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Lu L, Zhong H, Jia R, Su L, Xu M, Cao L, Liu P, Ao Y, Dong N, Xu J. Prevalence and genotypes distribution of group A rotavirus among outpatient children under 5 years with acute diarrhea in Shanghai, China, 2012-2018. BMC Gastroenterol 2022; 22:217. [PMID: 35505284 PMCID: PMC9066839 DOI: 10.1186/s12876-022-02288-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Group A rotavirus (RVA) remains the main causative agent of acute diarrhea among children under five years in countries that have not yet introduced the RVA vaccine worldwide. Long-term and continuous monitoring data on RVA infection in outpatient children were lacking in Shanghai. We investigated the prevalence and distribution of RVA genotypes in outpatient children with acute diarrhea in Shanghai from 2012 to 2018. Methods Stool specimens of outpatient children under five years were collected from the Children’s Hospital of Fudan University in Shanghai, China. All the samples enrolled in this study were detected and characterized for the P and G genotypes of RVA were determined using the semi-multiplex RT-PCR technique. Results Of 1814 children enrolled with acute diarrhea and having specimens collected, 246 (13.6%) were infected with RVA. The highest frequency of RVA was observed in children younger than two years old (87.0%, 214/246). Year-round RVA transmission was observed and the RVA detection rate peaked every winter and troughed in summer. In this study, 12 different RVA strains were identified in children. G9P[8] (49.2%, 121/246) was detected as the most prevalent genotype, followed by G–P[8] (22.8%, 56/246), G3P[8] (11.4%, 28/246), and G9P- (4.9%, 12/246). Although RVA strains detected in this study varied with the time, G9P[8] has been the most predominant circulating genotype since 2012. Furthermore, 12.2% (30/246) RVA positive samples were co-infected with other diarrhea viruses. Conclusion The present analysis showed that RVA was still a major cause of children with acute diarrhea in Shanghai from 2012 to 2018. A great diversity of RVA strains circulated in children with acute diarrhea with G9P[8] being the predominant genotype since 2012. Long-term and continuous monitoring of RVA genotypes is therefore indispensable to refine future vaccine strategy in Shanghai.
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Affiliation(s)
- Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Huaqing Zhong
- Department of Pediatric Institute, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Ran Jia
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Liyun Su
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Menghua Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Lingfeng Cao
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Pengcheng Liu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Yuanyun Ao
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Niuniu Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, People's Republic of China.
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Peck ME, Hampton LM, Antoni S, Ogbuanu I, Serhan F, Nakamura T, Walldorf JA, Cohen AL. Global Rotavirus and Pneumococcal Conjugate Vaccine Introductions and the Association With Country Disease Surveillance, 2006-2018. J Infect Dis 2021; 224:S184-S193. [PMID: 34469564 PMCID: PMC8414915 DOI: 10.1093/infdis/jiab069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To inform the introduction of pneumococcal conjugate vaccine (PCV) and rotavirus vaccine, the World Health Organization (WHO) established the Global Invasive Bacterial Vaccine-Preventable Disease Surveillance Network (GISN) and the Global Rotavirus Surveillance Network (GRSN) in 2008. We investigated whether participation in these networks or other surveillance was associated with vaccine introduction. METHODS Between 2006 and 2018, among all WHO member states, we used multivariable models adjusting for economic status to assess (1) the association between surveillance for pneumococcal disease or rotavirus disease, including participation in GISN or GRSN and the introduction of the PCV or the rotavirus vaccine, respectively, and (2) the association between the rotavirus disease burden and the rotavirus vaccine introduction among 56 countries participating in GRSN from 2008 to 2018. RESULTS Countries that participated in or conducted surveillance for invasive pneumococcal disease or rotavirus disease were 3.5 (95% confidence interval [CI], 1.7-7.1) and 4.2 (95% CI, 2.1-8.6) times more likely to introduce PCV or rotavirus respectively, compared to those without surveillance. Among countries participating in GRSN, there was insufficient evidence to demonstrate an association between countries with higher rotavirus positivity and vaccine introduction. CONCLUSIONS Surveillance should be incorporated into advocacy strategies to encourage the introduction of vaccines, with countries benefiting from data from, support for, and coordination of international disease surveillance networks.
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Affiliation(s)
- Megan E Peck
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lee M Hampton
- Monitoring and Evaluation, Gavi, the Vaccine Alliance, Geneva, Switzerland
| | - Sebastian Antoni
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Ike Ogbuanu
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Fatima Serhan
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Tomoka Nakamura
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Jenny A Walldorf
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adam L Cohen
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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Klivitsky A, Algabria S, Paret G, Michaan N, Goldberg L, Halutz O, Grisaru‐Soen G. Impact of rotavirus vaccine on admissions due to acute gastroenteritis and rotavirus gastroenteritis in Israel. Acta Paediatr 2021; 110:634-640. [PMID: 32654273 DOI: 10.1111/apa.15480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/21/2020] [Accepted: 07/09/2020] [Indexed: 11/27/2022]
Abstract
AIM We examined the impact of insertion of the Rotavirus vaccine (RVV) into the Israeli National Immunisation Programme (NIP) on hospitalisations due to both acute gastroenteritis (AGE) and Rotavirus gastroenteritis (RVGE) in children. METHODS We retrospectively analysed the medical records of children aged <5 years admitted with a diagnosis of AGE between 2008 and 2016 in two children's hospitals in central Israel. Clinical, laboratory, microbiological data and RV immunisation status were retrieved. Data were compared before and after the introduction of the RVV into the NIP. RESULTS A total of 2042 children were admitted with AGE. Hospitalisations due to AGE and RVGE decreased from 3310 to 1950 and from 1027 to 585 per 100 000 admissions, respectively, after the RVV (relative risk reduction (RRR) of 41% and 43%, respectively). RV remained the most common pathogen in both study periods. There was no significant difference in the clinical course between immunised and non-immunised children admitted with RVGE. CONCLUSION The introduction of the RVV to the NIP significantly reduced the admissions due to both AGE and RVGE in children <5 years. However, RV is still the most common agent for admissions due to AGE in this age group.
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Affiliation(s)
- Amir Klivitsky
- Pediatric Infectious Disease Unit Dana Children's Hospital Tel Aviv Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Salam Algabria
- Pediatric Infectious Disease Unit Dana Children's Hospital Tel Aviv Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Gideon Paret
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Pediatric Intensive Care Sheba Medical Center Safra Children's Hospital Tel Hashomer Israel
| | - Nadav Michaan
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Obstetrics and Gynecology Lis Maternity Hospital Tel Aviv Israel
| | - Lior Goldberg
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Pediatric Intensive Care Sheba Medical Center Safra Children's Hospital Tel Hashomer Israel
| | - Ora Halutz
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Microbiology Laboratory Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - Galia Grisaru‐Soen
- Pediatric Infectious Disease Unit Dana Children's Hospital Tel Aviv Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
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Kung YH, Chi H, Liu CC, Huang YC, Huang YC, Wu FT, Huang LM. Hospital-based surveillance of severe rotavirus gastroenteritis and rotavirus strains in young Taiwanese children. J Formos Med Assoc 2020; 119:1158-1166. [PMID: 32359880 DOI: 10.1016/j.jfma.2020.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND/PURPOSE Rotavirus remains a leading cause of pediatric gastroenteritis-related hospitalization. Surveillance studies have revealed that several major rotaviral genotypes are responsible for most cases of rotavirus gastroenteritis (RVGE). This study aimed to understand the characteristics of acute gastroenteritis (AGE) caused by rotavirus in young children in Taiwan. METHODS Ten hospitals in Taiwan were subjected to prospective hospital-based AGE surveillance during 2014-2017, and children younger than 5 years old who were hospitalized due to AGE were enrolled in the study. Medical and demographic variables were recorded and analyzed, and stool specimens were collected for rotavirus identification and genotyping via real-time RT-PCR. Non-rotavirus AGE age-matched controls were enrolled. RESULTS Surveillance identified 4747 young children hospitalized with AGE during this study period. The median age of these patients was 2.0 years. Rotavirus was detected in stool samples from 518 patients (10.9%). The prevalent months of RVGE in 2014, 2015, and 2017, wherein the rotavirus positivity rates exceeded 30%. The most common serotypes were G3P[8] (303/518, 58.9%) and G1P[8] (86/518, 16.6%). The percentage of G3P[8] increased from 4.9% in 2014 to 74.3% in 2016 (P < 0.0001), whereas the percentage of G1P[8] decreased from 61.0% in 2014 to 22.5% in 2015 (P < 0.0001). Compared with G3P[8], G1P[8] was associated with a significantly higher C-reactive protein level (P < 0.05). CONCLUSION Rotavirus remains a notable pathogenic etiology of childhood AGE and the G3P[8] serotype was dominant in Taiwan. This study highlighted the importance of rotavirus surveillance to ensure protective effectiveness against the circulating strains.
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Affiliation(s)
- Yen-Hsin Kung
- Department of Pediatrics, Mackay Memorial Hospital and Mackay Children's Hospital, Taipei, Taiwan
| | - Hsin Chi
- Department of Pediatrics, Mackay Memorial Hospital and Mackay Children's Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yhu-Chering Huang
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yi-Chuan Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fang-Tzy Wu
- Department of Health, Research and Diagnostic Center, Centers for Disease Control, Taiwan
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
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Priority setting for the introduction of rotavirus vaccine: what evidence was essential? COST EFFECTIVENESS AND RESOURCE ALLOCATION 2018; 16:42. [PMID: 30455601 PMCID: PMC6225549 DOI: 10.1186/s12962-018-0126-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Rotavirus (RV) diarrhea is the most common cause of severe diarrhea in children worldwide and since 2006, vaccines have been available and recommended by WHO for use in all children. We developed protocols that countries could use to assess the burden of RV disease in their own countries and the cost-effectiveness of a program for vaccine introduction. A decade later and in the setting of extreme tiering of prices so that the poorest countries pay the least for the vaccine, more than 92 countries have introduced this vaccine into their national programs and more than 90 have not. Those countries that introduced determined by protocol that the burden of RV disease was substantial and the cost of vaccine reasonable, especially in low income settings where GAVI subsidizes the vaccines’ purchase. However, elsewhere, WHO's global recommendation has not been enacted leaving a majority of the world’s children still at risk of this severe and sometimes fatal disease. We remain with much to learn about how to encourage countries to make decisions that will improve the health of their own children.
