The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji.
Journal
The Lancet regional health. Western Pacific
ISSN: 2666-6065
Titre abrégé: Lancet Reg Health West Pac
Pays: England
ID NLM: 101774968
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
03
06
2020
revised:
14
10
2020
accepted:
25
10
2020
entrez:
30
7
2021
pubmed:
31
7
2021
medline:
31
7
2021
Statut:
epublish
Résumé
In 2012, Fiji became the first independent Pacific island country to introduce rotavirus vaccine. We describe the impact of rotavirus vaccine on all-cause diarrhoea admissions in all ages, and rotavirus diarrhoea in children <5 years of age. An observational study was conducted retrospectively on all admissions to the public tertiary hospitals in Fiji (2007-2018) and prospectively on all rotavirus-positive diarrhoea admissions in children <5 years at two hospital sites (2006-2018, and 2010-2015), along with rotavirus diarrhoea outpatient presentations at one secondary public hospital (2010-2015). The impact of rotavirus vaccine was determined using incidence rate ratios (IRR) of all-cause diarrhoea admissions and rotavirus diarrhoea, comparing the pre-vaccine and post-vaccine periods. All-cause admissions were used as a control. Multiple imputation was used to impute missing stool samples. All-cause diarrhoea admissions declined among all age groups except among infants ≤2 months old and adults ≥55 years. For children <5 years, all-cause diarrhoea admissions declined by 39% (IRR)=0•61, 95%CI; 0•57-0•65, Morbidity and mortality due to rotavirus and all-cause diarrhoea in Fiji has declined in people aged 2 months to 54 years after the introduction of the RV vaccine. Supported by WHO and the Australian Government.
Sections du résumé
BACKGROUND
BACKGROUND
In 2012, Fiji became the first independent Pacific island country to introduce rotavirus vaccine. We describe the impact of rotavirus vaccine on all-cause diarrhoea admissions in all ages, and rotavirus diarrhoea in children <5 years of age.
METHODS
METHODS
An observational study was conducted retrospectively on all admissions to the public tertiary hospitals in Fiji (2007-2018) and prospectively on all rotavirus-positive diarrhoea admissions in children <5 years at two hospital sites (2006-2018, and 2010-2015), along with rotavirus diarrhoea outpatient presentations at one secondary public hospital (2010-2015). The impact of rotavirus vaccine was determined using incidence rate ratios (IRR) of all-cause diarrhoea admissions and rotavirus diarrhoea, comparing the pre-vaccine and post-vaccine periods. All-cause admissions were used as a control. Multiple imputation was used to impute missing stool samples.
FINDINGS
RESULTS
All-cause diarrhoea admissions declined among all age groups except among infants ≤2 months old and adults ≥55 years. For children <5 years, all-cause diarrhoea admissions declined by 39% (IRR)=0•61, 95%CI; 0•57-0•65,
INTERPRETATIONS
CONCLUSIONS
Morbidity and mortality due to rotavirus and all-cause diarrhoea in Fiji has declined in people aged 2 months to 54 years after the introduction of the RV vaccine.
FUNDING
BACKGROUND
Supported by WHO and the Australian Government.
Identifiants
pubmed: 34327400
doi: 10.1016/j.lanwpc.2020.100053
pii: S2666-6065(20)30053-5
pmc: PMC8315333
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100053Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Informations de copyright
© 2020 The Authors. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
CK reports a patent development of the unlicensed ‘RV3 BB’ rotavirus vaccine currently in clinical trials. JB reports grants from World Health Organization, Bill and Melinda Gates Foundation and the Australian National Health and Medical Research Council, Australian Department of Health, GlaxoSmithKline, and CDC Foundation outside of the submitted work for the development of the ‘RV3 BB’ rotavirus vaccine. CN reports grants from Pfizer Inc. outside the submitted work. The authors have nothing other to declare and no competing interests.
Références
Clin Infect Dis. 2016 May 1;62 Suppl 2:S147-54
pubmed: 27059349
Sci Rep. 2018 Sep 24;8(1):14291
pubmed: 30250267
PLoS One. 2016 Jan 11;11(1):e0145977
pubmed: 26751375
Western Pac Surveill Response J. 2014 May 30;5(2):9-14
pubmed: 25077032
Vaccine. 2009 Nov 20;27 Suppl 5:F108-11
pubmed: 19931707
Vaccine. 2020 Jan 10;38(2):202-211
pubmed: 31668367
Vaccine. 2017 Feb 1;35(5):796-801
pubmed: 28057385
Clin Infect Dis. 2017 Sep 1;65(5):840-850
pubmed: 28444323
J Infect Dis. 2018 Jul 13;218(4):546-554
pubmed: 29790933
Lancet Glob Health. 2019 Jul;7(7):e893-e903
pubmed: 31200889
N Engl J Med. 2018 Feb 22;378(8):719-730
pubmed: 29466164
J Infect Dis. 2017 Jul 15;216(2):220-227
pubmed: 28838152
Emerg Infect Dis. 2016 May;22(5):875-9
pubmed: 27088272
Clin Infect Dis. 2016 May 1;62 Suppl 2:S161-7
pubmed: 27059351
Pediatr Infect Dis J. 2017 Oct;36(10):995-999
pubmed: 28640001
Vaccine. 2018 May 31;36(23):3308-3314
pubmed: 29729994
Vaccine. 2017 Nov 7;35(47):6416-6421
pubmed: 29037577
Vaccine. 2016 Aug 17;34(37):4351-3
pubmed: 27443593
Vaccine. 2012 Apr 27;30 Suppl 1:A44-51
pubmed: 22520136
Lancet Infect Dis. 2017 Sep;17(9):909-948
pubmed: 28579426
Medicine (Baltimore). 2017 Apr;96(15):e6574
pubmed: 28403085
BMC Pediatr. 2017 Jul 11;17(1):156
pubmed: 28693503
Lancet Glob Health. 2016 Feb;4(2):e129-36
pubmed: 26823214
J Infect Dis. 2017 Jan 15;215(2):183-191
pubmed: 27815381
Pediatr Infect Dis J. 2018 Aug;37(8):e216-e221
pubmed: 29341984
Lancet Infect Dis. 2012 Feb;12(2):136-41
pubmed: 22030330
Hum Vaccin Immunother. 2014;10(8):2255-66
pubmed: 25424930
Lancet. 2018 Jul 14;392(10142):175-186
pubmed: 30025810