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Incidence of rotavirus and circulating genotypes in Northeast Brazil during 7 years of national rotavirus vaccination.

Gurgel RQ, Alvarez Ade J, Rodrigues A, Ribeiro RR, Dolabella SS, Da Mota NL, Santos VS, Iturriza-Gomara M, Cunliffe NA, Cuevas LE - PLoS ONE (2014)

Bottom Line: Diarrhoea-hospitalizations decreased nationally from 89,934 (2003) to 53,705 (2012; 40.3% reduction) and in the state from 1729 to 748 (56.7% reduction).Diarrhoea-deaths decreased nationally from 4368 in 1999 to 697 in 2012 (84% reduction, p<0.001) and in the state from 132 to 18 (86% reduction).The vaccine was associated with substantial reductions in rotavirus incidence and diarrhoea-hospitalizations and deaths.

View Article: PubMed Central - PubMed

Affiliation: Federal University of Sergipe, Aracaju, Brazil.

ABSTRACT

Background and aims: Rotavirus causes severe diarrhoea and Brazil introduced the Rotarix G1P[8] vaccine in 2006. We aimed to describe changes in rotavirus incidence and diarrhoea epidemiology before and after vaccine introduction.

Design: (i) hospital-based survey of children with diarrhoea (2006-2012); (ii) diarrhea-mortality and hospitalization surveillance (1999-2012).

Setting: (i) Aracaju and (ii) state and national level.

Results: 1841 children were enrolled and 231 (12.5%) had rotavirus. Rotavirus was less frequent from January-June than from July-December (9.4% versus 20.9%, p<0.01), but the seasonal variation was less defined after 2009. Very few rotavirus cases (8-3.9%) were detected in 2011, with an increase in 2012 (13-18.5%). In 2006, unvaccinated children were more likely to have rotavirus, but thereafter unvaccinated and vaccinated children had equally low incidence. Older children and those with rotavirus were more likely to have severe diarrhea episodes. The most frequent genotype from 2006 to 2010 was G2P[4]; except in 2009, when most cases were G1P[8]. Very few G2P[4] were detected from 2011 and 50% cases in 2012 were G8P[4]. Diarrhoea-hospitalizations decreased nationally from 89,934 (2003) to 53,705 (2012; 40.3% reduction) and in the state from 1729 to 748 (56.7% reduction). Diarrhoea-deaths decreased nationally from 4368 in 1999 to 697 in 2012 (84% reduction, p<0.001) and in the state from 132 to 18 (86% reduction). These changes were much larger after vaccine introduction.

Conclusions: The vaccine was associated with substantial reductions in rotavirus incidence and diarrhoea-hospitalizations and deaths. The G2P[4] genotype predominance disappeared over time and may be replaced by other heterotypic genotypes.

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Related in: MedlinePlus

Number of children enrolled and proportion with rotavirus infection by month, November 2006 to April 2012.The arrow illustrates the date of vaccine introduction.
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pone-0110217-g001: Number of children enrolled and proportion with rotavirus infection by month, November 2006 to April 2012.The arrow illustrates the date of vaccine introduction.

Mentions: Two-hundred and thirty one (12.5%) children were rotavirus-ELISA positive. The proportion of children with positive ELISAs varied by month and was lower during the months of January to June and higher from July to December (86/914 [9.4%] versus 145/695 [20.9%], respectively, p<0.01). This seasonal variation became less well defined since 2009 and very few rotavirus cases were detected in 2011 (Figure 1). The 2011 nadir however was then followed by an increase in the number of cases in 2012, when a much higher percentage of children had rotavirus.


Incidence of rotavirus and circulating genotypes in Northeast Brazil during 7 years of national rotavirus vaccination.

Gurgel RQ, Alvarez Ade J, Rodrigues A, Ribeiro RR, Dolabella SS, Da Mota NL, Santos VS, Iturriza-Gomara M, Cunliffe NA, Cuevas LE - PLoS ONE (2014)

Number of children enrolled and proportion with rotavirus infection by month, November 2006 to April 2012.The arrow illustrates the date of vaccine introduction.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215980&req=5

pone-0110217-g001: Number of children enrolled and proportion with rotavirus infection by month, November 2006 to April 2012.The arrow illustrates the date of vaccine introduction.
Mentions: Two-hundred and thirty one (12.5%) children were rotavirus-ELISA positive. The proportion of children with positive ELISAs varied by month and was lower during the months of January to June and higher from July to December (86/914 [9.4%] versus 145/695 [20.9%], respectively, p<0.01). This seasonal variation became less well defined since 2009 and very few rotavirus cases were detected in 2011 (Figure 1). The 2011 nadir however was then followed by an increase in the number of cases in 2012, when a much higher percentage of children had rotavirus.

Bottom Line: Diarrhoea-hospitalizations decreased nationally from 89,934 (2003) to 53,705 (2012; 40.3% reduction) and in the state from 1729 to 748 (56.7% reduction).Diarrhoea-deaths decreased nationally from 4368 in 1999 to 697 in 2012 (84% reduction, p<0.001) and in the state from 132 to 18 (86% reduction).The vaccine was associated with substantial reductions in rotavirus incidence and diarrhoea-hospitalizations and deaths.

View Article: PubMed Central - PubMed

Affiliation: Federal University of Sergipe, Aracaju, Brazil.

ABSTRACT

Background and aims: Rotavirus causes severe diarrhoea and Brazil introduced the Rotarix G1P[8] vaccine in 2006. We aimed to describe changes in rotavirus incidence and diarrhoea epidemiology before and after vaccine introduction.

Design: (i) hospital-based survey of children with diarrhoea (2006-2012); (ii) diarrhea-mortality and hospitalization surveillance (1999-2012).

Setting: (i) