Hospital-based Surveillance to Evaluate the Impact of Rotavirus Vaccination in São Paulo, Brazil
- 1 November 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Pediatric Infectious Disease Journal
- Vol. 29 (11), 1019-1022
- https://doi.org/10.1097/inf.0b013e3181e7886a
Abstract
Background: Brazil implemented routine immunization with the human rotavirus vaccine, Rotarix, in 2006 and vaccination coverage reached 81% in 2008 in São Paulo. Our aim was to assess the impact of immunization on the incidence of severe rotavirus acute gastroenteritis (AGE). Methods: We performed a 5-year (2004–2008) prospective surveillance at a sentinel hospital in São Paulo, with routine testing for rotavirus in all children less than 5 years of age hospitalized with AGE. Genotypes of positive samples were determined by reverse transcription polymerase chain reaction. Results: During the study, 655 children hospitalized with AGE were enrolled; of whom 169 (25.8%) were positive for rotavirus. In the postvaccine period, a 59% reduction in the number of hospitalizations of rotavirus AGE and a 42.2% (95% confidence interval [CI], 18.6%–59.0%; P = 0.001) reduction in the proportion of rotavirus-positive results among children younger than 5 years were observed, with the greatest decline among infants (69.2%; 95% CI, 24.7%–87.4%; P = 0.004). Furthermore, the number of all-cause hospitalizations for AGE was reduced by 29% among children aged <5 years. The onset and peak incidences of rotavirus AGE occurred 3 months later in the 2007 and 2008 seasons compared with previous years. Genotype G2 accounted for 15%, 70%, and 100% of all cases identified, respectively, in 2006, 2007, and 2008. Conclusions: After vaccine implementation, a marked decline in rotavirus AGE hospitalizations was demonstrated among children younger than 5 years of age, with the greatest reduction in the age groups targeted for vaccination. The predominance of genotype G2P[4] highlights the need of continued postlicensure surveillance studies.Keywords
This publication has 17 references indexed in Scilit:
- Rotavirus Gastroenteritis in Children in 4 Regions in Brazil: A Hospital‐Based Surveillance StudyThe Journal of Infectious Diseases, 2009
- Decline and Change in Seasonality of US Rotavirus Activity After the Introduction of Rotavirus VaccinePublished by American Academy of Pediatrics (AAP) ,2009
- Rotavirus morbidity and mortality in children in Brazil.Revista Panamericana de Salud Pública, 2008
- Routine Laboratory Testing Data for Surveillance of Rotavirus Hospitalizations to Evaluate the Impact of VaccinationThe Pediatric Infectious Disease Journal, 2007
- Rotavirus and Severe Childhood DiarrheaEmerging Infectious Diseases, 2006
- Safety and Efficacy of an Attenuated Vaccine against Severe Rotavirus GastroenteritisNew England Journal of Medicine, 2006
- Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccineReviews in Medical Virology, 2004
- Global Illness and Deaths Caused by Rotavirus Disease in ChildrenEmerging Infectious Diseases, 2003
- Rotavirus-associated medical visits and hospitalizations in South America: a prospective study at three large sentinel hospitalsThe Pediatric Infectious Disease Journal, 2001
- Rotavirus Strain Diversity in Blantyre, Malawi, from 1997 to 1999Journal of Clinical Microbiology, 2001