Impact of rotavirus vaccine on childhood diarrheal hospitalization after introduction into the south african public immunization program

Veerle M.Y. Msimang*, Nicola Page, Michelle J. Groome, Jocelyn Moyes, Margaret M. Cortese, Mapaseka Seheri, Kathleen Kahn, Meera Chagan, Shabir A. Madhi, Cheryl Cohen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

67 Citations (Scopus)

Abstract

Background: Oral rotavirus vaccine was introduced into the South African routine immunization program in August 2009 administered at 6 and 14 weeks with no catch-up. We described the change in rotavirus-associated diarrheal hospitalizations among children <5 years at 3 sentinel sites from 2009 through 2011. Methods: During 2009 through 2011, we compared the proportion of enrolled children aged <5 years hospitalized with acute gastroenteritis and testing rotavirus positive. We used hospital data to determine the change in diarrhea hospitalizations and estimated total numbers of rotavirus hospitalizations by adjusting for nonenrolled patients. Stool samples were tested for rotavirus using enzyme immunoassay. Results: In 2009 (May.December), 46% (404/883) of samples among children <5 years tested rotavirus positive, decreasing to 33% (192/580) (P < 0.001) in 2010 and 29% (113/396) (P < 0.001) in 2011. Compared with May.December 2009, total diarrhea hospitalizations among children aged <5 years was one-third lower in May.December of 2010 and 2011. Among infants, adjusted rotavirus hospitalizations were 61% (n = 267) and 69% (n = 214) lower, respectively, in 2010 and 2011 when compared with 2009 (n = 689), and 45 and 50 percentage points greater than the reduction in rotavirus-negative cases. Among children <5 years, rotavirus hospitalizations were 54% and 58% lower in 2010 and 2011, compared with 2009 (40 and 44 percentage points greater than reduction in rotavirus-negative cases). Rotavirus reductions occurred in rural and urban settings. Conclusion: Using published estimates of rotavirus hospitalization burden, we estimate that at least 13,000 to 20,000 hospitalizations in children <2 years were prevented in the 2 years after rotavirus vaccine introduction.

Original languageEnglish
Pages (from-to)1359-1364
Number of pages6
JournalPediatric Infectious Disease Journal
Volume32
Issue number12
DOIs
Publication statusPublished - 2013

Keywords

  • Childhood diarrhea
  • Hospitalization
  • Rotavirus vaccine

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