Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jul 31;33(32):3923-8.
doi: 10.1016/j.vaccine.2015.06.058. Epub 2015 Jun 23.

Effect of rotavirus vaccine on childhood diarrhea mortality in five Latin American countries

Angel Paternina-Caicedo  1 , Umesh D Parashar  2 , Nelson Alvis-Guzmán  3 , Lucia Helena De Oliveira  4 , Andres Castaño-Zuluaga  5 , Karol Cotes-Cantillo  6 , Oscar Gamboa-Garay  6 , Wilfrido Coronell-Rodríguez  7 , Fernando De la Hoz-Restrepo  6
Affiliations

Effect of rotavirus vaccine on childhood diarrhea mortality in five Latin American countries

Angel Paternina-Caicedo et al. Vaccine. .

Abstract

Background: The aim of this study was to estimate the association between rotavirus vaccine (RV) introduction and reduction of all-cause diarrhea death rates among children in five Latin American countries that introduced RV in 2006.

Methods: Diarrhea mortality data was gathered from 2002 until 2009 from the Pan American Health Organization Mortality Database for five "vaccine adopter" countries (Brazil, El Salvador, Mexico, Nicaragua, and Panama) that introduced RV in 2006 and four "control" countries (Argentina, Chile, Costa Rica, and Paraguay) that did not introduce RV by 2009. Time trend analyses were carried out, and effects and 95% confidence intervals (CI) were estimated.

Results: Each of the five vaccine adopter countries, except Panama, showed a significant trend in declining mortality rates during the post-vaccine period from 2006 to 2009, whereas no decline was seen in control countries during these years. Furthermore, trends of reduction of all-cause diarrhea mortality in both children <1 year of age and <5 years of age were greater in the post-vaccination period compared with the pre-vaccine period in all vaccine adopter countries (except for Nicaragua), whereas in control countries, a reverse pattern was seen with greater reduction in the early years from 2002 to 2005 versus 2006-2009. An estimatedtotal of 1777 of annual under-5 deaths were avoided in Brazil, El Salvador, Mexico, and Nicaragua during the post-vaccination period.

Conclusion: All vaccine adopter countries, except Panama, showed a significant decrease in all-cause diarrhea-related deaths after RV implementation, even after adjusting for declining trends over time in diarrhea mortality. These data strongly support continuous efforts to increase vaccination coverage of RV vaccines, particularly in countries with high levels of child mortality from diarrhea.

Keywords: Ecological; Effectiveness; Latin America and the Caribbean; Rotavirus vaccines.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement

Authors report no conflict of interests.

Figures

Fig. 1.
Fig. 1.
Linear time-trends of diarrhea-related deaths in children before and after RV vaccination in selected Latin American countries who introduced the vaccine by 2006.
Fig. 2.
Fig. 2.
Linear time-trends of diarrhea-related deaths in children before and after RV vaccination in “control” Latin American countries who did not introduced the vaccine by 2009.
See this image and copyright information in PMC

References

    1. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012;379(9832):2151–61. - PubMed
    1. Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, et al. Global burden of childhood pneumonia and diarrhoea. Lancet 2013;381(9875):1405–16. - PMC - PubMed
    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2095–128. - PMC - PubMed
    1. Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD. 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. Lancet Infect Dis 2012;12(2):136–41. - PubMed
    1. Vesikari T, Matson DO, Dennehy P, Van Damme P, Santosham M, Rodriguez Z, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med 2006;354(1):23–33. - PubMed

Publication types

Substances