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Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana.
Clin Infect Dis. 2016 May 01; 62 Suppl 2:S200-7.CI

Abstract

BACKGROUND

Ghana was among the first African nations to introduce monovalent rotavirus vaccine (RV1) into its childhood immunization schedule in April 2012. We aimed to assess the impact of vaccine introduction on rotavirus and acute gastroenteritis (AGE) hospitalizations and to estimate vaccine effectiveness (VE).

METHODS

Using data from 2 teaching hospitals, monthly AGE and rotavirus admissions by age were examined 40 months before and 31 months after RV1 introduction using interrupted time-series analyses. From January 2013, we enrolled children <2 years of age who were eligible for RV1 from a total of 7 sentinel sites across the country. To estimate VE, we fit unconditional logistic regression models to calculate odds ratios of vaccination by rotavirus case-patient status, controlling for potential confounders.

RESULTS

Vaccine coverage ranged from 95% to 100% for dose 1 and 93% to 100% for dose 2. In the first 3 years after vaccine introduction, the percentage of hospital admissions positive for rotavirus fell from 48% in the prevaccine period to 28% (49% adjusted rate reduction; 95% confidence interval [CI], 32%-63%) postvaccination among <5-year-olds. With high vaccine coverage, it was not possible to arrive at robust VE estimates; any-dose VE against rotavirus hospitalization was estimated at 60% (95% CI, -2% to 84%;P= .056).

CONCLUSIONS

Results from the first 3 years following RV1 introduction suggest substantial reductions of pediatric diarrheal disease as a result of vaccination. Our VE estimate is consistent with the observed rotavirus decrease and with efficacy estimates from elsewhere in sub-Saharan Africa.

Authors+Show Affiliations

Noguchi Memorial Institute for Medical Research, University of Ghana, Accra.Centers for Disease Control and Prevention, Atlanta, Georgia.School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra.Komfo Anokye Teaching Hospital, Kumasi, Ghana.World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo.Ghana World Health Organization Country Office, Accra.Noguchi Memorial Institute for Medical Research, University of Ghana, Accra School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.Noguchi Memorial Institute for Medical Research, University of Ghana, Accra.School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.

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

27059357

Citation

Armah, George, et al. "Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62 Suppl 2, 2016, pp. S200-7.
Armah G, Pringle K, Enweronu-Laryea CC, et al. Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana. Clin Infect Dis. 2016;62 Suppl 2:S200-7.
Armah, G., Pringle, K., Enweronu-Laryea, C. C., Ansong, D., Mwenda, J. M., Diamenu, S. K., Narh, C., Lartey, B., Binka, F., Grytdal, S., Patel, M., Parashar, U., & Lopman, B. (2016). Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62 Suppl 2, S200-7. https://doi.org/10.1093/cid/ciw014
Armah G, et al. Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana. Clin Infect Dis. 2016 May 1;62 Suppl 2:S200-7. PubMed PMID: 27059357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana. AU - Armah,George, AU - Pringle,Kimberly, AU - Enweronu-Laryea,Christabel C, AU - Ansong,Daniel, AU - Mwenda,Jason M, AU - Diamenu,Stanley K, AU - Narh,Clement, AU - Lartey,Belinda, AU - Binka,Fred, AU - Grytdal,Scott, AU - Patel,Manish, AU - Parashar,Umesh, AU - Lopman,Ben, PY - 2016/4/10/entrez PY - 2016/4/10/pubmed PY - 2016/12/29/medline KW - Ghana KW - case-control KW - rotavirus KW - surveillance KW - vaccine effectiveness SP - S200 EP - 7 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 Suppl 2 N2 - BACKGROUND: Ghana was among the first African nations to introduce monovalent rotavirus vaccine (RV1) into its childhood immunization schedule in April 2012. We aimed to assess the impact of vaccine introduction on rotavirus and acute gastroenteritis (AGE) hospitalizations and to estimate vaccine effectiveness (VE). METHODS: Using data from 2 teaching hospitals, monthly AGE and rotavirus admissions by age were examined 40 months before and 31 months after RV1 introduction using interrupted time-series analyses. From January 2013, we enrolled children <2 years of age who were eligible for RV1 from a total of 7 sentinel sites across the country. To estimate VE, we fit unconditional logistic regression models to calculate odds ratios of vaccination by rotavirus case-patient status, controlling for potential confounders. RESULTS: Vaccine coverage ranged from 95% to 100% for dose 1 and 93% to 100% for dose 2. In the first 3 years after vaccine introduction, the percentage of hospital admissions positive for rotavirus fell from 48% in the prevaccine period to 28% (49% adjusted rate reduction; 95% confidence interval [CI], 32%-63%) postvaccination among <5-year-olds. With high vaccine coverage, it was not possible to arrive at robust VE estimates; any-dose VE against rotavirus hospitalization was estimated at 60% (95% CI, -2% to 84%;P= .056). CONCLUSIONS: Results from the first 3 years following RV1 introduction suggest substantial reductions of pediatric diarrheal disease as a result of vaccination. Our VE estimate is consistent with the observed rotavirus decrease and with efficacy estimates from elsewhere in sub-Saharan Africa. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27059357/Impact_and_Effectiveness_of_Monovalent_Rotavirus_Vaccine_Against_Severe_Rotavirus_Diarrhea_in_Ghana_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciw014 DB - PRIME DP - Unbound Medicine ER -