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10 19, 2022;40 (44): 6422-6430.

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

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
Author Information
  1. Filomena Manjate: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), 1349-008 Lisbon, Portugal. Electronic address: filomena.manjate@manhica.net.
  2. Llorenç Quintó: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain. Electronic address: llorenc.quinto@isglobal.org.
  3. Percina Chirinda: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique. Electronic address: percina.chirinda@manhica.net.
  4. Sozinho Acácio: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Instituto Nacional de Saúde (INS), Ministério da Saúde, Marracuene 1120, Mozambique. Electronic address: sozinho.acacio@manhica.net.
  5. Marcelino Garrine: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), 1349-008 Lisbon, Portugal. Electronic address: marcelino.garrine@manhica.net.
  6. Delfino Vubil: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique. Electronic address: delfino.vubil@manhica.net.
  7. Tacilta Nhampossa: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Instituto Nacional de Saúde (INS), Ministério da Saúde, Marracuene 1120, Mozambique. Electronic address: tacilta.nhampossa@manhica.net.
  8. Eva D João: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique. Electronic address: eva.joao@manhica.net.
  9. Arsénio Nhacolo: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique. Electronic address: arsenio.nhacolo@manhica.net.
  10. Anelsio Cossa: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique. Electronic address: anelsio.cossa@manhica.net.
  11. Sérgio Massora: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique. Electronic address: sergio.massora@manhica.net.
  12. Gizela Bambo: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique. Electronic address: gizela.bambo@manhica.net.
  13. Quique Bassat: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain; ICREA, Pg. Lluís Companys 23, 08010 Barcelona, Spain; Pediatrics Department, Hospital Sant Joan de Déu, (University of Barcelona), 2, 08950, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Electronic address: quique.bassat@isglobal.org.
  14. Karen Kotloff: Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, MD 21201, USA. Electronic address: Kkotloff@medicine.umaryland.edu.
  15. Myron Levine: Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, MD 21201, USA. Electronic address: mlevine@som.umaryland.edu.
  16. Pedro L Alonso: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, 08036 Barcelona, Spain; Global Malaria Programme, World Health Organization, 1211 Geneva, Switzerland.
  17. Jacqueline E Tate: Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA. Electronic address: jqt8@cdc.gov.
  18. Umesh Parashar: Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.
  19. Jason M Mwenda: African Rotavirus Surveillance Network, Immunization, Vaccines and Development Program, World Health Organization, Regional Office for Africa, Brazzaville P.O. Box 2465, Congo. Electronic address: mwendaj@who.int.
  20. Inácio Mandomando: Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; Instituto Nacional de Saúde (INS), Ministério da Saúde, Marracuene 1120, Mozambique. Electronic address: inacio.mandomando@manhica.net.
PMID: 36192272 DOI: 10.1016/j.vaccine.2022.09.050

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.

Keywords

Diarrhea Manhiça Mozambique Rotavirus Vaccine impact

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Grants

  1. 001/World Health Organization

MeSH Term

Infant
Humans
Child
Rotavirus Vaccines
Rotavirus
Rotavirus Infections
Mozambique
Diarrhea
Gastroenteritis
Vaccination
Hospitalization

Chemicals

Rotavirus Vaccines
Review Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 3

Word Cloud

Created with Highcharts 10.0.0rotavirusintroductionvaccineMozambiquevaccinationhospitalizations95%CI:impactpost-vaccineprevalenceAGEamongperiod0CYARRotavirusSeptember2015ruralsoutherncomparedincidencelaboratoryconfirmedJanuary2020childrenageManhiça95 % IE:infants8-foldlower4reductionBACKGROUND:Rotarix®introducedExpandedProgramImmunizationassessedchildhoodgastroenteritis-associatedhighHIVsettingMETHODS:reviewedtrendratesacutegastroenteritisassociated-diarrheapre-2008-Augustpost-rotavirusperiods2015-December<5 yearsadmittedDistrictHospitalRESULTS:2008Decemberfoundcontributedecline19%1814-2044prior10%889-1148post-introductionpreventing40%38-4284%80-87expectedcasesrespectivelySimilarlyoverall114/1000child-years-at-risk[CYAR]3-06pre-vaccination7/10002-51highestobserved16151/1000pre-vaccine9/1000erasCONCLUSIONS:documentedsignificantall-causediarrheapositivitydemonstratingbeneficialhighlyvulnerablepopulationImpactdiarrhealyounger5 yearsDiarrheaVaccine

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