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Wu JY, Zhou Y, Zhang GM, Mu GF, Yi S, Yin N, Xie YP, Lin XC, Li HJ, Sun MS. Isolation and characterization of a new candidate human inactivated rotavirus vaccine strain from hospitalized children in Yunnan, China: 2010-2013. World J Clin Cases 2018; 6:426-440. [PMID: 30294607 PMCID: PMC6163142 DOI: 10.12998/wjcc.v6.i11.426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/23/2018] [Accepted: 08/02/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To determine the distribution of rotavirus VP7 gene in hospitalized children in Yunnan, China.
METHODS A total of 366 stool specimens were collected from hospitalized children in hospitals in Yunnan Province from September 2010 to December 2013. The genomic RNA electropherotypes and the G genotypes of the rotaviruses were determined. A phylogenetic analysis of the VP7 gene was performed. Rotavirus isolation was performed, and characterized by plaque, minimum essential medium, and all genes sequence analysis. Quantification of antibodies for inactivated vaccine prepared with ZTR-68 was examined by enzyme-linked immunosorbent assay and microneutralization assay.
RESULTS Group A human rotavirus was detected in 177 of 366 (48.4%) stool samples using a colloidal gold device assay. The temporal distribution of rotavirus cases showed significant correlation with the mean air temperature. Rotaviruses were isolated from 13% of the rotavirus-positive samples. The predominant genotype was G1 (43.5%), followed by G3 (21.7%), G9 (17.4%), G2 (4.3%), G4 (8.7%), and mixed (4.3%) among a total of 23 rotavirus isolates. A rotavirus strain was isolated from a rotavirus-positive stool sample of a 4-month-old child in The First People’s Hospital of Zhaotong (2010) for use as a candidate human inactivated rotavirus vaccine strain and for further research, and was designated ZTR-68. The genotype of 11 gene segments of strain ZTR-68 (RVA/Human-wt/CHN/ZTR-68/2010/G1P[8]) was characterized. The genotype constellation of strain ZTR-68 was identified as G1-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. The VP7 and VP4 genotypes of strain ZTR-68 were similar to Wa-like strains.
CONCLUSIONS
A high prevalence of the G1, G2, and G3 genotypes was detected from 2010 to 2012. However, a dominant prevalence of the G9 genotype was identified as the cause of gastroenteritis in children in Yunnan, China, in 2013. A candidate human inactivated rotavirus vaccine strain, designated ZTR-68 was isolated, characterized, and showed immunogenicity. Our data will be useful for the future formulation and development of a vaccine in China.
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Affiliation(s)
- Jin-Yuan Wu
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Yan Zhou
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Guang-Ming Zhang
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Guo-Fa Mu
- Pediatrics Department, the First People’s Hospital of Zhaotong City, Zhaotong 657000, Yunnan Province, China
| | - Shan Yi
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Na Yin
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Yu-Ping Xie
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Xiao-Chen Lin
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Hong-Jun Li
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
| | - Mao-Sheng Sun
- Department of Molecular Biology, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming 650118, Yunnan Province, China
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Mahmud-Al-Rafat A, Muktadir A, Muktadir H, Karim M, Maheshwari A, Ahasan MM. Rotavirus epidemiology and vaccine demand: considering Bangladesh chapter through the book of global disease burden. Infection 2018; 46:15-24. [PMID: 29047020 DOI: 10.1007/s15010-017-1082-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/11/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Rotavirus is the major cause of gastroenteritis in children throughout the world. Every year, a large number of children aged < 5 years die from rotavirus-related diarrhoeal diseases. Though these infections are vaccine-preventable, the vast majority of children in low-income countries suffer from the infection. The situation leads to severe economic loss and constitutes a major public health problem. METHODS We searched electronic databases including PubMed and Google scholar using the following words: "features of rotavirus," "epidemiology of rotavirus," "rotavirus serotypes," "rotavirus in Bangladesh," "disease burden of rotavirus," "rotavirus vaccine," "low efficacy of rotavirus vaccine," "inactivated rotavirus vaccine". Publications until July 2017 have been considered for this work. RESULTS AND CONCLUSION Currently, two live attenuated vaccines are available throughout the world. Many countries have included rotavirus vaccines in national immunization program to reduce the disease burden. However, due to low efficacy of the available vaccines, satisfactory outcome has not yet been achieved in developing countries such as Bangladesh. Poor economic, public health, treatment, and sanitation status of the low-income countries necessitate the need for the most effective rotavirus vaccines. Therefore, the present scenario demands the development of a highly effective rotavirus vaccine. In this regard, inactivated rotavirus vaccine concept holds much promise for reducing the current disease burden. Recent advancements in developing an inactivated rotavirus vaccine indicate a significant progress towards disease prophylaxis and control.
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Affiliation(s)
| | - Abdul Muktadir
- Research & Development Division, Incepta Vaccine Ltd, Zirabo, Savar, Dhaka, 1341, Bangladesh
| | - Hasneen Muktadir
- Research & Development Division, Incepta Vaccine Ltd, Zirabo, Savar, Dhaka, 1341, Bangladesh
| | - Mahbubul Karim
- Research & Development Division, Incepta Vaccine Ltd, Zirabo, Savar, Dhaka, 1341, Bangladesh
| | - Arpan Maheshwari
- Research & Development Division, Incepta Vaccine Ltd, Zirabo, Savar, Dhaka, 1341, Bangladesh
| | - Mohammad Mainul Ahasan
- Research & Development Division, Incepta Vaccine Ltd, Zirabo, Savar, Dhaka, 1341, Bangladesh.
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Nirwati H, Hakim MS, Aminah S, Dwija IBNP, Pan Q, Aman AT. Identification of Rotavirus Strains Causing Diarrhoea in Children under Five Years of Age in Yogyakarta, Indonesia. Malays J Med Sci 2017; 24:68-77. [PMID: 28894406 DOI: 10.21315/mjms2017.24.2.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 02/14/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Rotavirus is an important cause of severe diarrhoea in children. The aims of this study were to identify the rotavirus strains that cause diarrhoea in children in Yogyakarta and to determine the association between rotavirus positivity and its clinical manifestations. METHODS Clinical data and stool samples were collected from children hospitalised at Kodya Yogyakarta Hospital, Indonesia. Rotavirus was detected in stool samples using an enzyme immunoassay (EIA), which was followed by genotyping using reverse transcriptase polymerase chain reaction (RT-PCR). Electropherotyping was performed for the rotavirus-positive samples. RESULTS In total, 104 cases were included in the study, 57 (54.8%) of which were rotavirus-positive. Based on a multiple logistic regression analysis, age group, vomiting and stool mucous were associated with rotavirus positivity. Most of the 56 samples subjected to genotyping were classified as G1 (80.36%) and P[8] (69.64%) genotypes. The genotype combination G1P[8] was identified as the most prevalent strain (66.07%). Of the 19 samples subjected to electropherotyping, 17 G1 isolates and 1 G3 isolate had long patterns, and 1 G1 isolate had a short pattern. CONCLUSION G1P[8] was the most dominant strain of rotavirus causing diarrhoea in children in Yogyakarta. Age group, vomiting and stool mucous were associated with rotavirus positivity.
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Affiliation(s)
- Hera Nirwati
- Department of Microbiology, Faculty of Medicine, Universitas Gadjah Mada, 55281 Yogyakarta, Indonesia
| | - Mohamad Saifudin Hakim
- Department of Microbiology, Faculty of Medicine, Universitas Gadjah Mada, 55281 Yogyakarta, Indonesia.,Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center and Postgraduate School Molecular Medicine, 3015 CE Rotterdam, The Netherlands
| | - Sri Aminah
- Department of Pediatric, Kodya Yogyakarta Hospital, 55162 Yogyakarta, Indonesia
| | | | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center and Postgraduate School Molecular Medicine, 3015 CE Rotterdam, The Netherlands
| | - Abu Tholib Aman
- Department of Microbiology, Faculty of Medicine, Universitas Gadjah Mada, 55281 Yogyakarta, Indonesia
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Tharmaphornpilas P, Jiamsiri S, Boonchaiya S, Rochanathimoke O, Thinyounyong W, Tuntiwitayapun S, Guntapong R, Riewpaiboon A, Rasdjarmrearnsook AO, Glass RI. Evaluating the first introduction of rotavirus vaccine in Thailand: Moving from evidence to policy. Vaccine 2017; 35:796-801. [PMID: 28057385 DOI: 10.1016/j.vaccine.2016.12.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND We assessed the effectiveness and possible impact of introducing rotavirus vaccine into the routine immunization program. METHODS Two provinces were selected for an observational study, one where vaccine was introduced and another where vaccine was not available. In these areas, two sub-studies were linked. The prospective cohort study enrolled children 2month old and followed them to the age of 18months to detect all diarrhea episodes. The hospital surveillance study enrolled all children up to age 5 hospitalized with diarrhea whose fecal samples were tested for rotavirus. Rates of rotavirus hospitalizations in older children who had not been vaccinated in both settings provided data to determine whether immunization had an indirect herd effect. The key endpoints for the study were both vaccine effectiveness (VE) based upon hospitalized rotavirus diarrhea and herd protection. FINDINGS From the cohort study, the overall VE for hospitalized rotavirus diarrhea was 88% (95%CI 76-94). Data from hospital surveillance indicated that for 2 consecutive years, the seasonal peak of rotavirus admissions was no longer present in the vaccinated area. Herd protection was observed among older children born before the rotavirus vaccine program was introduced, who experienced a 40-69% reduction in admission for rotavirus. CONCLUSIONS Rotavirus vaccine was highly effective in preventing diarrheal hospitalizations and in conferring herd protection among older children who had not been vaccinated.
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Affiliation(s)
| | - Suchada Jiamsiri
- Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Somchit Boonchaiya
- Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | | | | | | | - Ratigorn Guntapong
- Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand
| | | | | | - Roger I Glass
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
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Gastañaduy PA, Contreras-Roldán I, Bernart C, López B, Benoit SR, Xuya M, Muñoz F, Desai R, Quaye O, Tam KI, Evans-Bowen DK, Parashar UD, Patel M, McCracken JP. Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala. Clin Infect Dis 2016; 62 Suppl 2:S121-6. [PMID: 27059345 DOI: 10.1093/cid/civ1208] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Concerns remain about lower effectiveness and waning immunity of rotavirus vaccines in resource-poor populations. We assessed vaccine effectiveness against rotavirus in Guatemala, where both the monovalent (RV1; 2-dose series) and pentavalent (RV5; 3-dose series) vaccines were introduced in 2010. METHODS A case-control evaluation was conducted in 4 hospitals from January 2012 to August 2013. Vaccine status was compared between case patients (children with laboratory-confirmed rotavirus diarrhea) and 2 sets of controls: nondiarrhea "hospital" controls (matched by birth date and site) and nonrotavirus "test-negative" diarrhea controls (adjusted for age, birth month/year, and site). Vaccine effectiveness ([1 - odds ratio of vaccination] × 100%) was computed using logistic regression models. RESULTS We evaluated 213 case patients, 657 hospital controls, and 334 test-negative controls. Effectiveness of 2-3 doses of a rotavirus vaccine against rotavirus requiring emergency department visit or hospitalization was 74% (95% confidence interval [CI], 58%-84%) with hospital controls, and 52% (95% CI, 26%-69%) with test-negative controls. Using hospital controls, no significant difference in effectiveness was observed between infants 6-11 months (74% [95% CI, 18%-92%]) and children ≥12 months of age (71% [95% CI, 44%-85%]) (P= .85), nor between complete courses of RV1 (63% [95% CI, 23%-82%]) and RV5 (69% [95% CI, 29%-87%]) (P= .96). An uncommon G12P[8] strain, partially heterotypic to strains in both vaccines, was identified in 89% of cases. CONCLUSIONS RV1 and RV5 were similarly effective against severe rotavirus diarrhea caused by a heterotypic strain in Guatemala. This supports broader implementation of rotavirus vaccination in low-income countries where >90% global deaths from rotavirus occur.
