance. Several early introducing African countries previously evaluated the impact, vaccine effectiveness, and/or cost effectiveness of their routine rotavirus vaccination programs and found that rotavirus vaccine was effective and resulted in substantial declines in hospitalizations due to rotavirus. This Special Issue of Vaccine provides additional rotavirus vaccine effectiveness and impact data from a broader range of African countries, describes the longer term impact and potential indirect benefits of rotavirus vaccination programs, describes trends in circulating genotypes in the pre- and post-vaccine introduction eras, and evaluates the cost-effectiveness of a rotavirus vaccination program in a post-introduction setting. As countries begin transitioning from Gavi support, the findings of these studies provide evidence of the impact and effectiveness of rotavirus vaccination programs under conditions of routine use.
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Affiliation(s)
- Jason M Mwenda
- World Health Organization Regional Office for Africa, (WHO/AFRO), Brazzaville, Congo
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22
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Bonkoungou IJO, Ouédraogo N, Tamini L, Teguera RK, Yaméogo P, Drabo MK, Medah I, Barro N, Sharma S, Svensson L, Nordgren J. Rotavirus and norovirus in children with severe diarrhea in Burkina Faso before rotavirus vaccine introduction. J Med Virol 2018; 90:1453-1460. [PMID: 29718582 DOI: 10.1002/jmv.25213] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/19/2018] [Indexed: 11/06/2022]
Abstract
Burkina Faso introduced rotavirus vaccine (RotaTeq) to the national immunization program in November 2013. This study describes the detection rates, clinical profiles, and molecular epidemiology of rotavirus and norovirus (NoV) infections among children <5 years hospitalized (n = 154) because of acute diarrhea in Ouagadougou, Burkina Faso, from December 2012 to November 2013, just before the start of vaccination. Overall, 44% and 23% of fecal samples were positive for rotavirus and NoV, respectively, most of them detected during the cold dry season (December-March). The predominant G/P combinations were G12P[8] (47%) and G6P[6] (30%). G2P[4] (n = 3), G12P[6] (n = 3), and G6P[8] (n = 1) were also detected. Nearly all (94%) successfully genotyped NoV strains belonged to genotype GII.4. The predominance of rotavirus and NoV was noteworthy in the age group ≤6 months, with 67% rotavirus and 22% NoV, respectively. Vomiting was significantly more common among rotavirus-infected children. To conclude, this study shows high detection rates of both rotavirus and NoV in children with severe diarrhea in Burkina Faso just before the introduction of rotavirus group A vaccination. The results can be used for estimating the impact of rotavirus group A vaccination, which started in the end of 2013. Furthermore, this study shows that the G6P[6] rotavirus strains emerging in Burkina Faso in 2010 is now established as a regionally important genotype.
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Affiliation(s)
- Isidore Juste O Bonkoungou
- UFR/SVT, Department of Biochemistry and Microbiology, University Ouaga 1, Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso.,Department of Medical Biology, National Public Health Laboratory, Ouagadougou, Burkina Faso
| | - Nafissatou Ouédraogo
- UFR/SVT, Department of Biochemistry and Microbiology, University Ouaga 1, Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Laure Tamini
- UFR/SVT, Department of Biochemistry and Microbiology, University Ouaga 1, Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso.,Department of Pediatric, Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | | | - Pouiré Yaméogo
- Department of Medical Biology, National Public Health Laboratory, Ouagadougou, Burkina Faso
| | - Maxime Koiné Drabo
- Department of Medical Biology, National Public Health Laboratory, Ouagadougou, Burkina Faso
| | - Isaïe Medah
- National Immunization Program, Ministry of Health, Ouagadougou, Burkina Faso
| | - Nicolas Barro
- UFR/SVT, Department of Biochemistry and Microbiology, University Ouaga 1, Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Sumit Sharma
- Division of Molecular Virology, Linköping University, Linköping, Sweden
| | - Lennart Svensson
- Division of Molecular Virology, Linköping University, Linköping, Sweden.,Division of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Johan Nordgren
- Division of Molecular Virology, Linköping University, Linköping, Sweden
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Coldiron ME, Guindo O, Makarimi R, Soumana I, Matar Seck A, Garba S, Macher E, Isanaka S, Grais RF. Safety of a heat-stable rotavirus vaccine among children in Niger: Data from a phase 3, randomized, double-blind, placebo-controlled trial. Vaccine 2018; 36:3674-3680. [PMID: 29752026 DOI: 10.1016/j.vaccine.2018.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rotavirus remains a major cause of diarrhea among children under 5 years of age. The efficacy of RotaSIIL, a pentavalent rotavirus vaccine, was shown in an event-driven trial in Niger. We describe the two-year safety follow-up of this trial. METHODS Follow-up of safety outcomes began upon administration of the first dose of RotaSIIL or placebo. Adverse events were followed until 28 days after the third dose, and serious adverse events were followed until 2 years of age. Suspected cases of intussusception were evaluated at first point of contact and then referred to hospital for surgical evaluation. Causes of death were obtained by chart review and verbal autopsy. Passive surveillance was carried out in health centers. Community health workers carried out active surveillance in villages. Between-group differences were evaluated using the chi-squared test and Fisher's exact test. RESULTS A total of 4092 children were randomized, and 4086 received at least one dose of RotaSIIL or placebo, constituting the intention-to-treat population, who accrued a total of 7385 child-years of follow-up time. At two years of follow-up, 58 (2.8%) participants who received RotaSIIL and 49 (2.4%) participants who received placebo had died (p = 0.38). Most deaths were due to infectious causes common to the study area. One participant had confirmed intussusception, 542 days after receiving the third dose of RotaSIIL. A total of 395 (19.3%) participants receiving RotaSIIL and 419 (20.5%) participants receiving placebo experienced any serious adverse event (p = 0.36). Most serious adverse events were hospitalizations due to infection (malaria, lower respiratory tract infection and gastroenteritis) or marasmus. Overall, 1474 (72.1%) participants receiving RotaSIIL and 1456 (71.1%) participants receiving placebo had at least one adverse event (p = 0.49) in the follow-up period. CONCLUSIONS At two years of follow-up, RotaSIIL was found to be safe. TRIAL REGISTRATION ClinicalTrials.gov: NCT02145000.
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Affiliation(s)
| | | | | | | | | | | | - Emilie Macher
- Médecins Sans Frontières, 78 rue de Lausanne, Geneva, Switzerland.
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