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Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda.
Clin Infect Dis. 2016 May 01; 62 Suppl 2:S208-12.CI

Abstract

BACKGROUND

Rotavirus vaccine efficacy is lower in low-income countries than in high-income countries. Rwanda was one of the first low-income countries in sub-Saharan Africa to introduce rotavirus vaccine into its national immunization program. We sought to evaluate rotavirus vaccine effectiveness (VE) in this setting.

METHODS

VE was assessed using a case-control design. Cases and test-negative controls were children who presented with a diarrheal illness to 1 of 8 sentinel district hospitals and 10 associated health centers and had a stool specimen that tested positive (cases) or negative (controls) for rotavirus by enzyme immunoassay. Due to high vaccine coverage almost immediately after vaccine introduction, the analysis was restricted to children 7-18 weeks of age at time of rotavirus vaccine introduction. VE was calculated as (1 - odds ratio) × 100, where the odds ratio was the adjusted odds ratio for the rotavirus vaccination rate among case-patients compared with controls.

RESULTS

Forty-eight rotavirus-positive and 152 rotavirus-negative children were enrolled. Rotavirus-positive children were significantly less likely to have received rotavirus vaccine (33/44 [73%] unvaccinated) compared with rotavirus-negative children (81/136 [59%] unvaccinated) (P= .002). A full 3-dose series was 75% (95% confidence interval [CI], 31%-91%) effective against rotavirus gastroenteritis requiring hospitalization or a health center visit and was 65% (95% CI, -80% to 93%) in children 6-11 months of age and 81% (95% CI, 25%-95%) in children ≥12 months of age.

CONCLUSIONS

Rotavirus vaccine is effective in preventing rotavirus disease in Rwandan children who began their rotavirus vaccine series from 7 to 18 weeks of age. Protection from vaccination was sustained after the first year of life.

Authors+Show Affiliations

Centers for Disease Control and Prevention, Atlanta, Georgia.Universite Libre de Bruxelles, Ecole de Santé Publique, Brussels, Belgium.Universite Libre de Bruxelles, Ecole de Santé Publique, Brussels, Belgium.Rwanda Biomedical Center.University Teaching Hospital.World Health Organization, Rwanda Office, Kigali.World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo.Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

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

Language

eng

PubMed ID

27059358

Citation

Tate, Jacqueline E., et al. "Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62 Suppl 2, 2016, pp. S208-12.
Tate JE, Ngabo F, Donnen P, et al. Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda. Clin Infect Dis. 2016;62 Suppl 2:S208-12.
Tate, J. E., Ngabo, F., Donnen, P., Gatera, M., Uwimana, J., Rugambwa, C., Mwenda, J. M., & Parashar, U. D. (2016). Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62 Suppl 2, S208-12. https://doi.org/10.1093/cid/civ1016
Tate JE, et al. Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda. Clin Infect Dis. 2016 May 1;62 Suppl 2:S208-12. PubMed PMID: 27059358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda. AU - Tate,Jacqueline E, AU - Ngabo,Fidele, AU - Donnen,Philippe, AU - Gatera,Maurice, AU - Uwimana,Jeannine, AU - Rugambwa,Celse, AU - Mwenda,Jason M, AU - Parashar,Umesh D, PY - 2016/4/10/entrez PY - 2016/4/10/pubmed PY - 2016/12/29/medline KW - rotavirus KW - rotavirus vaccine KW - vaccine effectiveness SP - S208 EP - 12 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 Suppl 2 N2 - BACKGROUND: Rotavirus vaccine efficacy is lower in low-income countries than in high-income countries. Rwanda was one of the first low-income countries in sub-Saharan Africa to introduce rotavirus vaccine into its national immunization program. We sought to evaluate rotavirus vaccine effectiveness (VE) in this setting. METHODS: VE was assessed using a case-control design. Cases and test-negative controls were children who presented with a diarrheal illness to 1 of 8 sentinel district hospitals and 10 associated health centers and had a stool specimen that tested positive (cases) or negative (controls) for rotavirus by enzyme immunoassay. Due to high vaccine coverage almost immediately after vaccine introduction, the analysis was restricted to children 7-18 weeks of age at time of rotavirus vaccine introduction. VE was calculated as (1 - odds ratio) × 100, where the odds ratio was the adjusted odds ratio for the rotavirus vaccination rate among case-patients compared with controls. RESULTS: Forty-eight rotavirus-positive and 152 rotavirus-negative children were enrolled. Rotavirus-positive children were significantly less likely to have received rotavirus vaccine (33/44 [73%] unvaccinated) compared with rotavirus-negative children (81/136 [59%] unvaccinated) (P= .002). A full 3-dose series was 75% (95% confidence interval [CI], 31%-91%) effective against rotavirus gastroenteritis requiring hospitalization or a health center visit and was 65% (95% CI, -80% to 93%) in children 6-11 months of age and 81% (95% CI, 25%-95%) in children ≥12 months of age. CONCLUSIONS: Rotavirus vaccine is effective in preventing rotavirus disease in Rwandan children who began their rotavirus vaccine series from 7 to 18 weeks of age. Protection from vaccination was sustained after the first year of life. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27059358/Effectiveness_of_Pentavalent_Rotavirus_Vaccine_Under_Conditions_of_Routine_Use_in_Rwanda_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ1016 DB - PRIME DP - Unbound Medicine ER -