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Temporal decline in diarrhea episodes and mortality in Kiribati children two years following rotavirus vaccine introduction, despite high malnutrition rates: a retrospective review.

Lai, Jana; Nguyen, Cattram; Tabwaia, Beia; Nikuata, Agnes; Baueri, Nikarawa; Timeon, Eretii; Diaaldeen, Mohammed; Iuta, Tinai; Ozturk, Murat Hakan; Moore, Aaron; Hall, Alice; Nyambat, Batmunkh; Davis, Stephanie; Rahman, Ataur; Erasmus, Wendy; Fox, Kimberley; Russell, Fiona.
BMC Infect Dis; 20(1): 207, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164562

BACKGROUND:

Kiribati introduced rotavirus vaccine in 2015. To estimate the impact of rotavirus vaccine on acute gastroenteritis (AGE) and severe acute malnutrition (SAM) among children under 5 in Kiribati, a retrospective review of inpatient and outpatient AGE and hospitalized SAM was undertaken.

METHODS:

Inpatient data for admissions and hospital deaths due to AGE, SAM and all-causes were collected for children under 5 from all hospitals on the main island, Tarawa, from January 2010-December 2013 (pre-rotavirus vaccine) and January 2016-September 2017 (post-rotavirus vaccine). National outpatient diarrhea data were collected from January 2010 to August 2017 for under 5. An interrupted time-series analysis was undertaken to estimate the effect of rotavirus vaccine on the rates of inpatient and outpatient AGE, inpatient SAM; and inpatient case fatality rates for AGE and SAM, were calculated pre- and post-rotavirus vaccine introduction.

RESULTS:

The incidence rate of AGE admissions from Tarawa and national AGE outpatient presentations significantly declined by 37 and 44%, respectively, 2 years following rotavirus vaccine introduction. There was a significant decline in the percentage of AGE contributing to all-cause under 5 admissions (12·8% vs. 7·2%, p < 0·001) and all-cause under-five mortality (15·9% vs. 5·7%, p = 0·006) pre- and post-rotavirus vaccine introduction. The estimated incidence rate of inpatient SAM decreased by 24% in under 5 s, 2 years following rotavirus vaccine introduction.

CONCLUSIONS:

AGE morbidity and mortality and hospitalized SAM rates have declined following rotavirus vaccine introduction in Kiribati children.
Selo DaSilva