Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Otieno, Grieven P ; Bottomley, Christian ; Khagayi, Sammy ; Adetifa, Ifedayo ; Ngama, Mwanajuma ; Omore, Richard ; Ogwel, Billy ; Owor, Betty E ; Bigogo, Godfrey ; Ochieng, John B ; Onyango, Clayton ; Juma, Jane ; Mwenda, Jason ; Tabu, Collins ; Tate, Jacqueline E ; Addo, Yaw ; Britton, Tuck ; Parashar, Umesh D ; Breiman, Robert F ; Verani, Jennifer R ; Nokes, D James
  More +
• Description:
  Background ; Monovalent rotavirus vaccine, Rotarix (GlaxoSmithKline), was introduced in Kenya in July 2014 and is recommended to infants as oral doses at ages 6 and 10 weeks. A multisite study was established in 2 population-based surveillance sites to evaluate vaccine impact on the incidence of rotavirus-associated hospitalizations (RVHs). ; Methods ; Hospital-based surveillance was conducted from January 2010 to June 2017 for acute diarrhea hospitalizations among children aged <5 years in 2 health facilities in Kenya. A controlled interrupted time-series analysis was undertaken to compare RVH pre– and post–vaccine introduction using rotavirus-negative cases as a control series. The change in incidence post–vaccine introduction was estimated from a negative binomial model that adjusted for secular trend, seasonality, and multiple health worker industrial actions (strikes). ; Results ; Between January 2010 and June 2017 there were 1513 and 1652 diarrhea hospitalizations in Kilifi and Siaya; among those tested for rotavirus, 28% (315/1142) and 23% (197/877) were positive, respectively. There was a 57% (95% confidence interval CI, 8–80%) reduction in RVHs observed in the first year post–vaccine introduction in Kilifi and a 59% (95% CI, 20–79%) reduction in Siaya. In the second year, RVHs decreased further at both sites, 80% (95% CI, 46–93%) reduction in Kilifi and 82% reduction in Siaya (95% CI. 61–92%); this reduction was sustained at both sites into the third year. ; Conclusions ; A substantial reduction in RVHs and all-cause diarrhea was observed in 2 demographic surveillance sites in Kenya within 3 years of vaccine introduction.
• Subjects:
  • Articles and Commentaries
  • AcademicSubjects/MED00290
  • rotavirus vaccine
  • interrupted time series
  • control
  • vaccine impact
• Source:
  Clin Infect Dis. 2019; 70(11):2306-2313
• Pubmed ID:
  31544211
• Pubmed Central ID:
  PMC7245159
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health Organization/International ; MR/R010161/1/MRC_/Medical Research Council/United Kingdom
• Place as Subject:
  Kenya
• Volume:
  70
• Issue:
  11
• Download URL:
  https://stacks.cdc.gov/view/cdc/89266/cdc_89266_DS1.pdf
• File Type:
  [PDF - 1.06 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1cc68bea2f32816f41b6029404507f38a34eb8ac730871cf85aeb9835dac441d