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Affiliation(s)
- Paul A Gastañaduy
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Chris Bernart
- Center for Health Studies, Universidad del Valle de Guatemala
| | - Beatriz López
- Center for Health Studies, Universidad del Valle de Guatemala
| | - Stephen R Benoit
- International Emerging Infections Program, Centers for Disease Control and Prevention, Guatemala City
| | - Marvin Xuya
- Center for Health Studies, Universidad del Valle de Guatemala
| | - Fredy Muñoz
- Center for Health Studies, Universidad del Valle de Guatemala
| | - Rishi Desai
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Osbourne Quaye
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia West African Center for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon
| | - Ka Ian Tam
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Diana K Evans-Bowen
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Umesh D Parashar
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manish Patel
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
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11
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Riewpaiboon A, Shin S, Le TPM, Vu DT, Nguyen THA, Alexander N, Dang DA. Cost of rotavirus diarrhea for programmatic evaluation of vaccination in Vietnam. BMC Public Health 2016; 16:777. [PMID: 27514373 PMCID: PMC4982427 DOI: 10.1186/s12889-016-3458-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 08/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rotavirus is the most common etiology of diarrhea-associated hospitalizations and clinic visits in Vietnamese children < 5 years old. To estimate the economic burden of rotavirus-associated formal healthcare encounters, an economic study was conducted. METHODS A cost-of-illness study was performed from a societal perspective. Data were collected from children below the age of five years who presented to a clinic or hospital with symptoms of acute gastroenteritis (AGE). Patient-specific information on resource use and cost was obtained through caregiver interviews and medical chart review. Costs are presented in 2014 US dollar ($). RESULTS A total of 557 children with symptoms of AGE were enrolled from March through June 2009, with mean age of 16.5 months. Of the 340 outpatients and 217 admitted patients enrolled, 41 % tested rotavirus positive. It was found that, from a societal perspective, the mean total cost of AGE was $175. Costs of patients with and without rotavirus were $217 and $158, respectively. From multiple regression analysis, it was found that rotavirus infection, patient age and receiving oral rehydration solution before visiting health facility had significant effect on the costs. CONCLUSIONS This study clearly demonstrated substantial economic burden of AGE including rotavirus disease. They were significantly greater than the previously reported cost estimates in Vietnam. These updated costs of illness result in more favorable vaccine cost-effectiveness than in previous economic evaluations.
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Affiliation(s)
- Arthorn Riewpaiboon
- Faculty of Pharmacy, Mahidol University, 447 Sri Ayutthaya Road, Ratchathevi, Bangkok, 10400, Thailand.
| | - Sunheang Shin
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.,International Vaccine Institute, Seoul, South Korea
| | | | - Dinh Thiem Vu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Duc Anh Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
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12
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Steele AD, Madhi SA, Cunliffe NA, Vesikari T, Phua KB, Lim FS, Nelson EAS, Lau YL, Huang LM, Karkada N, Debrus S, Han HH, Benninghoff B. Incidence of rotavirus gastroenteritis by age in African, Asian and European children: Relevance for timing of rotavirus vaccination. Hum Vaccin Immunother 2016; 12:2406-12. [PMID: 27260009 PMCID: PMC5027698 DOI: 10.1080/21645515.2016.1179412] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Variability in rotavirus gastroenteritis (RVGE) epidemiology can influence the optimal vaccination schedule. We evaluated regional trends in the age of RVGE episodes in low- to middle- versus high-income countries in three continents. We undertook a post-hoc analysis based on efficacy trials of a human rotavirus vaccine (HRV; Rotarix™, GSK Vaccines), in which 1348, 1641, and 5250 healthy infants received a placebo in Europe (NCT00140686), Africa (NCT00241644), and Asia (NCT00197210, NCT00329745). Incidence of any/severe RVGE by age at onset was evaluated by active surveillance over the first two years of life. Severity of RVGE episodes was assessed using the Vesikari-scale. The incidence of any RVGE in Africa was higher than in Europe during the first year of life (≤2.78% vs. ≤2.03% per month), but much lower during the second one (≤0.86% versus ≤2.00% per month). The incidence of severe RVGE in Africa was slightly lower than in Europe during the first year of life. Nevertheless, temporal profiles for the incidence of severe RVGE in Africa and Europe during the first (≤1.00% and ≤1.23% per month) and second (≤0.53% and ≤1.13% per month) years of life were similar to those of any RVGE. Any/severe RVGE incidences peaked at younger ages in Africa vs. Europe. In high-income Asian regions, severe RVGE incidence (≤0.31% per month) remained low during the study. The burden of any RVGE was higher earlier in life in children from low- to middle- compared with high-income countries. Differing rotavirus vaccine schedules are likely warranted to maximize protection in different settings.
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Affiliation(s)
- A Duncan Steele
- a Initiative for Vaccine Research, World Health Organization , Geneva , Switzerland.,b Diarrhoeal Pathogens Research Unit, Medical Research Council , MEDUNSA , South Africa
| | - Shabir A Madhi
- c Medical Research Council , Respiratory and Meningeal Pathogens Research Unit & Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences , Johannesburg , South Africa
| | - Nigel A Cunliffe
- d Institute of Infection and Global Health, University of Liverpool , Ronald Ross Building, Liverpool , UK
| | - Timo Vesikari
- e Vaccine Research Center, Medical School, University of Tampere , Tampere , Finland
| | - Kong Boo Phua
- f Department of Pediatrics , KK, Women's & Children's Hospital , Singapore , Singapore
| | - Fong Seng Lim
- g Division of Family Medicine , Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore , Singapore
| | - E Anthony S Nelson
- h Department of Pediatrics , Faculty of Medicine, The Chinese University of Hong Kong , China
| | - Yu-Lung Lau
- i Department of Pediatrics and Adolescent Medicine , Queen Mary Hospital, LKS Faculty of Medicine, University of Hong Kong , China
| | - Li-Min Huang
- j Division of Infectious Diseases, Children's Hospital, National Taiwan University College of Medicine
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13
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Prasetyo D, Sabaroedin IM, Ermaya YS, Soenarto Y. Association between Severe Dehydration in Rotavirus Diarrhea and Exclusive Breastfeeding among Infants at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. J Trop Med 2015; 2015:862578. [PMID: 26612990 PMCID: PMC4647027 DOI: 10.1155/2015/862578] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/20/2015] [Accepted: 10/20/2015] [Indexed: 11/17/2022] Open
Abstract
Background. Rotavirus is the leading cause of severe acute diarrhea in children. Infants who are exclusively breastfed develop fewer infections and have less severe illnesses. This study aimed to determine association between severe dehydration in rotavirus diarrhea and exclusive breastfeeding. Methods. This is a cross-sectional study in infants ≤ 6 months old with acute diarrhea in Dr. Hasan Sadikin Hospital, Bandung, Indonesia. Results. From 134 infants ≤ 6 months old with acute diarrhea enrolled from April 2009 to December 2012, there were 88 (65.6%) boys and 46 (34.4%) girls in this study. Rotavirus was detected in 60 (44.8 %), 32 (53.3%) of whom were exclusively breastfed. From rotavirus positive subjects, severe dehydration occurred in 4 (12.6%) exclusively breastfed infants and 6 (21.5%) not exclusively breastfed infants. No significant association was found between severe dehydration and exclusive breastfeeding (p = 0.491) in rotavirus diarrhea. Conclusions. In rotavirus diarrhea, there was no significant association between exclusive breastfeeding and severe dehydration.
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Affiliation(s)
- Dwi Prasetyo
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung 40161, Indonesia
| | - Iesje Martiza Sabaroedin
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung 40161, Indonesia
| | - Yudith Setiati Ermaya
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung 40161, Indonesia
| | - Yati Soenarto
- Departments of Child Health and Microbiology, Faculty of Medicine, Universitas Gadjah Mada, Sardjito Hospital, Yogyakarta 55281, Indonesia
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14
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Zhen SS, Li Y, Wang SM, Zhang XJ, Hao ZY, Chen Y, Wang D, Zhang YH, Zhang ZY, Ma JC, Zhou P, Zhang Z, Jiang ZW, Zhao YL, Wang XY. Effectiveness of the live attenuated rotavirus vaccine produced by a domestic manufacturer in China studied using a population-based case-control design. Emerg Microbes Infect 2015; 4:e64. [PMID: 26576341 PMCID: PMC4631931 DOI: 10.1038/emi.2015.64] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/01/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
Abstract
A universal rotavirus (RV) immunization program is a potentially cost-effective measure for preventing RV infection in China. However, the efficacy of the only licensed RV vaccine (Lanzhou lamb rotavirus vaccine, LLR), which is made by a domestic manufacturer, has not been proven by a properly designed clinical trial. In October 2011 to March 2012, to measure the potential protection provided by LLR, a case-control study nested in a population-based active diarrhea surveillance study of children <5 years of age was conducted in rural Zhengding county. During the study period, 308 episodes of diarrhea were identified as being caused by RV infection, resulting in an incidence rate of 48.0/1000 people/year. The predominant RV serotype was G3 (61.5%), followed by G1 (15.2%), and G9 (6.5%). Overall, a protection of 35.0% (95% confidence interval (CI), 13.0%-52.0%) was identified, and higher protection was found among moderate RV gastroenteritis cases caused by the serotype G3 (52.0% 95% CI: 2.0%-76.1%). A concurrently conducted case-control study comparing non-RV viral diarrheal cases with non-diarrheal controls in the same population found that the RV vaccine offered no protection against non-RV diarrhea. Even under a less ideal immunization schedule, the oral LLR conferred a certain level of protection against RV gastroenteritis. However, further studies are needed to understand the full characteristics of the LLR, including its efficacy when administered following the optimal regimen, the potential risk of inducing intussusception, and the direct and indirect protective effects of LLR.
