2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis
2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis
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DOI：
10.1016/s1473-3099(11)70253-5
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发表时间：
2012-02-01
影响因子：
56.3
通讯作者：
Parashar, Umesh D.
中科院分区：
文献类型：
--
作者：
Tate, Jacqueline E.;Burton, Anthony H.;Parashar, Umesh D.
世卫组织建议在所有国家常规使用轮状病毒疫苗，特别是在腹泻死亡率高的国家！疾病。为了在引入轮状病毒疫苗之前确定危及生命的轮状病毒病的负担，我们旨在更新世界范围内因轮状病毒感染引起的腹泻而死亡的5岁以下儿童的估计人数。方法：我们使用PubMed对至少100名5岁以下因腹泻入院的儿童进行研究。此外，我们要求这些研究在2000年或之后的中点收集数据，以全年为单位进行，并通过eia或聚丙烯酰胺凝胶电泳评估轮状病毒引起的腹泻。我们还纳入了参与世卫组织协调的全球轮状病毒监测网络（由2009年参与的成员国组成）并符合研究标准的国家的数据。对于已将轮状病毒疫苗引入其国家免疫规划的国家，我们排除了引入轮状病毒疫苗后的数据。我们根据研究所在国家的地区和儿童死亡率水平将研究分为五组。对于每一组，为了获得轮状病毒相关死亡率的估计值，我们将随机效应平均轮状病毒检出率乘以该组国家2008年腹泻相关死亡率数字。我们通过汇总我们的区域估计得出了全世界的死亡率估计。2008年，全世界5岁以下儿童中由轮状病毒感染引起的腹泻导致45.3万例死亡（95%，42万至49.4万），占腹泻导致的死亡的37%，占5岁以下儿童死亡总数的5%。五个国家占轮状病毒感染导致的所有死亡人数的一半以上：刚果民主共和国、埃塞俄比亚、印度、尼日利亚和巴基斯坦；仅印度就占死亡人数的22%（98 621人死亡）。引入有效和可用的轮状病毒疫苗可大大影响全世界因腹泻导致的死亡。我们的新估计可用于倡导引入轮状病毒疫苗，并监测疫苗接种后对死亡率的影响。
Background WHO recommends routine use of rotavirus vaccines in all countries, particularly in those with high mortality attributable to diarrhoea! diseases. To establish the burden of life-threatening rotavims disease before the introduction of a rotavirus vaccine, we aimed to update the estimated number of deaths worldwide in children younger than 5 years due to diarrhoea attributable to rotavirus infection.Methods We used PubMed to identify studies of at least 100 children younger than 5 years who had been admitted to hospital with diarrhoea. Additionally, we required the studies to have a data collection midpoint of the year 2000 o later, to be done in full-year increments, and to assesses diarrhoea attributable to rotavirus with EIAs or polyacrylamide gel electrophoresis. We also included data from countries that participated in the WHO-coordinated Global Rotavirus Surveillance Network (consisting of participating member states during 2009) and that met study criteria. For countries that have introduced a rotavirus vaccine into their national immunisation programmes, we excluded data subsequent to the introduction. We classified studies into one of five groups on the basis of region and the level of child mortality in the country in which the study was done. For each group, to obtain estimates of rotavirus-associated mortality, we multiplied the random-effect mean rotavirus detection rate by the 2008 diarrhoea-related mortality figures for countries in that group. We derived the worldwide mortality estimate by summing our regional estimates.Findings Worldwide in 2008, diarrhoea attributable to rotavirus infection resulted in 453 000 deaths (95% C 420 000-494 000) in children younger than 5 years-37% of deaths attributable to diarrhoea and 5% of all deaths in children younger than 5 years. Five countries accounted for more than half of all deaths attributable to rotavirus infection: Democratic Republic of the Congo, Ethiopia, India, Nigeria, and Pakistan; India alone accounted for 22% of deaths (98 621 deaths).Interpretation Introduction of effective and available rotavirus vaccines could substantially affect worldwide death attributable to diarrhoea. Our new estimates can be used to advocate for rotavirus vaccine introduction and to monitor the effect of vaccination on mortality once introduced.