@article{d1054a1517ec4fbe9f6fedd52d21dd58,
title = "Rotavirus Vaccination and the Global Burden of Rotavirus Diarrhea among Children Younger Than 5 Years",
abstract = "Importance: Rotavirus infection is the global leading cause of diarrhea-associated morbidity and mortality among children younger than 5 years. Objectives: To examine the extent of rotavirus infection among children younger than 5 years by country and the number of deaths averted because of the rotavirus vaccine. Design, Setting, and Participants: This report builds on findings from the Global Burden of Disease Study 2016, a cross-sectional study that measured diarrheal diseases and their etiologic agents. Models were used to estimate burden in data-sparse locations. Exposure: Diarrhea due to rotavirus infection. Main Outcomes and Measures: Rotavirus-associated mortality and morbidity by country and year and averted deaths attributable to the rotavirus vaccine by country. Results: Rotavirus infection was responsible for an estimated 128500 deaths (95% uncertainty interval [UI], 104500-155600) among children younger than 5 years throughout the world in 2016, with 104733 deaths occurring in sub-Saharan Africa (95% UI, 83406-128842). Rotavirus infection was responsible for more than 258 million episodes of diarrhea among children younger than 5 years in 2016 (95% UI, 193 million to 341 million), an incidence of 0.42 cases per child-year (95% UI, 0.30-0.53). Vaccine use is estimated to have averted more than 28000 deaths (95% UI, 14600-46700) among children younger than 5 years, and expanded use of the rotavirus vaccine, particularly in sub-Saharan Africa, could have prevented approximately 20% of all deaths attributable to diarrhea among children younger than 5 years. Conclusions and Relevance: Rotavirus-associated mortality has decreased markedly over time in part because of the introduction of the rotavirus vaccine. This study suggests that prioritizing vaccine introduction and interventions to reduce diarrhea-associated morbidity and mortality is necessary in the continued global reduction of rotavirus infection..",
author = "Christopher Troeger and Khalil, {Ibrahim A.} and Rao, {Puja C.} and Shujin Cao and Blacker, {Brigette F.} and Tahmeed Ahmed and George Armah and Bines, {Julie E.} and Brewer, {Thomas G.} and Colombara, {Danny V.} and Gagandeep Kang and Kirkpatrick, {Beth D.} and Kirkwood, {Carl D.} and Mwenda, {Jason M.} and Parashar, {Umesh D.} and Petri, {William A.} and Riddle, {Mark S.} and Steele, {A. Duncan} and Thompson, {Robert L.} and Walson, {Judd L.} and Sanders, {John W.} and Mokdad, {Ali H.} and Murray, {Christopher J.L.} and Hay, {Simon I.} and Reiner, {Robert C.}",
note = "Funding Information: Author Contributions: Drs Reiner and Hay had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Troeger, Khalil, Rao, Ahmed, Brewer, Mwenda, Parashar, Steele, Murray, Hay, Reiner. Acquisition, analysis, or interpretation of data: Troeger, Khalil, Cao, Blacker, Ahmed, Armah, Bines, Colombara, Kang, Kirkpatrick, Kirkwood, Petri, Riddle, Steele, Thompson, Walson, Sanders, Mokdad, Reiner. Drafting of the manuscript: Troeger, Khalil, Rao, Cao, Blacker, Steele, Walson, Reiner. Critical revision of the manuscript for important intellectual content: Troeger, Blacker, Ahmed, Armah, Bines, Brewer, Colombara, Kang, Kirkpatrick, Kirkwood, Mwenda, Parashar, Petri, Riddle, Steele, Thompson, Walson, Sanders, Mokdad, Murray, Hay, Reiner. Statistical analysis: Troeger, Cao, Hay, Reiner. Obtained funding: Ahmed, Murray. Administrative, technical, or material support: Rao, Blacker, Ahmed, Kang, Mwenda, Riddle, Hay. Supervision: Khalil, Rao, Ahmed, Thompson, Mokdad, Murray, Hay, Reiner. Conflict of Interest Disclosures: None reported. Funding/Support: This analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study was supported by grant OPP1132415 from the Bill & Melinda Gates Foundation. Publisher Copyright: {\textcopyright} 2018 American Medical Association. All rights reserved.",
year = "2018",
month = oct,
doi = "10.1001/jamapediatrics.2018.1960",
language = "English",
volume = "172",
pages = "958--965",
journal = "JAMA Pediatrics",
issn = "2168-6203",
publisher = "American Medical Association",
number = "10",
}