Effectiveness of rotavirus vaccination against childhood diarrhoea in El Salvador: case-control study
Effectiveness of rotavirus vaccination against childhood diarrhoea in El Salvador: case-control study
复制标题
DOI：
10.1136/bmj.c2825
复制
发表时间：
2010-06-15
影响因子：
105.7
通讯作者：
Patel, Manish
中科院分区：
文献类型：
--
作者：
de Palma, Orbelina;Cruz, Lilian;Patel, Manish
目的评价单价轮状病毒疫苗对严重轮状病毒病的有效性，并评估其对中美洲中低收入国家萨尔瓦多2岁以下儿童腹泻的影响。设计匹配病例对照研究。2007年1月至2009年6月，323名2岁以下的儿童因实验室确诊的轮状病毒腹泻入院，969名健康对照组在年龄和社区方面相匹配。（（1-调整优势比的疫苗接种）× 100）对轮状病毒腹泻需要住院accounting.Results例和对照组相似的母乳喂养，早产，母亲的教育，和社会经济变量。在92%的轮状病毒病例中鉴定出G1 P [8]株。两剂疫苗接种对需要住院的腹泻的有效性为76%（95%置信区间为64%至84%）。与6-11个月的儿童（83%，68%至91%）相比，12个月或以上的儿童（59%，27%至77%）的保护率明显较低（P=0.046）。一剂疫苗的有效性为51%（26%至67%）。在哨点医院，所有5岁以下儿童腹泻的入院率在2008年下降了40%，在2009年下降了51%，从接种疫苗前的2006年。结论单价轮状病毒疫苗是非常有效的，对轮状病毒腹泻的入院率在2岁以下的儿童在萨尔瓦多，并大大减少了这种入院的数量在这个中低收入的设置。疫苗接种后对疾病流行病学的影响，特别是在年龄较大的儿童中，值得进一步关注。
Objective To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America.Design Matched case-control study.Setting Seven hospitals in cities across El Salvador, January 2007 to June 2009.Participants 323 children aged less than 2 years admitted with laboratory confirmed rotavirus diarrhoea and 969 healthy controls matched for age and neighbourhood.Main outcome measure Effectiveness of rotavirus vaccination ((1-adjusted odds ratio of vaccination) x 100) against rotavirus diarrhoea requiring hospital admission.Results Cases and controls were similar for breast feeding, premature birth, maternal education, and socioeconomic variables. G1P[8] strains were identified in 92% of rotavirus cases. Effectiveness of two doses of vaccination against diarrhoea requiring hospital admission was 76% (95% confidence interval 64% to 84%). Protection was significantly lower (P=0.046) among children aged 12 months or more (59%, 27% to 77%) compared with children aged 6-11 months (83%, 68% to 91%). One dose of vaccine was 51% (26% to 67%) effective. At the sentinel hospitals, all admissions for diarrhoea among children under 5 declined by 40% in 2008 and by 51% in 2009 from the prevaccine year 2006.Conclusions A monovalent rotavirus vaccine was highly effective against admissions for rotavirus diarrhoea in children aged less than 2 years in El Salvador and substantially reduced the number of such admissions in this low-middle income setting. The impact on disease epidemiology after vaccination, particularly among older children, warrants future attention.