Impact of rotavirus vaccine on rotavirus diarrhoea in countries of East and Southern Africa |
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| Affiliation: | 1. World Health Organization IST ESA, Harare, Zimbabwe;2. World Health Organization Regional Office for Africa, Brazzaville, Congo;3. Centres for Disease Control and Prevention, USA;1. Centers for Disease Control and Prevention, Atlanta, GA, USA;2. World Health Organization Regional Office for Africa (WHO/AFRO), Brazzaville, Congo;3. World Health Organization, Geneva, Switzerland;4. Centers for Disease Control and Prevention, Atlanta, GA, USA;4. OPEN, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark;5. Navrongo Health Research Centre, Navrongo, Ghana;6. Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso;7. African Population and Health Research Center, Nairobi, Kenya;8. Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya;1. Bandim Health Project, Bissau, Guinea-Bissau;9. International Centre for Diarrheal Disease Research, Dhaka, Bangladesh;1. Bandim Health Project, Bissau, Guinea-Bissau;2. Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark;3. Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark;4. OPEN, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark;1. KEMRI/Nagasaki University, Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya;2. Graduate School of Biomedical Sciences, Nagasaki University, Japan;3. National Biosafety Authority, Nairobi, Kenya;4. Department of Virology and Parasitology, School of Medicine, Fujita Health University, Japan;5. Centre for Virus Research, KEMRI, Nairobi, Kenya;1. Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana;2. School of Medicine and Dentistry, University of Ghana, Ghana;3. School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;4. School of Biomedical and Allied Health Sciences, University of Ghana, Ghana;5. World Health Organization (WHO) Regional Office for Africa (WHO/AFRO), Brazzaville, Congo;6. WHO Country Office, Accra, Ghana;7. School of Public Health, University of Health and Allied Sciences, Ho, Ghana;8. Centers for Disease Control and Prevention, Atlanta, GA, USA;9. Dept. of Epidemiology, Rollins School of Public Health, Emory University, USA;1. Department of Paediatrics, Medical School of Lome, Togo;2. The World Health Organization, Regional Office for Africa, Brazzaville, Congo;3. Microbiology Departments, Medical School of Lome, Togo;4. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA;5. EPI Manager, Ministry of Health, Togo;6. WHO Country Office, Togo;1. National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia;2. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States;3. Edward Francis Small Teaching Hospital, Ministry of Health and Social Welfare, Banjul, Gambia;4. University of Noguchi, Ghana;5. ExpandedProgrammes in Immunization, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia;6. Ministry of Health and Social Welfare, Banjul, Gambia;7. World Health Organization, Regional Office for Africa, Immunization, Vaccines and Emergencies (IVE) Cluster, Brazzaville, Congo;8. World Health Organization, Geneva, Switzerland |
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| Abstract: | BackgroundEstablished in 2006 with four countries conducting hospital-based rotavirus surveillance, the African rotavirus surveillance network has expanded over subsequent years. By 2015, 14 countries in the World Health Organization (WHO) East and Southern Africa sub-region (Eritrea, Ethiopia, Kenya, Lesotho, Madagascar, Mauritius, Namibia, Rwanda, Seychelles, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe) were participating in the rotavirus surveillance network coordinated by WHO. We monitored the proportion of rotavirus diarrhoea among children under five years of age who were hospitalized for diarrhoea in the sentinel hospitals from 2010 to 2015 among countries that introduced rotavirus vaccine during or before 2013 (Rwanda, Tanzania, Zambia and Ethiopia) and compared with the other countries in the network.MethodsChildren under the age of five years hospitalized due to acute diarrhoea were enrolled into the sentinel surveillance system and had stool samples collected and tested for rotavirus antigens by enzyme immunoassay. We described trends in rotavirus positivity among tested stool samples before and after rotavirus vaccine introduction.ResultsIn countries that introduced rotavirus vaccine by 2013 (Rwanda, Tanzania, Zambia and Ethiopia), average rotavirus vaccine coverage from 2010 to 2015 improved from 0% in 2010 and 2011, 13% in 2012, 46% in 2013, 83% in 2014 to 90% in 2015. Annual average rotavirus positivity from 2010 to 2015 was 35%, 33%, 38%, 28%, 27%, and 19%, respectively. In countries that introduced rotavirus vaccine after 2013 or had not introduced by 2015, average rotavirus vaccine coverage was 0% in 2010–2013, 13% in 2014 and 51% in 2015. In these countries, rotavirus positivity was 44% in 2010, 32% in 2011, 33% in 2012, 41% in 2013, 40% in 2014 and 25% in 2015.ConclusionCountries that introduced rotavirus vaccine by 2013 had a lower proportion of rotavirus positive hospitalizations in 2013–2015 as compared to those that had not introduced rotavirus vaccine by 2013. The decrease in rotavirus positivity was inversely related to increase in rotavirus vaccine coverage showing impact of rotavirus vaccines. |
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| Keywords: | Diarrhoea Rotavirus Vaccine impact East and Southern Africa |
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