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Affiliation(s)
- Shan-Shan Zhen
- Key Laboratory Medical Molecular Virology, MoE/MoH, and the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University , Shanghai 200032, China
| | - Yue Li
- Key Laboratory Medical Molecular Virology, MoE/MoH, and the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University , Shanghai 200032, China
| | - Song-Mei Wang
- Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University , Shanghai 200032, China
| | - Xin-Jiang Zhang
- Zhengding County Center for Disease Control and Prevention , Zhengding 050800, Hebei Province, China
| | - Zhi-Yong Hao
- Zhengding County Center for Disease Control and Prevention , Zhengding 050800, Hebei Province, China
| | - Ying Chen
- Key Laboratory Medical Molecular Virology, MoE/MoH, and the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University , Shanghai 200032, China
| | - Dan Wang
- Key Laboratory Medical Molecular Virology, MoE/MoH, and the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University , Shanghai 200032, China
| | - Yan-Hong Zhang
- Zhengding County Center for Disease Control and Prevention , Zhengding 050800, Hebei Province, China
| | - Zhi-Yong Zhang
- Zhengding County Center for Disease Control and Prevention , Zhengding 050800, Hebei Province, China
| | - Jing-Chen Ma
- Hebei Province Center for Disease Control and Prevention , Shijiazhuang 050800, Hebei Province, China
| | - Peng Zhou
- Key Laboratory Medical Molecular Virology, MoE/MoH, and the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University , Shanghai 200032, China
| | - Zhen Zhang
- Key Laboratory Medical Molecular Virology, MoE/MoH, and the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University , Shanghai 200032, China
| | - Zhi-Wei Jiang
- Department of Health Statistics, Fourth Military Medical University , Xi'an 710032, Shanxi Province, China
| | - Yu-Liang Zhao
- Hebei Province Center for Disease Control and Prevention , Shijiazhuang 050800, Hebei Province, China
| | - Xuan-Yi Wang
- Key Laboratory Medical Molecular Virology, MoE/MoH, and the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University , Shanghai 200032, China
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15
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Cunliffe N, Zaman K, Rodrigo C, Debrus S, Benninghoff B, Pemmaraju Venkata S, Han HH. Early exposure of infants to natural rotavirus infection: a review of studies with human rotavirus vaccine RIX4414. BMC Pediatr 2014; 14:295. [PMID: 25433534 PMCID: PMC4261882 DOI: 10.1186/s12887-014-0295-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 11/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rotaviruses are the leading cause of severe acute gastroenteritis in children aged <5 years worldwide. A live attenuated human rotavirus vaccine, RIX4414 has been developed to reduce the global disease burden associated with rotavirus gastroenteritis. Serum anti-rotavirus immunoglobulin A (IgA) antibody measured in unvaccinated infants during clinical trials of RIX4414 reflects natural rotavirus exposure, and may inform the optimal timing for rotavirus vaccination. METHODS We reviewed phase II and III randomized, placebo-controlled clinical trials conducted by GlaxoSmithKline Vaccines, Wavre, Belgium between 2000 and 2008 which used the commercial formulation of RIX4414 lyophilized vaccine. We included trials for which demographic data and pre-dose-1 and post-last-dose anti-rotavirus IgA antibody status were available from placebo recipients. RESULTS Sixteen clinical trials met the inclusion criteria. The studies were conducted across Africa (N = 3), Asia (N = 4), Latin America (N = 4), Europe (N = 4) and North America (N = 1). Overall, 46,398 infants were enrolled and among these, 20,099 received placebo. The mean age at pre-dose-1 time point ranged from 6.4 - 12.2 weeks while the mean age at post-last-dose time point ranged from 13.5 - 19.6 weeks. The anti-RV IgA seropositivity rates at both time points were higher in less developed countries of Africa, Asia and Latin America (pre-dose-1: 2.1%-26.3%; post-last-dose: 6.3%-34.8%) when compared to more developed countries of Asia, Europe and North America (pre-dose-1: 0%-9.4%; post-last-dose: 0%-21.3%), indicating that rotavirus infections occurred at a younger age in these regions. CONCLUSION Exposure to rotavirus infection occurred early in life among infants in most geographical settings, especially in developing countries. These data emphasize the importance of timely rotavirus vaccination within the Expanded Program on Immunization schedule to maximize protection.
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Affiliation(s)
| | | | - Carlos Rodrigo
- />Germans Trias i Pujol University Hospital, Universidad Autónoma de barcelona, Barcelona, Spain
| | | | | | | | - Htay-Htay Han
- />GlaxoSmithKline Vaccines, 2301 Renaissance Boulevard, King of Prussia, PA 19406 U.S.A
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16
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Schuchat A, Bell BP. Monitoring the impact of vaccines postlicensure: new challenges, new opportunities. Expert Rev Vaccines 2014; 7:437-56. [DOI: 10.1586/14760584.7.4.437] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Glass RI, Parashar U, Patel M, Gentsch J, Jiang B. Rotavirus vaccines: successes and challenges. J Infect 2013; 68 Suppl 1:S9-18. [PMID: 24156947 DOI: 10.1016/j.jinf.2013.09.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2013] [Indexed: 11/15/2022]
Abstract
Since 2006, the availability of two new rotavirus vaccines has raised enthusiasm to consider the eventual control and elimination of severe rotavirus diarrhea through the global use of vaccines. Rotavirus remains the most severe cause of acute diarrhea in children worldwide responsible for several hundred thousands of deaths in low income countries and up to half of hospital admissions for diarrhea around the world. The new vaccines have been recommended by WHO for all infants and in more than 47 countries, their introduction into routine childhood immunization programs has led to a remarkable decline in hospital admissions and even deaths within 3 years of introduction. Challenges remain with issues of vaccine finance globally and the problem that these live oral vaccines perform less well in low income settings where they are needed most. Ongoing research that will accompany vaccine introduction might help address these issues of efficacy and new vaccines and novel financing schemes may both help make these vaccines universally available and affordable in the decade.
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Affiliation(s)
- Roger I Glass
- Fogarty International Center, National Institutes of Health, 31 Center Drive, Mailstop 2220, Bethesda, MD 20892, USA.
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18
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Nelson EAS, de Quadros CA, Santosham M, Parashar UD, Steele D. Overcoming perceptions of financial barriers to rotavirus vaccine introduction in Asia. Hum Vaccin Immunother 2013; 9:2418-26. [PMID: 23955246 DOI: 10.4161/hv.26107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Despite a WHO recommendation in 2009, reaffirmed in 2013, that all countries should consider introducing rotavirus vaccines into their National Immunization Programs, as of June 2013 only 45 have done so. One major consideration appears to have been the costs of the vaccine to countries. Of concern, is that Asian countries have been slow to introduce rotavirus vaccines despite having robust data that could inform the decision-making process. Although decisions on new vaccine introduction are very complex and vary by country and region, economic evaluations are often pivotal once vaccine efficacy and safety has been established, and disease burden documented and communicated. Unfortunately, with private sector list prices of vaccines often used in economic evaluations, rather than a potential public health sector pricing structure, policy-makers may defer decisions on rotavirus vaccine introduction based on the belief that "the vaccine price is too high," even though this might be based on erroneous data. The Pan American Health Organization's Revolving Fund provides one example of how vaccine price can be made more competitive and transparent through a regional tendering process. Other mechanisms, such as tiered pricing and UNICEF procurement, also exist that could help Asian and other countries move forward more quickly with rotavirus vaccine introduction.
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Affiliation(s)
- E Anthony S Nelson
- Department of Paediatrics; The Chinese University of Hong Kong; Hong Kong, P.R. China
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19
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Cunliffe N, Nakagomi O. Introduction of rotavirus vaccines in developing countries: remaining challenges. ACTA ACUST UNITED AC 2013; 27:157-67. [PMID: 17716443 DOI: 10.1179/146532807x220262] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Rotavirus is the principal agent of severe, dehydrating gastro-enteritis in infants and young children worldwide. The main public health tool that can prevent hospitalisation and death from rotavirus is vaccination. One of two current rotavirus vaccines is now licensed in more than 80 countries and is incorporated into childhood immunisation schedules across several countries in the Americas and Europe. However, since the majority of childhood deaths from rotavirus occur in the developing countries of Africa and Asia, widespread use of vaccine in these two continents will be necessary before a major impact on global diarrhoea mortality is seen. Challenges in these latter settings which primarily relate to vaccine efficacy, safety and financing will be addressed within the next 3-5 years, and thus perhaps finally allow introduction of rotavirus vaccine into the populations in greatest need.
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Affiliation(s)
- Nigel Cunliffe
- Department of Medical Microbiology & Genitourinary Medicine, University of Liverpool, UK.
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Patel MM, Patzi M, Pastor D, Nina A, Roca Y, Alvarez L, Iniguez V, Rivera R, Tam KI, Quaye O, Bowen M, Parashar U, De Oliveira LH. Effectiveness of monovalent rotavirus vaccine in Bolivia: case-control study. BMJ 2013; 346:f3726. [PMID: 23783434 PMCID: PMC3687514 DOI: 10.1136/bmj.f3726] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of two doses of a monovalent rotavirus vaccine (RV1) against hospital admission for rotavirus in Bolivia. DESIGN Case-control study. SETTING Six hospitals in Bolivia, between March 2010 and June 2011. PARTICIPANTS 400 hospital admissions for rotavirus, 1200 non-diarrhea hospital controls, and 718 rotavirus negative hospital controls. MAIN OUTCOME MEASURES Odds of antecedent vaccination between case patients and controls; effectiveness of vaccination ((1-adjusted odds ratio)×100), adjusted for age and other confounders; and stratified effectiveness by dose, disease severity, age group, and serotype. RESULTS In comparison with non-diarrhea controls, case patients were more likely to be male and attend day care but less likely to have chronic underlying illness, higher level maternal education, and telephones and computers in their home. Rotavirus negative controls were somewhat more similar to case patients but also were more likely to be male and attend day care and less likely to have higher level maternal education and computers in their homes. The adjusted effectiveness of RV1 against hospital admission for rotavirus was 69% (95% confidence interval 54% to 79%) with rotavirus negative controls and 77% (65% to 84%) with non-diarrhea controls. The effectiveness of one dose of RV1 was 36% and 56%, respectively. With both control groups, protection was sustained through two years of life, with similar efficacy against hospital admission among children under 1 year (64% and 77%) and over 1 year of age (72% and 76%). RV1 provided significant protection against diverse serotypes, partially and fully heterotypic to the G1P[8] vaccine. Effectiveness using the two control groups was 80% and 85% against G9P[8], 74% and 93%% against G3P[8], 59% and 69% against G2P[4], and 80% and 87% against G9P[6] strains. CONCLUSION The monovalent rotavirus vaccine conferred high protection against hospital admission for diarrhea due to rotavirus in Bolivian children. Protection was sustained through two years of life against diverse serotypes different from the vaccine strain.
