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Effectiveness of rotavirus vaccination against childhood diarrhoea in El Salvador: case-control study.

Abstract：

OBJECTIVE:To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America. DESIGN:Matched case-control study. SETTING:Seven hospitals in cities across El Salvador, January 2007 to June 2009. PARTICIPANTS:323 children aged less than 2 years admitted with laboratory confirmed rotavirus diarrhoea and 969 healthy controls matched for age and neighbourhood. MAIN OUTCOME MEASURE:Effectiveness of rotavirus vaccination ((1-adjusted odds ratio of vaccination)x100) against rotavirus diarrhoea requiring hospital admission. RESULTS:Cases and controls were similar for breast feeding, premature birth, maternal education, and socioeconomic variables. G1P[8] strains were identified in 92% of rotavirus cases. Effectiveness of two doses of vaccination against diarrhoea requiring hospital admission was 76% (95% confidence interval 64% to 84%). Protection was significantly lower (P=0.046) among children aged 12 months or more (59%, 27% to 77%) compared with children aged 6-11 months (83%, 68% to 91%). One dose of vaccine was 51% (26% to 67%) effective. At the sentinel hospitals, all admissions for diarrhoea among children under 5 declined by 40% in 2008 and by 51% in 2009 from the prevaccine year 2006. CONCLUSIONS:A monovalent rotavirus vaccine was highly effective against admissions for rotavirus diarrhoea in children aged less than 2 years in El Salvador and substantially reduced the number of such admissions in this low-middle income setting. The impact on disease epidemiology after vaccination, particularly among older children, warrants future attention.

journal_name

BMJ

journal_title

BMJ (Clinical research ed.)

authors

de Palma O,Cruz L,Ramos H,de Baires A,Villatoro N,Pastor D,de Oliveira LH,Kerin T,Bowen M,Gentsch J,Esposito DH,Parashar U,Tate J,Patel M

doi

10.1136/bmj.c2825

subject

Has Abstract

pub_date

2010-06-15 00:00:00

pages

c2825

eissn

0959-8138

issn

1756-1833

journal_volume

340

pub_type

杂志文章,多中心研究

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Effectiveness of rotavirus vaccination against childhood diarrhoea in El Salvador: case-control study.