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

Filomena Manjate, Llorenç Quintó, Percina Chirinda, Sozinho Acácio, Marcelino Garrine, Delfino Vubil, Tacilta Nhampossa, Eva D. João, Arsénio Nhacolo, Anelsio Cossa, Sérgio Massora, Gizela Bambo, Quique Bassat, Karen Kotloff, Myron Levine, Pedro L. Alonso, Jacqueline E. Tate, Umesh Parashar, Jason M. Mwenda, Inácio Mandomando

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
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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.

Original languageEnglish
Pages (from-to)6422-6430
Number of pages9
JournalVaccine
Volume40
Issue number44
DOIs
Publication statusPublished - 19 Oct 2022

Keywords

  • Diarrhea
  • Manhiça
  • Mozambique
  • Rotavirus
  • Vaccine impact

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