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Affiliation(s)
- Manish M Patel
- Viral Gastroenteritis Team, DVD, NCIRD, MS-A34, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, USA
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Epidemiology and phylogenetic analysis of VP7 and VP4 genes of rotaviruses circulating in Rawalpindi, Pakistan during 2010. INFECTION GENETICS AND EVOLUTION 2013. [DOI: 10.1016/j.meegid.2012.10.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, Pitan F, Cunliffe N. Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev 2012; 11:CD008521. [PMID: 23152260 DOI: 10.1002/14651858.cd008521.pub3] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Rotavirus results in more diarrhoea-related deaths in children less than five years of age than any other single agent in countries with high childhood mortality. It is also a common cause of diarrhoea-related hospital admissions in countries with low childhood mortality. Currently licensed rotavirus vaccines include a monovalent rotavirus vaccine (RV1; Rotarix, GlaxoSmithKline Biologicals) and a pentavalent rotavirus vaccine (RV5; RotaTeq, Merck & Co., Inc.). Lanzhou lamb rotavirus vaccine (LLR; Lanzhou Institute of Biomedical Products) is used in China only. OBJECTIVES To evaluate rotavirus vaccines approved for use (RV1, RV5, and LLR) for preventing rotavirus diarrhoea. SEARCH METHODS We searched MEDLINE (via PubMed) (1966 to May 2012), the Cochrane Infectious Diseases Group Specialized Register (10 May 2012), CENTRAL (published in The Cochrane Library 2012, Issue 5), EMBASE (1974 to 10 May 2012), LILACS (1982 to 10 May 2012), and BIOSIS (1926 to 10 May 2012). We also searched the ICTRP (10 May 2012), www.ClinicalTrials.gov (28 May 2012) and checked reference lists of identified studies. SELECTION CRITERIA We selected randomized controlled trials (RCTs) in children comparing rotavirus vaccines approved for use with placebo, no intervention, or another vaccine. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial eligibility, extracted data, and assessed risk of bias. We combined dichotomous data using the risk ratio (RR) and 95% confidence intervals (CI). We stratified the analysis by child mortality, and used GRADE to evaluate evidence quality. MAIN RESULTS Forty-one trials met the inclusion criteria and enrolled a total of 186,263 participants. Twenty-nine trials (101,671 participants) assessed RV1, and 12 trials (84,592 participants) evaluated RV5. We did not find any trials assessing LLR.RV1Children aged less than one year: In countries with low-mortality rates, RV1 prevents 86% of severe rotavirus diarrhoea cases (RR 0.14, 95% CI 0.07 to 0.26; 40,631 participants, six trials; high-quality evidence), and, based on one large multicentre trial in Latin America and Finland, probably prevents 40% of severe all-cause diarrhoea episodes (rate ratio 0.60, 95% CI 0.50 to 0.72; 17,867 participants, one trial; moderate-quality evidence). In countries with high-mortality rates, RV1 probably prevents 63% of severe rotavirus diarrhoea cases (RR 0.37, 95% CI 0.18 to 0.75; 5414 participants, two trials; moderate-quality evidence), and, based on one trial in Malawi and South Africa, 34% of severe all-cause diarrhoea cases (RR 0.66, 95% CI 0.44 to 0.98; 4939 participants, one trial; moderate-quality evidence).Children aged up to two years: In countries with low-mortality rates, RV1 prevents 85% of severe rotavirus diarrhoea cases (RR 0.15, 95% CI 0.12 to 0.20; 32,854 participants, eight trials; high-quality evidence), and probably 37% of severe all-cause diarrhoea episodes (rate ratio 0.63, 95% CI 0.56 to 0.71; 39,091 participants, two trials; moderate-quality evidence). In countries with high-mortality rates, based on one trial in Malawi and South Africa, RV1 probably prevents 42% of severe rotavirus diarrhoea cases (RR 0.58, 95% CI 0.42 to 0.79; 2764 participants, one trial; moderate-quality evidence), and 18% of severe all-cause diarrhoea cases (RR 0.82, 95% CI 0.71 to 0.95; 2764 participants, one trial; moderate-quality evidence).RV5Children aged less than one year: In countries with low-mortality rates, RV5 probably prevents 87% of severe rotavirus diarrhoea cases (RR 0.13, 95% CI 0.04 to 0.45; 2344 participants, three trials; moderate-quality evidence), and, based on one trial in Finland, may prevent 72% of severe all-cause diarrhoea cases (RR 0.28, 95% CI 0.16 to 0.48; 1029 participants, one trial; low-quality evidence). In countries with high-mortality rates, RV5 prevents 57% of severe rotavirus diarrhoea (RR 0.43, 95% CI 0.29 to 0.62; 5916 participants, two trials; high-quality evidence), but there was insufficient data to assess the effect on severe all-cause diarrhoea.Children aged up to two years: Four studies provided data for severe rotavirus and all-cause diarrhoea in countries with low-mortality rates. Three trials reported on severe rotavirus diarrhoea cases and found that RV5 probably prevents 82% (RR 0.18, 95% CI 0.07 to 0.50; 3190 participants, three trials; moderate-quality evidence), and another trial in Finland reported on severe all-cause diarrhoea cases and found that RV5 may prevent 96% (RR 0.04, 95% CI 0.00 to 0.70; 1029 participants, one trial; low-quality evidence). In high-mortality countries, RV5 prevents 41% of severe rotavirus diarrhoea cases (RR 0.59, 95% CI 0.43 to 0.82; 5885 participants, two trials; high-quality evidence), and 15% of severe all-cause diarrhoea cases (RR 0.85, 95% CI 0.75 to 0.98; 5977 participants, two trials; high-quality evidence).There was no evidence of a vaccine effect on mortality (181,009 participants, 34 trials; low-quality evidence), although the trials were not powered to detect an effect on this end point.Serious adverse events were reported in 4565 out of 99,438 children vaccinated with RV1 and in 1884 out of 78,226 children vaccinated with RV5. Fifty-eight cases of intussusception were reported in 97,246 children after RV1 vaccination, and 34 cases in 81,459 children after RV5 vaccination. No significant difference was found between children receiving RV1 or RV5 and placebo in the number of serious adverse events, and intussusception in particular. AUTHORS' CONCLUSIONS RV1 and RV5 prevent episodes of rotavirus diarrhoea. The vaccine efficacy is lower in high-mortality countries; however, due to the higher burden of disease, the absolute benefit is higher in these settings. No increased risk of serious adverse events including intussusception was detected, but post-introduction surveillance studies are required to detect rare events associated with vaccination.
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Soltani M, Bouanene I, Trabelsi A, Harbi A, Hachicha M, Amri F, Boussnina S, Gueddiche MN, Sfar MT, Teleb N, Ben Ghorbel M, Ben Hamida E. [Epidemiology of rotavirus gastroenteritis among children under 5 years of age in Tunisia - results of sentinel hospital surveillance 2009 to 2011]. Rev Epidemiol Sante Publique 2012; 60:473-80. [PMID: 23141818 DOI: 10.1016/j.respe.2012.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 03/02/2012] [Accepted: 04/05/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Rotavirus is the major cause of severe acute gastroenteritis among young children. The objectives of this study were to assess the epidemiology, clinical and virological features of community-acquired rotavirus acute gastroenteritis, in children under 5 years of age, hospitalized in Tunisia. METHODS A multicenter prospective observational study was conducted from April 2009 to March 2011, in 11 sentinel pediatric departments. Clinical data and stool samples were collected for all children under 5 years, admitted for acute gastroenteritis. Rotavirus was detected by Elisa immunoassay test and genotyped for G and P by semi-nested multiplex RT-PCR. RESULT A total of 621 children were enrolled in this study. Rotavirus was detected in 30.3% of cases (95% CI [26.7-33.9]). The estimated incidence rate of rotavirus acute gastroenteritis was 11 cases/100,000 child-years (95% CI [9.43-12.57]). This infection affected predominantly children aged under 24 months, and occurred mainly in winter (55.3%). Vomiting, fever and dehydration were observed in 79.6%, 69.5% and 57% respectively. Genotype analysis identified four G types (G1, G2, G3 and G4) and 4 P types (P[4], P[6], P[8] and P[9]). The most common G/P combination was G3P[8] (24.4%), followed by G4P[8] (13.3%) and G1P[8] (6.5%). CONCLUSION These results highlight the frequency and potential severity of rotavirus acute gastroenteritis in pediatric hospital settings. The present study could provide a sufficient database to make a decision related to the introduction of rotavirus vaccine in Tunisian national immunization program.
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Affiliation(s)
- M Soltani
- Service de médecine préventive et d'épidémiologie, CHU Fattouma Bourguiba, 5000 Monastir, Tunisie.
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Liu N, Yen C, Fang ZY, Tate JE, Jiang B, Parashar UD, Zeng G, Duan ZJ. Projected health impact and cost-effectiveness of rotavirus vaccination among children <5 years of age in China. Vaccine 2012; 30:6940-5. [PMID: 22705174 PMCID: PMC11984756 DOI: 10.1016/j.vaccine.2012.05.084] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 05/30/2012] [Accepted: 05/30/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Two rotavirus vaccines have been licensed globally since 2006. In China, only a lamb rotavirus vaccine is licensed and several new rotavirus vaccines are in development. Data regarding the projected health impact and cost-effectiveness of vaccination of children in China against rotavirus will assist policy makers in developing recommendations for vaccination. METHODS Using a Microsoft Excel model, we compared the national health and economic burden of rotavirus disease in China with and without a vaccination program. Model inputs included 2007 data on burden and cost of rotavirus outcomes (deaths, hospitalizations, outpatient visits), projected vaccine efficacy, coverage, and cost. Cost-effectiveness was measured in US dollars per disability-adjusted life-year (DALY) and US dollars per life saved. RESULTS A 2-dose rotavirus vaccination program could annually avert 3013 (62%) deaths, 194,794 (59%) hospitalizations and 1,333,356 (51%) outpatient visits associated with rotavirus disease in China. The medical break-even price of the vaccine is $1.19 per dose. From a societal perspective, a vaccination program would be highly cost-effective in China at the vaccine price of $2.50 to $5 per dose, and be cost-effective at the price of $10 to $20 per dose. CONCLUSIONS A national rotavirus vaccination program could be a cost-effective measure to effectively reduce deaths, hospitalizations, and outpatient visits due to rotavirus disease in China.
