A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia
A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia
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DOI：
10.1093/cid/civ1206
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发表时间：
2016-05-01
影响因子：
11.8
通讯作者：
Chilengi, Roma
中科院分区：
文献类型：
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作者：
Beres, Laura K.;Tate, Jacqueline E.;Chilengi, Roma
背景。腹泻是赞比亚儿童死亡的第三大原因。在导致住院和/或死亡的腹泻病例中，多达三分之一是由疫苗可预防的轮状病毒引起的。2012年1月，赞比亚开始在卢萨卡省的所有公共卫生机构试点引入Rotarix活的口服轮状病毒疫苗。方法：在2012年7月至2013年10月期间，我们在6个公共部门站点进行了一项病例对照研究，以估计轮状病毒疫苗对符合年龄的腹泻儿童的有效性（VE）。我们计算了在大便轮状病毒抗原呈阳性的儿童（病例）和大便呈阴性的儿童（对照组）中接受过至少1剂轮状病毒疫苗的几率。我们根据患者年龄、出现的日历月份和临床部位调整了结果的优势比（OR），并将VE表示为（1 -调整OR） × 100。在病例对照分析中，共有91例轮状病毒阳性病例和298例轮状病毒阴性对照，他们均接种了5岁以下疫苗，年龄为千分之一（6个月）。在符合接种年龄条件的轮状病毒阳性儿童中，20%住院。对于所有严重程度的轮状病毒腹泻，在每千分之一的6个月大的儿童中，调整后的2剂VE为26%（95%可信区间[CI]， -30%至58%）。6个月大的住院儿童的VE为56% （95% CI， -34%至86%）。我们观察到，与较轻疾病相比，VE对加重疾病的点估计值较高，但无法检测到较轻疾病的低水平VE。
Background. Diarrhea is the third leading cause of child death in Zambia. Up to one-third of diarrhea cases resulting in hospitalization and/or death are caused by vaccine-preventable rotavirus. In January 2012, Zambia initiated a pilot introduction of the Rotarix live, oral rotavirus vaccine in all public health facilities in Lusaka Province.Methods.aEuro integral Between July 2012 and October 2013, we conducted a case-control study at 6 public sector sites to estimate rotavirus vaccine effectiveness (VE) in age-eligible children presenting with diarrhea. We computed the odds of having received at least 1 dose of Rotarix among children whose stool was positive for rotavirus antigen (cases) and children whose stool was negative (controls). We adjusted the resulting odds ratio (OR) for patient age, calendar month of presentation, and clinical site, and expressed VE as (1 - adjusted OR) x 100.Results.aEuro integral A total of 91 rotavirus-positive cases and 298 rotavirus-negative controls who had under-5 card-confirmed vaccination status and were a parts per thousand yen6 months of age were included in the case-control analysis. Among rotavirus-positive children who were age-eligible to be vaccinated, 20% were hospitalized. Against rotavirus diarrhea of all severity, the adjusted 2-dose VE was 26% (95% confidence interval [CI], -30% to 58%) among children a parts per thousand yen6 months of age. VE against hospitalized children a parts per thousand yen6 months of age was 56% (95% CI, -34% to 86%).Conclusions.aEuro integral We observed a higher point estimate for VE against increased severity of illness compared with milder disease, but were not powered to detect a low level of VE against milder disease.