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. 2016 May 1;62 Suppl 2(Suppl 2):S200-7.
doi: 10.1093/cid/ciw014.

Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana

George Armah  1 , Kimberly Pringle  2 , Christabel C Enweronu-Laryea  3 , Daniel Ansong  4 , Jason M Mwenda  5 , Stanley K Diamenu  6 , Clement Narh  7 , Belinda Lartey  1 , Fred Binka  8 , Scott Grytdal  2 , Manish Patel  2 , Umesh Parashar  2 , Ben Lopman  2
Affiliations

Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana

George Armah et al. Clin Infect Dis. .

Abstract

Background: Ghana was among the first African nations to introduce monovalent rotavirus vaccine (RV1) into its childhood immunization schedule in April 2012. We aimed to assess the impact of vaccine introduction on rotavirus and acute gastroenteritis (AGE) hospitalizations and to estimate vaccine effectiveness (VE).

Methods: Using data from 2 teaching hospitals, monthly AGE and rotavirus admissions by age were examined 40 months before and 31 months after RV1 introduction using interrupted time-series analyses. From January 2013, we enrolled children <2 years of age who were eligible for RV1 from a total of 7 sentinel sites across the country. To estimate VE, we fit unconditional logistic regression models to calculate odds ratios of vaccination by rotavirus case-patient status, controlling for potential confounders.

Results: Vaccine coverage ranged from 95% to 100% for dose 1 and 93% to 100% for dose 2. In the first 3 years after vaccine introduction, the percentage of hospital admissions positive for rotavirus fell from 48% in the prevaccine period to 28% (49% adjusted rate reduction; 95% confidence interval [CI], 32%-63%) postvaccination among <5-year-olds. With high vaccine coverage, it was not possible to arrive at robust VE estimates; any-dose VE against rotavirus hospitalization was estimated at 60% (95% CI, -2% to 84%;P= .056).

Conclusions: Results from the first 3 years following RV1 introduction suggest substantial reductions of pediatric diarrheal disease as a result of vaccination. Our VE estimate is consistent with the observed rotavirus decrease and with efficacy estimates from elsewhere in sub-Saharan Africa.

Keywords: Ghana; case-control; rotavirus; surveillance; vaccine effectiveness.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Age in weeks of receipt of dose 1 (A) and dose 2 (B) of monovalent rotavirus vaccine, and 1-dose and 2-dose vaccine coverage by quarter of birth (C).
Figure 2.
Figure 2.
A, Rotavirus (RV)–positive and RV-negative hospital admissions among children <5 years of age. B, RV-positive hospital admissions by age. Ghana, January 2010–December 2014. Vaccine was introduced nationally in April 2012 (dashed lines).
Figure 3.
Figure 3.
Enrollment and exclusion flowchart for case-control study. Abbreviations: +ve, positive; −ve, negative.
Figure 4.
Figure 4.
Regional distribution (A) and vaccine coverage (B) among cases and controls.
See this image and copyright information in PMC

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References

    1. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385:117–71. - PMC - PubMed
    1. World Health Organization. Immunization, vaccines and biologicals. Geneva, Switzerland: WHO, 2010.
    1. Armah GE, Sow SO, Breiman RF, et al. Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in sub-Saharan Africa: a randomised, double-blind, placebo-controlled trial. Lancet 2010; 376:606–14. - PubMed
    1. Steele AD, Neuzil KM, Cunliffe NA, et al. Human rotavirus vaccine Rotarix provides protection against diverse circulating rotavirus strains in African infants: a randomized controlled trial. BMC Infect Dis 2012; 12:213. - PMC - PubMed
    1. Cortese MM, Immergluck LC, Held M, et al. Effectiveness of monovalent and pentavalent rotavirus vaccine. Pediatrics 2013; 132:e25–33. - PMC - PubMed

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