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Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis
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 rota...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245159/ https://www.ncbi.nlm.nih.gov/pubmed/31544211 http://dx.doi.org/10.1093/cid/ciz912 |
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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 |
author_facet | 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 |
author_sort | Otieno, Grieven P |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-7245159 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72451592020-05-27 Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis 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 Clin Infect Dis Articles and Commentaries 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. Oxford University Press 2020-06-01 2019-09-23 /pmc/articles/PMC7245159/ /pubmed/31544211 http://dx.doi.org/10.1093/cid/ciz912 Text en © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Articles and Commentaries 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 Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis |
title | Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis |
title_full | Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis |
title_fullStr | Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis |
title_full_unstemmed | Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis |
title_short | Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis |
title_sort | impact of the introduction of rotavirus vaccine on hospital admissions for diarrhea among children in kenya: a controlled interrupted time-series analysis |
topic | Articles and Commentaries |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245159/ https://www.ncbi.nlm.nih.gov/pubmed/31544211 http://dx.doi.org/10.1093/cid/ciz912 |
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