Detection of rotavirus before and after monovalent rotavirus vaccine introduction and vaccine effectiveness among children in mainland Tanzania.

Autor: Jani B; World Health Organization, Country Office, Dar Es Salaam, Tanzania., Hokororo A; Bugando Medical Center/Catholic University of Health and Allied Science, Mwanza, Tanzania., Mchomvu J; Tanga Referral Hospital, Tanga, Tanzania., Cortese MM; Divison of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: mcortese@cdc.gov., Kamugisha C; World Health Organization, Country Office, Dar Es Salaam, Tanzania., Mujuni D; Ministry of Health Community Development, Gender, Elderly and Children, Dar Es Salaam, Tanzania., Kallovya D; National Health Laboratory Quality Assurance Training Centre, Dar Es Salaam, Tanzania., Parashar UD; Divison of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA., Mwenda JM; Regional Office for AFRICA (WHO/AFRO), Brazzaville, Republic of Congo., Lyimo D; Ministry of Health Community Development, Gender, Elderly and Children, Dar Es Salaam, Tanzania., Materu A; Tanga Regional Referral Hospital, Tanzania., Omari KF; Tanga Regional Referral Hospital, Tanzania., Waziri M; Tanga Regional Referral Hospital, Tanzania., Laswai T; Tanga Regional Referral Hospital, Tanzania., Juma H; Tanga Regional Referral Hospital, Tanzania., Mlay J; Bugando Medical Center, Tanzania., Dogani J; Bugando Medical Center, Tanzania., Stephen E; Bugando Medical Center, Tanzania., Seugendo M; Bugando Medical Center, Tanzania., Nkumbi U; Sekou Toure Hospital, Tanzania., Lyakurwa A; Sekou Toure Hospital, Tanzania., Matojo A; Sekou Toure Hospital, Tanzania., Bendera E; Teule Hospital, Tanzania., Senyota J; Teule Hospital, Tanzania., Msingwa V; Teule Hospital, Tanzania., Fungo Y; Mbeya Referral Hospital, Tanzania., Michael F; Mbeya Referral Hospital, Tanzania., Mpamba A; Mbeya Referral Hospital, Tanzania., Chambo A; Mbalizi Hospital, Tanzania., Cholobi H; Mbalizi Hospital, Tanzania., Lyamuya F; Dodoma Regional Hospital, Tanzania., Chami I; Dodoma Regional Hospital, Tanzania., Mchome E; Mawenzi Hospital, Tanzania., Mshana AM; Mawenzi Hospital, Tanzania., Mushi E; Mawenzi Hospital, Tanzania., Mariki U; Mawenzi Hospital, Tanzania., Chard R; Nyamagana Hospital, Tanzania., Tuju D; Nyamagana Hospital, Tanzania., Ambokile N; Temeke Hospital, Tanzania., Lukwale F; Temeke Hospital, Tanzania., Kyessi F; Temeke Hospital, Tanzania., Khamis A; Temeke Hospital, Tanzania., Michael I; Mwananyamala Hospital, Tanzania., Macha D; Mwananyamala Hospital, Tanzania., Saguti A; Mwananyamala Hospital, Tanzania.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2018 Nov 12; Vol. 36 (47), pp. 7149-7156. Date of Electronic Publication: 2018 Apr 11.
DOI: 10.1016/j.vaccine.2018.01.071
Abstrakt: Background: Monovalent rotavirus vaccine (RV1) was introduced in Tanzania in January 2013 under the Reach Every Child initiative, to be given at ages 6 and 10 weeks. We used the sentinel hospital rotavirus surveillance system to examine the rotavirus detection rate before and after vaccine introduction and estimate vaccine effectiveness.
Methods: Before vaccine introduction, rotavirus surveillance was established at two mainland hospitals; children admitted for acute diarrhea were eligible for enrollment and stools were tested for rotavirus antigen. We compared the rotavirus positivity rate in the pre-vaccine period (Tanga Hospital, 2009 and 2011; Bugando Medical Centre, 2012) to that from post-introduction years, 2014-2015. In 2013, surveillance was established at 9 additional hospitals. We examined rotavirus positivity among infants at these sites for 2014-2015. We obtained vaccine records and calculated vaccine effectiveness at 3 sites using case-test-negative control design.
Results: At Tanga Hospital, the rotavirus positivity rate among infants was 41% (102/251) pre-vaccine and 14% (28/197) in post-vaccine years (rate ratio: 0.35 [95% CI 0.22-0.54]). At Bugando, the positivity rate was 58% (83/143) pre-vaccine, and 18% (49/277) post-introduction (rate ratio 0.30 [95% CI 0.210.44]). Results were similar among children <5 years. At the new sites, the median site rotavirus positivity rate among infants was 26% in 2014 (range 19-44%) and 18% in 2015 (range 16-33%). The effectiveness of ≥1 RV1 dose against rotavirus hospitalization among children 5-23 months was 53% (95% CI: -14, 81), and 66% (95% CI: 9-87) against hospitalization with intravenous rehydration. Following introduction, peak rotavirus activity occurred later in the year and appeared more concentrated in time.
Conclusion: Rotavirus surveillance data from Tanzania indicate that the rotavirus positivity rate among children hospitalized with diarrhea that were enrolled was substantially reduced after vaccine introduction. Low positivity rates among infants were detected at hospitals across the country. Overall, the data support that rotavirus vaccine has been successfully introduced and is effective in Tanzanian children.
(Copyright © 2018. Published by Elsevier Ltd.)
Databáze: MEDLINE
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