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Affiliation(s)
- Na Liu
- Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control, Beijing, China
| | - Catherine Yen
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Zhao-yin Fang
- Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control, Beijing, China
| | - Jacqueline E. Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Baoming Jiang
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Umesh D. Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Guang Zeng
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control, Beijing, China
| | - Zhao-jun Duan
- Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control, Beijing, China
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Horwood PF, Luang-Suarkia D, Bebes S, Boniface K, Datta SS, Siba PM, Kirkwood CD. Surveillance and molecular characterization of group A rotaviruses in Goroka, Papua New Guinea. Am J Trop Med Hyg 2012; 87:1145-8. [PMID: 23128293 DOI: 10.4269/ajtmh.2012.12-0234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In this study, we investigated the molecular epidemiology of group A rotaviruses in cases of acute gastroenteritis in Goroka, Papua New Guinea. From April 2008 through November 2010, 813 diarrheal stool samples were collected from children < 5 years of age hospitalized with acute gastroenteritis. Rotavirus antigen was detected in 31.2% of samples using a commercial enzyme-linked immunosorbent assay. Genotyping revealed the presence of the globally circulating strains G1P[8] (50.0%), G3P[8] (23.0%), and G2P[4] (8.2%). The globally emerging strains G9 and G12 were detected in 1.2% and 6.1% of samples, respectively. Mixed infections were detected in a high proportion of samples (11.9%), with 9.0% and 3.7% of samples displaying multiple G and P genotypes, respectively.
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Fulfilling the promise of rotavirus vaccines: how far have we come since licensure? THE LANCET. INFECTIOUS DISEASES 2012; 12:561-70. [PMID: 22742639 DOI: 10.1016/s1473-3099(12)70029-4] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Rotavirus is the most common cause of fatal and severe childhood diarrhoea worldwide. Two new rotavirus vaccines have shown efficacy against severe rotavirus disease in large clinical trials. Between 2006 and 2010, 27 countries introduced rotavirus vaccination into national immunisation programmes and, subsequently, the burden of severe rotavirus disease in these countries has decreased substantially in both vaccinated and unvaccinated children. Rotavirus vaccination has led to large, sustained declines in childhood deaths from diarrhoea in Brazil and Mexico, which supports estimates that rotavirus was the leading cause of diarrhoeal deaths in these countries. Studies after licensing have provided new insights into these vaccines, such as the duration of protection, relative effectiveness in poor populations, and strain evolution after vaccine introduction. The challenge for policy makers worldwide is to analyse the effect of vaccination in early adopter countries and to assess whether the benefits outweigh the costs and encourage wider dissemination of these vaccines.
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Patel M, Pedreira C, De Oliveira LH, Umaña J, Tate J, Lopman B, Sanchez E, Reyes M, Mercado J, Gonzalez A, Perez MC, Balmaceda A, Andrus J, Parashar U. Duration of protection of pentavalent rotavirus vaccination in Nicaragua. Pediatrics 2012; 130:e365-72. [PMID: 22753550 DOI: 10.1542/peds.2011-3478] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the duration of protection of pentavaent rotavirus vaccine (RV5) against rotavirus hospitalizations in Nicaragua, a developing country in Central America. METHODS We conducted a case-control study at 4 hospitals from 2007 through 2010, including 1016 children hospitalized with laboratory-confirmed rotavirus diarrhea, 4930 controls with nonrotavirus diarrhea (ie, "test-negative"), and 5627 controls without diarrhea. All cases and controls were aged ≥ 6 months and born after August 2006. Outcomes included odds of antecedent vaccination between case-patients and controls, and effectiveness of vaccination (1 - adjusted odds ratio [OR] × 100). Duration of protection was assessed by comparing effectiveness among children aged <1 year compared with ≥ 1 year. RESULTS Indicators of socioeconomic conditions and nonrotavirus vaccination (oral polio vaccine and diphtheria/tetanus/pertussis/hepatitis A/hepatitis B) for test-negative controls were more comparable to the rotavirus case-patients than nondiarrhea controls. RV5 vaccination was associated with a significantly lower risk of rotavirus hospitalization by using test-negative controls (OR: 0.55; 95% confidence interval [CI]: 0.41-0.74) and nondiarrhea controls (OR: 0.30; 95% CI: 0.22-0.40). Risk of rotavirus hospitalization was twofold lower among RV5 vaccinated children aged <1 year (OR: 0.36; 95% CI: 0.22-0.57) compared with RV5 vaccinated children aged ≥ 1 year (OR: 0.70; 95% CI: 0.47-1.05). CONCLUSIONS RV5 provided good protection against severe rotavirus disease in Nicaragua during the first year of life, when most severe and fatal rotavirus disease in developing countries occurs. However, the decline in protection with age warrants monitoring of disease among older children and consideration of a booster dose evaluation at the end of infancy.
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Affiliation(s)
- Manish Patel
- Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Atlanta GA 30333, USA.
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Ghosh S, Saraswathi A, Indi SS, Hoti SL, Vasan HN. Ag@AgI, core@shell structure in agarose matrix as hybrid: synthesis, characterization, and antimicrobial activity. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2012; 28:8550-8561. [PMID: 22582868 DOI: 10.1021/la301322j] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A novel in situ core@shell structure consisting of nanoparticles of Ag (Ag Nps) and AgI in agarose matrix (Ag@AgI/agarose) has been synthesized as a hybrid, in order to have an efficient antibacterial agent for repetitive usage with no toxicity. The synthesized core@shell structure is very well characterized by XRD, UV-visible, photoluminescence, and TEM. A detailed antibacterial studies including repetitive cycles are carried out on Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus) bacteria in saline water, both in dark and on exposure to visible light. The hybrid could be recycled for the antibacterial activity and is nontoxic toward human cervical cancer cells (HeLa cells). The water insoluble Ag@AgI in agarose matrix forms a good coating on quartz, having good mechanical strength. EPR and TEM studies are carried out on the Ag@AgI/agarose and the bacteria, respectively, to elucidate a possible mechanism for killing of the bacteria.
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Affiliation(s)
- Somnath Ghosh
- Solid State and Structural Chemistry Unit, Indian Institute of Science, Bangalore-560 012, India
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Phua KB, Lim FS, Lau YL, Nelson EAS, Huang LM, Quak SH, Lee BW, Doorn LJV, Teoh YL, Tang H, Suryakiran P, Smolenov IV, Bock HL, Han HH. Rotavirus vaccine RIX4414 efficacy sustained during the third year of life: A randomized clinical trial in an Asian population. Vaccine 2012; 30:4552-7. [DOI: 10.1016/j.vaccine.2012.03.030] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 02/08/2012] [Accepted: 03/16/2012] [Indexed: 11/28/2022]
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Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, Pitan F, Cunliffe N. Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev 2012:CD008521. [PMID: 22336845 DOI: 10.1002/14651858.cd008521.pub2] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Rotavirus results in more diarrhoea-related deaths in children less than five years of age than any other single agent in low- and middle-income countries. It is also a common cause of diarrhoea-related hospital admissions in high-income countries. The World Health Organization (WHO) recommends that all children should be vaccinated with a monovalent rotavirus vaccine (RV1; Rotarix, GlaxoSmithKline Biologicals) or a pentavalent rotavirus vaccine (RV5; RotaTeq, Merck & Co., Inc.), with a stronger recommendation for countries where deaths due to diarrhoea comprise more than 10% of all deaths. Lanzhou lamb rotavirus vaccine (LLR; Lanzhou Institute of Biomedical Products) is used in China only. OBJECTIVES To evaluate rotavirus vaccines approved for use (RV1, RV5, and LLR) for preventing rotavirus diarrhoea. Secondary objectives were to evaluate the efficacy of rotavirus vaccines on all-cause diarrhoea, hospital admission, death, and safety profiles. SEARCH METHODS For this update, we searched MEDLINE (via PubMed) in October 2011, and in June 2011 we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (published in The Cochrane Library 2011, Issue 2), , EMBASE, LILACS, and BIOSIS. We also searched the ICTRP (28 June 2011) and checked reference lists of identified studies. SELECTION CRITERIA We selected randomized controlled trials in children comparing rotavirus vaccines approved for use with placebo, no intervention, or another vaccine. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial eligibility, extracted data, and assessed risk of bias. They combined dichotomous data using the risk ratio (RR) and 95% confidence intervals (CI) and used GRADE to evaluate evidence quality, which was reflected as follows: high quality ("vaccine prevents..."); moderate quality ("vaccine probably prevents..."); or low quality ("vaccine may prevent..."). MAIN RESULTS Forty-three trials, including nine new trials for this update, met the inclusion criteria and enrolled 190,551 participants. Thirty-one trials assessed RV1, and 12 trials evaluated RV5. We did not find any trials assessing LLR.In children aged less than one year, RV1, compared to placebo, probably prevents 70% of all cases of rotavirus diarrhoea (RR 0.30, 95% CI 0.18 to 0.50; seven trials, 12,130 participants; moderate-quality evidence), and 80% of severe rotavirus diarrhoea cases (RR 0.20, 95% CI 0.11 to 0.35; seven trials, 35,004 participants; moderate-quality evidence). Similarly, RV5 prevents 73% of all rotavirus diarrhoea cases (RR 0.27, 95% CI 0.22 to 0.33; four trials, 7614 participants; high-quality evidence), and 77% of severe rotavirus diarrhoea cases (RR 0.23, 95% CI 0.08 to 0.71; three trials, 6953 participants; high-quality evidence). Both vaccines prevent over 80% of rotavirus diarrhoea cases that require hospitalization. For all-cause diarrhoea, based on two multi-centred trials from South Africa, Malawi, and Europe, RV1 may reduce severe cases by 42% (RR 0.58, 95% CI 0.40 to 0.84; two trials, 8291 participants; low--quality evidence). Also, based on one trial from Finland, RV5 may reduce severe cases by 72% (RR 0.28, 95% CI 0.16 to 0.48; one trial, 1029 participants; low-quality evidence).During the second year of life, compared to placebo, RV1 probably prevents 70% of all cases of rotavirus diarrhoea of any severity (RR 0.30, 95% CI 0.21 to 0.43; six trials, 8041 participants; moderate-quality evidence), and 84% of severe rotavirus diarrhoea cases (RR 0.16, 95% CI 0.12 to 0.21; eight trials, 32,854 participants; moderate-quality evidence). RV5 prevents 49% of all rotavirus diarrhoea cases of any severity (RR 0.51, 95% CI 0.36 to 0.72; four trials, 9784 participants; high-quality evidence), and 56% of severe rotavirus diarrhoea cases (RR 0.44, 95% CI 0.22 to 0.88; four trials, 9783 participants; high-quality evidence). For all-cause diarrhoea, RV1 probably reduces severe cases by 51% (RR 0.49, 95% CI 0.40 to 0.60; two trials, 6269 participants; moderate-quality evidence), and RV5 showed no difference with placebo (three trials, 8533 participants).Reported serious adverse events (including intussusception) after vaccination were measured in 95,178 children for RV1 and 77,480 for RV5, with no difference between the vaccines. AUTHORS' CONCLUSIONS RV1 and RV5 vaccines are effective in preventing rotavirus diarrhoea. These data support the WHO's global vaccine recommendation. The potential for reduced vaccine efficacy in low-income countries needs to be investigated. No increased risk of intussusception was detected, but surveillance monitoring studies are probably advisable in countries introducing the vaccine nationally.
