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
• 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:
  AcademicSubjects/MED00290 Articles And Commentaries Control Interrupted Time Series Rotavirus Vaccine 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
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1cc68bea2f32816f41b6029404507f38a34eb8ac730871cf85aeb9835dac441d
• Download URL:
  https://stacks.cdc.gov/view/cdc/89266/cdc_89266_DS1.pdf
• File Type:
  [PDF - 1.06 MB ]