Impact of rotavirus vaccination on diarrheal hospitalizations in children younger than 5 years of age in a rural southern Mozambique.

Abstract

BACKGROUND:

Rotavirus vaccine(Rotarix®) was introduced in Mozambique through its Expanded Program of Immunization in September 2015. We assessed the impact of rotavirus vaccination on childhood gastroenteritis-associated hospitalizations post-vaccine introduction in a high HIV prevalence rural setting of southern Mozambique.

METHODS:

We reviewed and compared the trend of hospitalizations (prevalence) and incidence rates of acute gastroenteritis (AGE), and rotavirus associated-diarrhea (laboratory confirmed rotavirus) in pre- (January 2008-August 2015) and post-rotavirus vaccine introduction periods (September 2015-December 2020), among children <5 years of age admitted to Manhiça District Hospital.

RESULTS:

From January 2008 to December 2020, rotavirus vaccination was found to contribute to the decline of the prevalence of AGE from 19% (95% CI: 18.14-20.44) prior to the vaccine introduction to 10% (95% CI: 8.89-11.48) in the post-introduction period, preventing 40% (95 % IE: 38-42) and 84% (95 % IE: 80-87) of the expected AGE and laboratory confirmed rotavirus cases, respectively, among infants. Similarly, the overall incidence of rotavirus was 11.8-fold lower in the post-vaccine introduction period (0.4/1000 child-years-at-risk [CYAR]; 95% CI: 0.3-0.6) compared with the pre-vaccination period (4.7/1000 CYAR; 95% CI: 4.2-5.1) with the highest reduction being observed among infants (16.8-fold lower from the 15.1/1000 CYAR in the pre-vaccine to 0.9/1000 CYAR in the post-vaccine eras).

CONCLUSIONS:

We documented a significant reduction in all-cause diarrhea hospitalizations and rotavirus positivity after vaccine introduction demonstrating the beneficial impact of rotavirus vaccination in a highly vulnerable population.

• Authors: Filomena Manjate, Llorenç Quintó, Percina Chirinda, Sozinho Acácio, Marcelino Garrine, Delfino Vubil, Tacilta Nhampossa, Eva D João, Arsénio Nhacolo, Anelsio Cossa, Sérgio Massora, Gizela Bambo, Quique Bassat, Karen Kotloff, Myron Levine, Pedro L Alonso, Jacqueline E Tate, Umesh Parashar, Jason M Mwenda, Inácio Mandomando
• Journal: Vaccine (Vaccine) Vol. 40 Issue 44 Pg. 6422-6430 (10 19 2022) ISSN: 1873-2518 [Electronic] Netherlands
• PMID: 36192272 (Publication Type: Review, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022. Published by Elsevier Ltd.

Chemical References

• Rotavirus Vaccines

Topics

• Infant
• Humans
• Child
• Rotavirus Vaccines
• Rotavirus
• Rotavirus Infections (epidemiology, prevention & control)
• Mozambique (epidemiology)
• Diarrhea (epidemiology, prevention & control)
• Gastroenteritis (epidemiology, prevention & control)
• Vaccination
• Hospitalization