Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis.

Abstract

BACKGROUND:

Monovalent rotavirus vaccine, Rotarix (GlaxoSmithKline), was introduced in Kenya in July 2014 and is recommended to infants as oral doses at ages 6 and 10 weeks. A multisite study was established in 2 population-based surveillance sites to evaluate vaccine impact on the incidence of rotavirus-associated hospitalizations (RVHs).

METHODS:

Hospital-based surveillance was conducted from January 2010 to June 2017 for acute diarrhea hospitalizations among children aged <5 years in 2 health facilities in Kenya. A controlled interrupted time-series analysis was undertaken to compare RVH pre- and post-vaccine introduction using rotavirus-negative cases as a control series. The change in incidence post-vaccine introduction was estimated from a negative binomial model that adjusted for secular trend, seasonality, and multiple health worker industrial actions (strikes).

RESULTS:

Between January 2010 and June 2017 there were 1513 and 1652 diarrhea hospitalizations in Kilifi and Siaya; among those tested for rotavirus, 28% (315/1142) and 23% (197/877) were positive, respectively. There was a 57% (95% confidence interval [CI], 8-80%) reduction in RVHs observed in the first year post-vaccine introduction in Kilifi and a 59% (95% CI, 20-79%) reduction in Siaya. In the second year, RVHs decreased further at both sites, 80% (95% CI, 46-93%) reduction in Kilifi and 82% reduction in Siaya (95% CI. 61-92%); this reduction was sustained at both sites into the third year.

CONCLUSIONS:

A substantial reduction in RVHs and all-cause diarrhea was observed in 2 demographic surveillance sites in Kenya within 3 years of vaccine introduction.

• Authors: Grieven P Otieno, Christian Bottomley, Sammy Khagayi, Ifedayo Adetifa, Mwanajuma Ngama, Richard Omore, Billy Ogwel, Betty E Owor, Godfrey Bigogo, John B Ochieng, Clayton Onyango, Jane Juma, Jason Mwenda, Collins Tabu, Jacqueline E Tate, Yaw Addo, Tuck Britton, Umesh D Parashar, Robert F Breiman, Jennifer R Verani, D James Nokes
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 70 Issue 11 Pg. 2306-2313 (05 23 2020) ISSN: 1537-6591 [Electronic] United States
• PMID: 31544211 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
• Copyright: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Chemical References

• Rotavirus Vaccines

Topics

• Child
• Child, Preschool
• Diarrhea (epidemiology, prevention & control)
• Gastroenteritis
• Hospitalization
• Hospitals
• Humans
• Infant
• Kenya (epidemiology)
• Rotavirus
• Rotavirus Infections (epidemiology, prevention & control)
• Rotavirus Vaccines