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BMC Infect Dis. 2019 Jan 11;19(1):47. doi: 10.1186/s12879-018-3615-6.

Rates of hospitalization and death for all-cause and rotavirus acute gastroenteritis before rotavirus vaccine introduction in Kenya, 2010-2013.

Author information

1
Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya. Omorerichard@gmail.com.
2
Health Sciences Unit, Faculty of Social Sciences, University of Tampere, Tampere, Finland. Omorerichard@gmail.com.
3
Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya.
4
Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Nairobi, Kenya.
5
WHO Country Office for Kenya, Nairobi, Kenya.
6
Health Sciences Unit, Faculty of Social Sciences, University of Tampere, Tampere, Finland.
7
WHO Regional Office for Africa (WHO/AFRO), Brazzaville, Congo.
8
Global Health Institute, Emory University, Atlanta, GA, USA.
9
Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA.

Abstract

BACKGROUND:

Rotavirus vaccine was introduced in Kenya immunization program in July 2014. Pre-vaccine disease burden estimates are important for assessing vaccine impact.

METHODS:

Children with acute gastroenteritis (AGE) (≥3 loose stools and/or ≥ 1 episode of unexplained vomiting followed by loose stool within a 24-h period), hospitalized in Siaya County Referral Hospital (SCRH) from January 2010 through December 2013 were enrolled. Stool specimens were tested for rotavirus (RV) using an enzyme immunoassay (EIA). Hospitalization rates were calculated using person-years of observation (PYO) from the Health Demographic Surveillance System (HDSS) as a denominator, while adjusting for healthcare utilization at household level and proportion of stool specimen collected from patients who met the case definition at the surveillance hospital. Mortality rates were calculated using PYO as the denominator and number of deaths estimated using total deaths in the HDSS, proportion of deaths attributed to diarrhoea by verbal autopsy (VA) and percent positive for rotavirus AGE (RVAGE) hospitalizations.

RESULTS:

Of 7760 all-cause hospitalizations among children < 5 years of age, 3793 (49%) were included in the analysis. Of these, 21% (805) had AGE; RV was detected in 143 (26%) of 541 stools tested. Among children < 5 years, the estimated hospitalization rates per 100,000 PYO for AGE and RVAGE were 2413 and 429, respectively. Mortality rate associated with AGE and RVAGE were 176 and 45 per 100,000 PYO, respectively.

CONCLUSION:

AGE and RVAGE caused substantial health care burden (hospitalizations and deaths) before rotavirus vaccine introduction in Kenya.

KEYWORDS:

Children; Kenyan; Morbidity; Mortality; Rotavirus

PMID:
30634922
PMCID:
PMC6330491
DOI:
10.1186/s12879-018-3615-6
[Indexed for MEDLINE]
Free PMC Article

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