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. 2017 Oct;36(10):995-999.
doi: 10.1097/INF.0000000000001648.

Reduction in Diarrhea- and Rotavirus-related Healthcare Visits Among Children <5 Years of Age After National Rotavirus Vaccine Introduction in Zimbabwe

Hilda A Mujuru  1 , Catherine Yen, Kusum J Nathoo, Nhamo A Gonah, Ismail Ticklay, Arnold Mukaratirwa, Chipo Berejena, Ottias Tapfumanei, Kenneth Chindedza, Maxwell Rupfutse, Goitom Weldegebriel, Jason M Mwenda, Eleanor Burnett, Jacqueline E Tate, Umesh D Parashar, Portia Manangazira
Affiliations

Reduction in Diarrhea- and Rotavirus-related Healthcare Visits Among Children <5 Years of Age After National Rotavirus Vaccine Introduction in Zimbabwe

Hilda A Mujuru et al. Pediatr Infect Dis J. 2017 Oct.

Abstract

Background: In Zimbabwe, rotavirus accounted for 41%-56% of acute diarrhea hospitalizations before rotavirus vaccine introduction in 2014. We evaluated rotavirus vaccination impact on acute diarrhea- and rotavirus-related healthcare visits in children.

Methods: We examined monthly and annual acute diarrhea and rotavirus test-positive hospitalizations and Accident and Emergency Department visits among children <60 months of age at 3 active surveillance hospitals during 2012-2016; we compared prevaccine introduction (2012-2013) with postvaccine introduction (2015 and 2016) data for 2 of the hospitals. We examined monthly acute diarrhea hospitalizations by year and age group for 2013-2016 from surveillance hospital registers and monthly acute diarrhea outpatient visits reported to the Ministry of Health and Child Care during 2012-2016.

Results: Active surveillance data showed winter seasonal peaks in diarrhea- and rotavirus-related visits among children <60 months of age during 2012-2014 that were substantially blunted in 2015 and 2016 after vaccine introduction; the percentage of rotavirus test-positive visits followed a similar seasonal pattern and decrease. Hospital register data showed similar pre-introduction seasonal variation and post-introduction declines in diarrhea hospitalizations among children 0-11 and 12-23 months of age. Monthly variation in outpatient diarrhea-related visits mirrored active surveillance data patterns. At 2 surveillance hospitals, the percentage of rotavirus-positive visits declined by 40% and 43% among children 0-11 months of age and by 21% and 33% among children 12-23 months of age in 2015 and 2016, respectively.

Conclusion: Initial reductions in diarrheal illness among children <60 months of age, particularly among those 0-11 months of age, after vaccine introduction are encouraging. These early results provide evidence to support continued rotavirus vaccination and rotavirus surveillance in Zimbabwe.

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Conflict of interest statement

Disclosures: The authors have no conflicts of interest or funding to disclose.

Conflicts of interest: The authors indicate that they do not have a commercial or other association that might pose a conflict of interest.

Figures

Figure 1
Figure 1
Acute diarrhea hospitalizations and accident & emergency (A&E) visits among children <60 months of age enrolled in active surveillance, by rotavirus test result — 3 sentinel surveillance hospitals, Zimbabwe, 1 January 2012—31 December 2016
Figure 2
Figure 2
Annual acute diarrhea hospitalizations and A&E visits among children <60 months of age enrolled in active surveillance, by age group and rotavirus test result and proportion rotavirus test positive — Chitungwiza and Harare Central Hospitals, Zimbabwe, 1 January 2012—31 December 2016
See this image and copyright information in PMC

References

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