Effectiveness of Monovalent Rotavirus Vaccine Against Hospitalization With Acute Rotavirus Gastroenteritis in Kenyan Children.
Kenya
acute gastroenteritis
rotavirus
vaccine effectiveness
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
23 05 2020
23 05 2020
Historique:
received:
20
03
2019
accepted:
17
07
2019
pubmed:
22
7
2019
medline:
7
1
2021
entrez:
22
7
2019
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 31326980
pii: 5536640
doi: 10.1093/cid/ciz664
pmc: PMC7245145
doi:
Substances chimiques
Rotavirus Vaccines
0
Vaccines, Attenuated
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
2298-2305Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Wellcome Trust
ID : 102975
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 203077
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.
Références
Clin Infect Dis. 2016 May 1;62 Suppl 2:S161-7
pubmed: 27059351
Pediatr Infect Dis J. 2014 Jan;33 Suppl 1:S34-40
pubmed: 24343611
J Infect Dis. 2017 Jan 15;215(2):183-191
pubmed: 27815381
Clin Infect Dis. 2017 Oct 1;65(7):1144-1151
pubmed: 28575304
Clin Infect Dis. 2016 May 1;62 Suppl 2:S91-5
pubmed: 27059361
Vaccine. 2017 Jan 3;35(1):184-190
pubmed: 27876198
Clin Infect Dis. 2016 May 1;62 Suppl 2:S213-9
pubmed: 27059359
BMC Infect Dis. 2012 Sep 13;12:213
pubmed: 22974466
Lancet. 2010 Aug 21;376(9741):606-14
pubmed: 20692030
J Clin Virol. 2013 Sep;58(1):292-4
pubmed: 23850415
Clin Infect Dis. 2016 May 1;62 Suppl 2:S208-12
pubmed: 27059358
PLoS One. 2011 Jan 18;6(1):e16085
pubmed: 21267459
Int J Epidemiol. 2017 Jun 1;46(3):792-792h
pubmed: 27789669
Vaccine. 2017 Sep 12;35(38):5217-5223
pubmed: 28780116
Vaccine. 2017 Jun 5;35(25):3295-3302
pubmed: 28442231
PLoS Med. 2008 Jul 22;5(7):e153
pubmed: 18651787
N Engl J Med. 2010 Jan 28;362(4):289-98
pubmed: 20107214
Pathogens. 2017 Dec 12;6(4):
pubmed: 29231855
Hum Vaccin Immunother. 2016 Sep;12(9):2406-12
pubmed: 27260009
Trop Med Int Health. 2018 Apr;23(4):425-432
pubmed: 29432666
Hum Vaccin. 2010 Jul;6(7):532-42
pubmed: 20622508
Int J Epidemiol. 2012 Jun;41(3):650-7
pubmed: 22544844
Vaccine. 2013 Dec 16;31(52):6170-1
pubmed: 23746456
Pediatr Infect Dis J. 2014 Jan;33 Suppl 1:S76-84
pubmed: 24343619
Scand J Infect Dis. 1990;22(3):259-67
pubmed: 2371542
Clin Infect Dis. 2016 May 1;62 Suppl 2:S96-S105
pubmed: 27059362
Philos Trans R Soc Lond B Biol Sci. 2015 Jun 19;370(1671):
pubmed: 25964453
Vaccine. 2012 Apr 27;30 Suppl 1:A24-9
pubmed: 22520132
Lancet Infect Dis. 2014 Sep;14(9):847-56
pubmed: 25082561
Wkly Epidemiol Rec. 2009 Dec 18;84(50):533-40
pubmed: 20034143
Lancet Infect Dis. 2014 Nov;14(11):1096-1104
pubmed: 25303843
Lancet Infect Dis. 2015 Apr;15(4):422-8
pubmed: 25638521
Clin Infect Dis. 2016 May 1;62 Suppl 2:S200-7
pubmed: 27059357
Clin Infect Dis. 2016 May 1;62 Suppl 2:S175-82
pubmed: 27059353
Vaccine. 2018 Nov 12;36(47):7170-7178
pubmed: 29290478
Int J Epidemiol. 2012 Aug;41(4):977-87
pubmed: 22933646
BMC Microbiol. 2009 Nov 23;9:238
pubmed: 19930627
Clin Infect Dis. 2016 May 1;62 Suppl 2:S106-14
pubmed: 27059343