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A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia.
Clin Infect Dis. 2016 May 01; 62 Suppl 2:S175-82.CI

Abstract

BACKGROUND

Diarrhea is the third leading cause of child death in Zambia. Up to one-third of diarrhea cases resulting in hospitalization and/or death are caused by vaccine-preventable rotavirus. In January 2012, Zambia initiated a pilot introduction of the Rotarix live, oral rotavirus vaccine in all public health facilities in Lusaka Province.

METHODS

Between July 2012 and October 2013, we conducted a case-control study at 6 public sector sites to estimate rotavirus vaccine effectiveness (VE) in age-eligible children presenting with diarrhea. We computed the odds of having received at least 1 dose of Rotarix among children whose stool was positive for rotavirus antigen (cases) and children whose stool was negative (controls). We adjusted the resulting odds ratio (OR) for patient age, calendar month of presentation, and clinical site, and expressed VE as (1 - adjusted OR) × 100.

RESULTS

A total of 91 rotavirus-positive cases and 298 rotavirus-negative controls who had under-5 card-confirmed vaccination status and were ≥6 months of age were included in the case-control analysis. Among rotavirus-positive children who were age-eligible to be vaccinated, 20% were hospitalized. Against rotavirus diarrhea of all severity, the adjusted 2-dose VE was 26% (95% confidence interval [CI], -30% to 58%) among children ≥6 months of age. VE against hospitalized children ≥6 months of age was 56% (95% CI, -34% to 86%).

CONCLUSIONS

We observed a higher point estimate for VE against increased severity of illness compared with milder disease, but were not powered to detect a low level of VE against milder disease.

Authors+Show Affiliations

Centre for Infectious Disease Research in Zambia, Lusaka Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Centre for Infectious Disease Research in Zambia, Lusaka.Centre for Infectious Disease Research in Zambia, Lusaka.Centre for Infectious Disease Research in Zambia, Lusaka.Centre for Infectious Disease Research in Zambia, Lusaka.University of North Carolina School of Medicine, Chapel Hill.Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Centre for Infectious Disease Research in Zambia, Lusaka.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

27059353

Citation

Beres, Laura K., et al. "A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62 Suppl 2, 2016, pp. S175-82.
Beres LK, Tate JE, Njobvu L, et al. A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia. Clin Infect Dis. 2016;62 Suppl 2:S175-82.
Beres, L. K., Tate, J. E., Njobvu, L., Chibwe, B., Rudd, C., Guffey, M. B., Stringer, J. S., Parashar, U. D., & Chilengi, R. (2016). A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62 Suppl 2, S175-82. https://doi.org/10.1093/cid/civ1206
Beres LK, et al. A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia. Clin Infect Dis. 2016 May 1;62 Suppl 2:S175-82. PubMed PMID: 27059353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia. AU - Beres,Laura K, AU - Tate,Jacqueline E, AU - Njobvu,Lungowe, AU - Chibwe,Bertha, AU - Rudd,Cheryl, AU - Guffey,M Brad, AU - Stringer,Jeffrey S A, AU - Parashar,Umesh D, AU - Chilengi,Roma, PY - 2016/4/10/entrez PY - 2016/4/10/pubmed PY - 2016/12/29/medline KW - Zambia KW - immunization KW - rotavirus KW - rotavirus vaccine KW - vaccine effectiveness SP - S175 EP - 82 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 Suppl 2 N2 - BACKGROUND: Diarrhea is the third leading cause of child death in Zambia. Up to one-third of diarrhea cases resulting in hospitalization and/or death are caused by vaccine-preventable rotavirus. In January 2012, Zambia initiated a pilot introduction of the Rotarix live, oral rotavirus vaccine in all public health facilities in Lusaka Province. METHODS: Between July 2012 and October 2013, we conducted a case-control study at 6 public sector sites to estimate rotavirus vaccine effectiveness (VE) in age-eligible children presenting with diarrhea. We computed the odds of having received at least 1 dose of Rotarix among children whose stool was positive for rotavirus antigen (cases) and children whose stool was negative (controls). We adjusted the resulting odds ratio (OR) for patient age, calendar month of presentation, and clinical site, and expressed VE as (1 - adjusted OR) × 100. RESULTS: A total of 91 rotavirus-positive cases and 298 rotavirus-negative controls who had under-5 card-confirmed vaccination status and were ≥6 months of age were included in the case-control analysis. Among rotavirus-positive children who were age-eligible to be vaccinated, 20% were hospitalized. Against rotavirus diarrhea of all severity, the adjusted 2-dose VE was 26% (95% confidence interval [CI], -30% to 58%) among children ≥6 months of age. VE against hospitalized children ≥6 months of age was 56% (95% CI, -34% to 86%). CONCLUSIONS: We observed a higher point estimate for VE against increased severity of illness compared with milder disease, but were not powered to detect a low level of VE against milder disease. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27059353/A_Preliminary_Assessment_of_Rotavirus_Vaccine_Effectiveness_in_Zambia_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ1206 DB - PRIME DP - Unbound Medicine ER -