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Effectiveness of Pentavalent Rotavirus Vaccine under Conditions of Routine Use in Rwanda

Wednesday, 8th of June 2016

 

Effectiveness of Pentavalent Rotavirus Vaccine under Conditions of Routine Use in Rwanda

Jacqueline E. Tate1,

Fidele Ngabo2,

Philippe Donnen2,

Maurice Gatera3,

Jeannine Uwimana4,

Celse Rugambwa5,

Jason M. Mwenda6, and

Umesh D. Parashar1

+ Author Affiliations

1Centers for Disease Control and Prevention, Atlanta, Georgia

2Universite Libre de Bruxelles, Ecole de Santé Publique, Brussels, Belgium

3Rwanda Biomedical Center

4University Teaching Hospital

5World Health Organization, Rwanda Office, Kigali

6World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo

Correspondence: J. E. Tate, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS-A34, Atlanta, GA 30333 (jqt8@cdc.gov).

Abstract below; full text is at http://cid.oxfordjournals.org/content/62/suppl_2/S208.long

Background. Rotavirus vaccine efficacy is lower in low-income countries than in high-income countries. Rwanda was one of the first low-income countries in sub-Saharan Africa to introduce rotavirus vaccine into its national immunization program. We sought to evaluate rotavirus vaccine effectiveness (VE) in this setting.

Methods. VE was assessed using a case-control design. Cases and test-negative controls were children who presented with a diarrheal illness to 1 of 8 sentinel district hospitals and 10 associated health centers and had a stool specimen that tested positive (cases) or negative (controls) for rotavirus by enzyme immunoassay. Due to high vaccine coverage almost immediately after vaccine introduction, the analysis was restricted to children 7–18 weeks of age at time of rotavirus vaccine introduction. VE was calculated as (1 – odds ratio) × 100, where the odds ratio was the adjusted odds ratio for the rotavirus vaccination rate among case-patients compared with controls.

Results. Forty-eight rotavirus-positive and 152 rotavirus-negative children were enrolled. Rotavirus-positive children were significantly less likely to have received rotavirus vaccine (33/44 [73%] unvaccinated) compared with rotavirus-negative children (81/136 [59%] unvaccinated) (P = .002). A full 3-dose series was 75% (95% confidence interval [CI], 31%–91%) effective against rotavirus gastroenteritis requiring hospitalization or a health center visit and was 65% (95% CI, −80% to 93%) in children 6–11 months of age and 81% (95% CI, 25%–95%) in children ≥12 months of age.

Conclusions. Rotavirus vaccine is effective in preventing rotavirus disease in Rwandan children who began their rotavirus vaccine series from 7 to 18 weeks of age. Protection from vaccination was sustained after the first year of life.

Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Articles citing this article

Health Impact of Rotavirus Vaccination in Developing Countries: Progress and Way Forward Clinical Infectious Diseases (2016) 62 (suppl_2): S91-S95