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. 2016 May 1;62 Suppl 2(Suppl 2):S175-82.
doi: 10.1093/cid/civ1206.

A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia

Laura K Beres  1 , Jacqueline E Tate  2 , Lungowe Njobvu  3 , Bertha Chibwe  3 , Cheryl Rudd  3 , M Brad Guffey  3 , Jeffrey S A Stringer  4 , Umesh D Parashar  2 , Roma Chilengi  3
Affiliations

A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia

Laura K Beres et al. Clin Infect Dis. .

Abstract

Background: Diarrhea is the third leading cause of child death in Zambia. Up to one-third of diarrhea cases resulting in hospitalization and/or death are caused by vaccine-preventable rotavirus. In January 2012, Zambia initiated a pilot introduction of the Rotarix live, oral rotavirus vaccine in all public health facilities in Lusaka Province.

Methods: Between July 2012 and October 2013, we conducted a case-control study at 6 public sector sites to estimate rotavirus vaccine effectiveness (VE) in age-eligible children presenting with diarrhea. We computed the odds of having received at least 1 dose of Rotarix among children whose stool was positive for rotavirus antigen (cases) and children whose stool was negative (controls). We adjusted the resulting odds ratio (OR) for patient age, calendar month of presentation, and clinical site, and expressed VE as (1 - adjusted OR) × 100.

Results: A total of 91 rotavirus-positive cases and 298 rotavirus-negative controls who had under-5 card-confirmed vaccination status and were ≥6 months of age were included in the case-control analysis. Among rotavirus-positive children who were age-eligible to be vaccinated, 20% were hospitalized. Against rotavirus diarrhea of all severity, the adjusted 2-dose VE was 26% (95% confidence interval [CI], -30% to 58%) among children ≥6 months of age. VE against hospitalized children ≥6 months of age was 56% (95% CI, -34% to 86%).

Conclusions: We observed a higher point estimate for VE against increased severity of illness compared with milder disease, but were not powered to detect a low level of VE against milder disease.

Keywords: Zambia; immunization; rotavirus; rotavirus vaccine; vaccine effectiveness.

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Conflict of interest statement

Conflict of Interest Information for All Authors:

The authors declare no conflicts of interest in the work published here.

Figures

Figure 1.
Figure 1.
Rotavirus Detection among Children <5 Years of Age, July 2012 – October 2013 formula image Rotavirus Positive formula image Rotavirus Negative formula image % Rotavirus Positive
Figure 2.
Figure 2.
Inclusion Flow Chart
Figure 3.
Figure 3.
Age at Rotavirus and Pentavalent Vaccination among Children Age Eligible to Receive Rotavirus Vaccine formula image Rota Dose 1 formula imageRota Dose 2 formula image Penta Dose 1 formula image Penta Dose 2
See this image and copyright information in PMC

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