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Review
. 2022 Oct 19;40(44):6422-6430.
doi: 10.1016/j.vaccine.2022.09.050. Epub 2022 Oct 1.

Impact of rotavirus vaccination on diarrheal hospitalizations in children younger than 5 years of age in a rural southern Mozambique

Filomena Manjate  1 , Llorenç Quintó  2 , Percina Chirinda  3 , Sozinho Acácio  4 , Marcelino Garrine  5 , Delfino Vubil  6 , Tacilta Nhampossa  7 , Eva D João  8 , Arsénio Nhacolo  9 , Anelsio Cossa  10 , Sérgio Massora  11 , Gizela Bambo  12 , Quique Bassat  13 , Karen Kotloff  14 , Myron Levine  15 , Pedro L Alonso  16 , Jacqueline E Tate  17 , Umesh Parashar  18 , Jason M Mwenda  19 , Inácio Mandomando  20
Affiliations
Review

Impact of rotavirus vaccination on diarrheal hospitalizations in children younger than 5 years of age in a rural southern Mozambique

Filomena Manjate et al. Vaccine. .

Abstract

Background: Rotavirus vaccine(Rotarix®) was introduced in Mozambique through its Expanded Program of Immunization in September 2015. We assessed the impact of rotavirus vaccination on childhood gastroenteritis-associated hospitalizations post-vaccine introduction in a high HIV prevalence rural setting of southern Mozambique.

Methods: We reviewed and compared the trend of hospitalizations (prevalence) and incidence rates of acute gastroenteritis (AGE), and rotavirus associated-diarrhea (laboratory confirmed rotavirus) in pre- (January 2008-August 2015) and post-rotavirus vaccine introduction periods (September 2015-December 2020), among children <5 years of age admitted to Manhiça District Hospital.

Results: From January 2008 to December 2020, rotavirus vaccination was found to contribute to the decline of the prevalence of AGE from 19% (95% CI: 18.14-20.44) prior to the vaccine introduction to 10% (95% CI: 8.89-11.48) in the post-introduction period, preventing 40% (95 % IE: 38-42) and 84% (95 % IE: 80-87) of the expected AGE and laboratory confirmed rotavirus cases, respectively, among infants. Similarly, the overall incidence of rotavirus was 11.8-fold lower in the post-vaccine introduction period (0.4/1000 child-years-at-risk [CYAR]; 95% CI: 0.3-0.6) compared with the pre-vaccination period (4.7/1000 CYAR; 95% CI: 4.2-5.1) with the highest reduction being observed among infants (16.8-fold lower from the 15.1/1000 CYAR in the pre-vaccine to 0.9/1000 CYAR in the post-vaccine eras).

Conclusions: We documented a significant reduction in all-cause diarrhea hospitalizations and rotavirus positivity after vaccine introduction demonstrating the beneficial impact of rotavirus vaccination in a highly vulnerable population.

Keywords: Diarrhea; Manhiça; Mozambique; Rotavirus; Vaccine impact.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Trends of prevalence and incidence rates among children<5 years of age from Manhiça District, Manhiça Mozambique January 01, 2008 – December 2020. (a) Trends over time of all hospital admissions (b) trend over time of the incidence rate of all hospital admission due to acute gastroenteritis (c) trend over time of hospital admissions due to acute gastroenteritis (d) trends over time of the incidence rate of hospital admission due to acute gastroenteritis (e) Trends over time of rotavirus confirmed cases (f) trend over time of incidence rates of laboratory confirmed rotavirus.
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