Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda
Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda
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DOI：
10.1093/cid/civ1016
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发表时间：
2016-05-01
影响因子：
11.8
通讯作者：
Parashar, Umesh D.
中科院分区：
文献类型：
--
作者：
Tate, Jacqueline E.;Ngabo, Fidele;Parashar, Umesh D.
背景。轮状病毒疫苗在低收入国家的效力低于高收入国家。卢旺达是撒哈拉以南非洲最早将轮状病毒疫苗纳入其国家免疫规划的低收入国家之一。在这种情况下，我们试图评估轮状病毒疫苗的有效性（VE）。方法：采用病例对照设计评估欧洲积分VE。病例和检测阴性对照为在8个哨点区医院和10个相关卫生中心中的1个就诊的腹泻患儿，其粪便标本经酶免疫测定轮状病毒检测呈阳性（病例）或阴性（对照）。由于在接种疫苗后几乎立即有很高的疫苗覆盖率，因此分析仅限于接种轮状病毒疫苗时7-18周龄的儿童。VE计算为（1 -优势比）× 100，其中优势比为病例与对照组相比轮状病毒疫苗接种率的调整优势比。结果：纳入48例轮状病毒阳性儿童和152例轮状病毒阴性儿童。轮状病毒阳性儿童接种轮状病毒疫苗的可能性（未接种疫苗的33/44[73%]）明显低于轮状病毒阴性儿童接种轮状病毒疫苗的81/136 [59%]（P = 0.002）。完整3-dose系列为75%(95%可信区间(CI), 31% - -91%)有效对抗轮状病毒肠胃炎需要住院治疗或医疗中心访问和65%(95%可信区间,-80%到93%)11个月大的儿童和81%(95%可信区间,25% -95%)yen12一千分之一个月age.Conclusions.aEuro积分儿童轮状病毒疫苗是有效预防轮状病毒病在卢旺达的孩子开始他们的轮状病毒疫苗系列7 - 18周的年龄。在一岁之后，疫苗接种的保护作用持续存在。
Background. Rotavirus vaccine efficacy is lower in low-income countries than in high-income countries. Rwanda was one of the first low-income countries in sub-Saharan Africa to introduce rotavirus vaccine into its national immunization program. We sought to evaluate rotavirus vaccine effectiveness (VE) in this setting.Methods.aEuro integral VE was assessed using a case-control design. Cases and test-negative controls were children who presented with a diarrheal illness to 1 of 8 sentinel district hospitals and 10 associated health centers and had a stool specimen that tested positive (cases) or negative (controls) for rotavirus by enzyme immunoassay. Due to high vaccine coverage almost immediately after vaccine introduction, the analysis was restricted to children 7-18 weeks of age at time of rotavirus vaccine introduction. VE was calculated as (1 - odds ratio) x 100, where the odds ratio was the adjusted odds ratio for the rotavirus vaccination rate among case-patients compared with controls.Results.aEuro integral Forty-eight rotavirus-positive and 152 rotavirus-negative children were enrolled. Rotavirus-positive children were significantly less likely to have received rotavirus vaccine (33/44 [73%] unvaccinated) compared with rotavirus-negative children (81/136 [59%] unvaccinated) (P = .002). A full 3-dose series was 75% (95% confidence interval [CI], 31%-91%) effective against rotavirus gastroenteritis requiring hospitalization or a health center visit and was 65% (95% CI, -80% to 93%) in children 6-11 months of age and 81% (95% CI, 25%-95%) in children a parts per thousand yen12 months of age.Conclusions.aEuro integral Rotavirus vaccine is effective in preventing rotavirus disease in Rwandan children who began their rotavirus vaccine series from 7 to 18 weeks of age. Protection from vaccination was sustained after the first year of life.