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Affiliation(s)
- Karla Soares-Weiser
- Enhance Reviews Ltd,Wantage, UK. 2Cochrane Editorial Unit, The Cochrane Collaboration, London, UK. 3Enhance Reviews, Kfar-Saba, Israel.
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Park S, Oh S, Lee J, Park G, Choi S, Chae Y, Kim H. Genotypes of rotavirus associated with acute gastroenteritis in Seoul, Korea. Microbiol Immunol 2012; 55:641-4. [PMID: 21752085 DOI: 10.1111/j.1348-0421.2011.00366.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Acute viral gastroenteritis is one of the most common infectious diseases in infants and young children. Rotavirus is mainly important in childhood. The present study determined the detection rate, seasonality and G and P genotypes of rotaviruses in children hospitalized for acute gastroenteritis in Seoul, Korea in 2009. A total of 1,423 stool specimens were screened by ELISA for the presence of rotavirus antigens and the rotavirus-positive stools genotyped by RT-PCR. The G genotype was determined for 90% of samples (242/269) and the P genotype for 93.3% (251/269). During the study, 25 G-P combinations were detected with G1P[8] in 38.3% (n= 103) and G4P[6] in 5.9% (n= 16) cases. These data provided information on rotavirus in patients with acute gastroenteritis in Seoul, Korea and provided baseline data to motivate for the implementation of control measures for rotavirus disease.
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Affiliation(s)
- Sanghun Park
- Virus Team, Seoul Metropolitan Government Research Institute of Public Health and Environment, 202-3 Yangjae-Dong, Seocho-Gu, Seoul 137-734, Korea.
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Kang HY, Kim KH, Kim JH, Kim HM, Kim J, Kim MS, El Khoury AC, Kim DS. Economic evaluation of the national immunization program of rotavirus vaccination for children in Korea. Asia Pac J Public Health 2012; 25:145-58. [PMID: 22234827 DOI: 10.1177/1010539511416806] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The authors assessed the cost-effectiveness of rotavirus vaccination to develop an evidence-based national immunization program in Korea. A Markov model was constructed to compare the costs and clinical outcomes of vaccination versus no vaccination. The birth cohort of 493189 infants in 2007 was followed until the age of 5 years. Korea-specific data for epidemiological characteristics and economic burden of rotavirus diarrhea were used for the modeled estimation. Efficacy of RotaTeq® was based on a recent clinical trial. Rotavirus vaccination would prevent 181238 symptomatic cases (reduction rate = 63.2%) over 5 years after birth. From the societal perspective, at a vaccination cost of 100000 Korean won (KW; 1 US$ ≈ 1200 KW) per dose, universal vaccination would cost 375 620 KW per case averted. The breakeven price of vaccine was 56061 KW. Rotavirus vaccination would reduce the burden of the disease substantially and be a cost-effective strategy to prevent rotavirus diarrhea in Korea.
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Affiliation(s)
- Hye-Young Kang
- Yonsei University, College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Incheon, Korea
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El Khoury AC, Mast TC, Ciarlet M, Markson L, Goveia MG, Munford V, Rácz ML. Projecting the effectiveness of RotaTeq® against rotavirus-related hospitalisations in Brazil. Mem Inst Oswaldo Cruz 2011; 106:541-5. [DOI: 10.1590/s0074-02762011000500004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 05/24/2011] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Max Ciarlet
- Clinical Research and Development, Novartis Vaccines & Diagnostics, USA
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Featherstone DA, Rota PA, Icenogle J, Mulders MN, Jee Y, Ahmed H, de Filippis AMB, Ramamurty N, Gavrilin E, Byabamazima C, Dosseh A, Xu W, Komase K, Tashiro M, Brown D, Bellini WJ, Strebel P. Expansion of the global measles and rubella laboratory network 2005-09. J Infect Dis 2011; 204 Suppl 1:S491-8. [PMID: 21666205 DOI: 10.1093/infdis/jir107] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Enhancing measles surveillance with integration of epidemiologic and laboratory information is one of the key strategies for accelerated measles control and elimination. The World Health Organization (WHO) Global Measles and Rubella Laboratory Network (LabNet) has been developed since 2000 to currently include 690 laboratories serving 183 countries. The LabNet testing strategy follows well-validated, standardized procedures for confirming suspected cases and for monitoring measles and rubella virus transmission patterns. The strength of the LabNet is a strong quality assurance program that monitors the performance of all laboratories through annual proficiency testing and continuous assessment. In the 5-year period 2005-2009, the results of >1 million measles immunoglobulin M (IgM) tests have been reported by the LabNet and, in addition, sequence information on >7000 measles and 600 rubella viruses has been shared. Progress with the development of the LabNet during 2005-2009 is discussed.
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Affiliation(s)
- David A Featherstone
- Department of Immunization, Vaccines and Biologicals, Family and Community Health Cluster, World Health Organization (WHO), Geneva, Switzerland.
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Chouikha A, Fodha I, Ben Hadj Fredj M, Ardhaoui M, Teleb N, Brini I, Messaadi F, Mastouri M, Sfar T, Hachicha M, Kammoun T, Bouaaziz A, Amri F, Harbi A, Zribi M, Bousnina S, Khemakhem A, Boujaafar N, Trabelsi A, Steele A. Relationship between electropherotypes and VP7/VP4 genotypes of group A rotaviruses detected between 2000 and 2007 in Tunisian children. ACTA ACUST UNITED AC 2011; 59:e43-8. [DOI: 10.1016/j.patbio.2009.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 04/21/2009] [Indexed: 11/28/2022]
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El Khoury AC, Mast TC, Ciarlet M, Markson LE, Goveia MG. Projecting the effectiveness of RotaTeq® against rotavirus-related hospitalizations and deaths in six Asian countries. HUMAN VACCINES 2011; 7:506-10. [PMID: 21422820 DOI: 10.4161/hv.7.5.14620] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
RotaTeq is an oral pentavalent rotavirus vaccine (RV5) that has shown high and consistent efficacy in preventing rotavirus gastroenteritis (RGE) in randomized clinical trials conducted mostly in industrialized countries. We projected the effectiveness of RV5 against RGE-related hospitalizations and deaths in 6 Asian countries by using a simple mathematical model. Model inputs included rotavirus surveillance data collected 2006-2007 in China, 2001-2002 in Hong Kong, 2005-2007 in India, 2005-2007 in South Korea, 2005-2007 in Taiwan, and 2001-2003 in Thailand; the numbers of rotavirus-related deaths in each country; and published rotavirus serotype-specific efficacy of RV5. The model projected an overall effectiveness in the region of 82% to 89% against RGE-related hospitalizations and a substantial reduction in RGE-related deaths, suggesting that RV5 could substantially reduce the burden of rotavirus disease in Asia.
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Mitui MT, Chan PKS, Nelson EAS, Leung TF, Nishizono A, Ahmed K. Co-dominance of G1 and emerging G3 rotaviruses in Hong Kong: a three-year surveillance in three major hospitals. J Clin Virol 2011; 50:325-33. [PMID: 21330195 DOI: 10.1016/j.jcv.2011.01.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 12/21/2010] [Accepted: 01/17/2011] [Indexed: 01/10/2023]
Abstract
BACKGROUND The World Health Organization recommends rotavirus vaccines be included in all national immunization programs as part of a strategy to control diarrhoeal diseases. Sentinel surveillance is advised to monitor impact post-vaccine introduction and to document changes in genotype distribution. OBJECTIVES To determine the molecular epidemiology of circulating rotaviruses in Hong Kong prior to implementation of universal rotavirus vaccination. STUDY DESIGN From December 2004 through December 2007, 830 rotavirus-positive stool samples from subjects admitted for acute diarrhea to three major hospitals in Hong Kong were examined. The electropherotypes, and the G and P genotypes of these rotaviruses were determined. Phylogenetic analysis of the VP7 gene was performed. RESULTS G3P[8] was the dominant genotype (46.1%), followed by G1P[8] (36.5%) and G9P[8] (9.2%). A total of 35 electropherotypes were identified. The G3 and G1 strains had high sequence similarities among themselves and were clustered with strains from Asia particularly mainland China. The G9 strains were clustered with the globally spreading strains. G12 and G4 were not found. The prevalence of rotavirus infection peaked in winter season when temperature was low, atmospheric pressure was high, relative humidity was low and rainfall was negligible. CONCLUSIONS Genotype G3 and G1 were the dominant rotaviruses circulating in Hong Kong between 2004 and 2007. Strains were mainly related with those from mainland China. Ongoing surveillance of circulating genotypes should continue in anticipation of universal rotavirus vaccine introduction.
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Detection of rotavirus antigenemia in routinely obtained serum specimens to augment surveillance and vaccine effectiveness evaluations. Pediatr Infect Dis J 2010; 29:836-9. [PMID: 20526226 DOI: 10.1097/inf.0b013e3181e753d1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND : Antigenemia is common among children with rotavirus disease. Because obtaining stool specimens is cumbersome, we evaluated whether detection of antigenemia in sera obtained during routine clinical practice could augment rotavirus surveillance to assess the effect of vaccination. METHODS : We determined the sensitivity, specificity, and positive and negative predictive values of serum/plasma rotavirus antigen detection using fecal antigen positivity as the gold standard. Fecal specimens obtained by active surveillance and residual serum/plasma specimens obtained during routine clinical testing from children 15 days to 23 months of age presenting with acute gastroenteritis (AGE) to a children's hospital in Houston were tested for rotavirus using a commercially available enzyme immunoassay. Using case-control methods, we compared vaccine effectiveness (VE) using cases identified through serum/plasma testing versus stool testing. RESULTS : Of the 205 AGE patients with fecal specimens, 71 (35%) had a serum/plasma sample available. Among these 71 children, antigenemia was detected in 22 of 29 with rotavirus-positive fecal specimens (sensitivity = 75%; 95% confidence interval [CI] = 60%-91%) versus 2 of 42 children with rotavirus-negative fecal specimens (specificity = 95%; 95% CI = 89%-100%). The positive and negative predictive values of rotavirus antigenemia were 92% (95% CI = 81%-100%) and 85% (95% CI = 75%-95%), respectively. Thirty-four of 195 children with AGE without fecal specimens had serum/plasma available; 10 (29%) had rotavirus antigenemia. Three-dose VE using cases identified through serum/plasma testing was similar (VE = 84%; 95% CI = 25%-96%) to that using cases identified though fecal testing (VE = 85%; 95% CI = 55%-95%). CONCLUSIONS : Detection of antigenemia in routinely collected serum/plasma could augment identification of rotavirus disease for postlicensure evaluation of impact and effectiveness of rotavirus vaccination.
