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Vaccine. 2018 Nov 12;36(47):7179-7184. doi: 10.1016/j.vaccine.2018.02.091. Epub 2018 Mar 12.

Impact of pentavalent rotavirus vaccine against severe rotavirus diarrhoea in The Gambia.

Author information

1
National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia. Electronic address: sheikbakary@yahoo.com.
2
National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia.
3
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
4
Edward Francis Small Teaching Hospital, Ministry of Health and Social Welfare, Banjul, Gambia.
5
National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia; University of Noguchi, Ghana.
6
ExpandedProgrammes in Immunization, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia.
7
Ministry of Health and Social Welfare, Banjul, Gambia.
8
World Health Organization, Geneva, Switzerland.
9
World Health Organization, Regional Office for Africa, Immunization, Vaccines and Emergencies (IVE) Cluster, Brazzaville, Congo.

Abstract

INTRODUCTION:

Rotavirus vaccines protect against the leading cause of severe childhood diarrhoea, and have been introduced in many low-income African countries. The Gambia introducedRotateq® (RV5) into their national immunization program in 2013. We revieweddata from an active rotavirus sentinel surveillancesitefor early evidence of vaccine impact.

METHODS:

We compared rotavirus prevalence in diarrhoeal stool in children< 5 years of age admittedat the Edward Francis Small Teaching Hospital sentinel surveillance site before (2013) andafterRV5 introduction (2015-2016) in the Gambia. The rotavirus-percent positive was separately compared for all diarrhoealhospitalizations and for hospitalizations with severe symptoms. Rotavirus prevalence was compared annually for the pre-vaccine year of 2013 with post-vaccine years of 2015 and 2016 using chi-square or Fisher's exact tests and the p-value to establish significant relationship was set at p < 0.05. All analyses were completed in SAS 9.3 (SAS Analytics, North Carolina).

RESULTS:

Rotavirus prevalence among all diarrhoeahospitalizations decreased from 22% in 2013 to 11% in 2015 (p = 0.04), while remaining unchanged in 2016 (18%, p = 0.56). For hospitalizations that were clinically severe and/or treated with intravenous fluids (mean of 46 per year), the rotavirus prevalence decreased from 33% in 2013 to 8% in 2015 (p = 0.04), and to 15% in 2016 (p = 0.08). The children with age <1 year accounted for 45% the population infected with rotavirus in both pre and post rotavirus vaccination periods.

CONCLUSIONS:

Rotavirus vaccine introduction in the Gambia could be among factors resulting in decreased diarrhea hospitalizations among children at the Edward Francis Small Teaching Hospital, particularly those with severe disease. These results support the continuation of rotavirus vaccine and additional monitoring of rotavirus hospitalization trends in the country.

KEYWORDS:

Hospitalization; Rotavirus; Severe diarrhoea; Vaccine impact

PMID:
29544688
PMCID:
PMC6816024
DOI:
10.1016/j.vaccine.2018.02.091
[Indexed for MEDLINE]
Free PMC Article

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