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Wang YH, Kobayashi N, Nagashima S, Zhou X, Ghosh S, Peng JS, Hu Q, Zhou DJ, Yang ZQ. Full genomic analysis of a porcine-bovine reassortant G4P[6] rotavirus strain R479 isolated from an infant in China. J Med Virol 2010; 82:1094-102. [PMID: 20419827 DOI: 10.1002/jmv.21760] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
During the 2004 surveillance of rotaviruses in Wuhan, China, a G4P[6] rotavirus strain R479 was isolated from a stool specimen collected from a 2-year-old child with diarrhea. The strain R479 had an uncommon subgroup specificity I + II, and analysis of the VP6 gene suggested that it was related to porcine rotaviruses. In the present study, full-length nucleotide sequences of all the RNA segments of R479 were determined and analyzed phylogenetically to identify the origin of individual RNA segments. According to the rotavirus genotyping system based on 11 RNA segments, the genotype of R479 was expressed as G4-P[6]-I5-R1-C1-M1-A1-N1-T7-E1-H1. This genotype includes the porcine-like VP6 genotype (I5) and bovine-like NSP3 genotype (T7). Phylogenetic analysis revealed that R479 genes encoding VP1, VP2, VP3, VP6, VP7, VP8*, NSP1, NSP4, and NSP5 were more closely related to those of porcine rotaviruses than human or other animal rotaviruses. In contrast, it was remarkable that the NSP3 gene of R479 was genetically closely related to only a bovine rotavirus strain UK. The NSP2 gene of R479 was also unique and clustered with only the G5P[8] human strain IAL28 and G3P[24] simian strain TUCH. These results suggested that R479 may be a reassortant virus having the NSP3 gene from a bovine rotavirus in the genetic background of a porcine rotavirus, with an NSP2 gene related to the porcine-human reassortant strain IAL28. To our knowledge, R479 is the first porcine-bovine reassortant rotavirus isolated from a human.
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Affiliation(s)
- Yuan-Hong Wang
- Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei Province, China
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Soares-Weiser K, Maclehose H, Ben-Aharon I, Goldberg E, Pitan F, Cunliffe N. Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev 2010:CD008521. [PMID: 20464766 DOI: 10.1002/14651858.cd008521] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Rotavirus results in higher diarrhoea-related death in children less than five years of age than any other single agent, particularly in low- and middle-income countries. The World Health Organization has recommended the use of rotavirus vaccines in childhood immunization schedules. OBJECTIVES To evaluate rotavirus vaccines approved for use (Rotarix, RotaTeq, and Lanzhou Lamb Rotavirus (LLR)) for preventing rotavirus diarrhoea. SEARCH STRATEGY In February 2010, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (published in The Cochrane Library 2009, Issue 1), MEDLINE, EMBASE, LILACS, and BIOSIS. We also searched the ICTRP (January 2010) and checked reference lists of identified studies. SELECTION CRITERIA Randomized controlled trials comparing rotavirus vaccines approved for use with placebo, no intervention, or another vaccine in children. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial eligibility, extracted data, and assessed risk of bias. Dichotomous data were combined using the risk ratio (RR) and 95% confidence intervals (CI). MAIN RESULTS Thirty-four trials that included 175,944 participants met the inclusion criteria. They evaluated Rotarix (26 trials; 99,841 participants) and RotaTeq (eight trials; 76,103 participants), and had variable risk of bias (where information provided). None of the identified trials used LLR or compared rotavirus vaccines. Compared to placebo, Rotarix and RotaTeq were both effective at reducing rotavirus diarrhoea (severe cases and cases of any severity). They also reduced all-cause diarrhoea (severe cases), and hospitalizations and need for medical attention caused by rotavirus diarrhoea. However, few data were available for Rotarix and all-cause diarrhoea. Versus the placebo groups, participants in each vaccine group had similar numbers of deaths, serious adverse events, reactogenicity profiles (fever, diarrhoea, and vomiting), and adverse events that required discontinuation of the vaccination schedule. Both vaccines were immunogenic (measured by virus shedding in stool and/or seroconversion). Subgroup analyses indicate that both vaccines are effective in countries with different incomes, but few data are available. AUTHORS' CONCLUSIONS Rotarix and RotaTeq are effective vaccines for the prevention of rotavirus diarrhoea. The balance between benefit and harm favours benefit. Ongoing safety monitoring should be continued. Trials comparing LLR with placebo should be conducted and the results made available.
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Cunliffe N, Wittel D, Ngwira B. History of rotavirus research in children in Malawi: the pursuit of a killer. Malawi Med J 2010; 21:113-5. [PMID: 20345020 DOI: 10.4314/mmj.v21i3.45631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Rotavirus gastroenteritis is a major health problem among Malawian children. Studies spanning 20 years have described the importance, epidemiology and viral characteristics of rotavirus infections in the country. Despite a wide diversity of circulating rotavirus strains causing severe disease in young infants, a clinical trial of a human rotavirus vaccine clearly demonstrated the potential for rotavirus vaccination to greatly reduce the morbidity and mortality due to rotavirus diarrhoea in Malawi. This new enteric vaccine initiative represents a major opportunity to improve the health and survival of Malawian children.
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Affiliation(s)
- Nigel Cunliffe
- Division of Medical Microbiology, School of Infection and Host Defence, University of Liverpool, Duncan Building, Daulby Street, Liverpool L69 3GA, UK
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Mukherjee A, Chattopadhyay S, Bagchi P, Dutta D, Singh NB, Arora R, Parashar UD, Gentsch JR, Chawla-Sarkar M. Surveillance and molecular characterization of rotavirus strains circulating in Manipur, North-Eastern India: Increasing prevalence of emerging G12 strains. INFECTION GENETICS AND EVOLUTION 2010; 10:311-20. [DOI: 10.1016/j.meegid.2010.01.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 01/01/2010] [Accepted: 01/11/2010] [Indexed: 10/20/2022]
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Rotavirus surveillance to determine disease burden and epidemiology in Java, Indonesia, August 2001 through April 2004. Vaccine 2010; 27 Suppl 5:F61-6. [PMID: 19931722 DOI: 10.1016/j.vaccine.2009.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study estimates rotavirus disease burden in children under age 3 years presenting with acute gastroenteritis to hospitals in Purworejo district and Yogyakarta city from August 2001 to April 2004. Among a total of 8929 hospitalized children, 1397 (16%) presented with acute gastroenteritis and of the 1321 stool samples tested, 705 (53%) were positive for rotavirus. Rotavirus infections were most common among children aged 7-23 months and rotavirus was more common during the dry season (June through August). Logistic regression analysis showed no differences in socioeconomic indicators between the rotavirus positive and negative admissions. Rotavirus vaccination may prevent a large proportion of all hospitalizations of young children under 3 years of age presenting with acute gastroenteritis.
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A decade of the Asian Rotavirus Surveillance Network: achievements and future directions. Vaccine 2010; 27 Suppl 5:F1-3. [PMID: 19931705 DOI: 10.1016/j.vaccine.2009.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zaman K, Yunus M, Faruque ASG, El Arifeen S, Hossain I, Azim T, Rahman M, Podder G, Roy E, Luby S, Sack DA. Surveillance of rotavirus in a rural diarrhoea treatment centre in Bangladesh, 2000-2006. Vaccine 2010; 27 Suppl 5:F31-4. [PMID: 19931715 DOI: 10.1016/j.vaccine.2009.08.063] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Rotavirus was detected in 33% of 4519 children less than 5 years of age admitted with diarrhoea to treatment centres at Matlab in rural Bangladesh from 2000 to 2006. Highest rotavirus detection rates were in children aged 6-11 months with 56% being less than 1 year old. The peak seasonal detection was in July-September and December-February. The population-based incidence rates of rotavirus ranged from 10.8 to 19.6/1000 children less than 5 years of age. G1 serotype predominated between June 2002-May 2005 and June 2005-May 2006 the predominant type was G2 (41%) followed by G1 (22%) and G9 (22%). Rotavirus is an important cause of childhood diarrhoea in rural Bangladesh and this burden may be reduced with a rotavirus vaccination programme.
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Affiliation(s)
- K Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Mohakhali, Dhaka 1212, Bangladesh.
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Rotarix™ significantly reduced severe rotavirus gastroenteritis in African babies during their first year of life. S Afr Fam Pract (2004) 2010. [DOI: 10.1080/20786204.2010.10873922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Wilopo SA, Kilgore P, Kosen S, Soenarto Y, Aminah S, Cahyono A, Ulfa M, Tholib A. Economic evaluation of a routine rotavirus vaccination programme in Indonesia. Vaccine 2009; 27 Suppl 5:F67-74. [DOI: 10.1016/j.vaccine.2009.09.040] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wu F, Liang S, Tsao K, Huang C, Lin C, Lin J, Su C, Eng H, Yang J, Chen P, Yang C. Hospital-based surveillance and molecular epidemiology of rotavirus infection in Taiwan, 2005–2007. Vaccine 2009; 27 Suppl 5:F50-4. [DOI: 10.1016/j.vaccine.2009.08.090] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Li DD, Liu N, Yu JM, Zhang Q, Cui SX, Zhang DL, Yang SH, Cao DJ, Xu ZQ, Duan ZJ. Molecular epidemiology of G9 rotavirus strains in children with diarrhoea hospitalized in Mainland China from January 2006 to December 2007. Vaccine 2009; 27 Suppl 5:F40-5. [DOI: 10.1016/j.vaccine.2009.08.073] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mirzayeva R, Steele A, Parashar U, Zaman K, Neuzil K, Nelson E. Evaluation of rotavirus vaccines in Asia—Are there lessons to be learnt? Vaccine 2009; 27 Suppl 5:F120-9. [DOI: 10.1016/j.vaccine.2009.09.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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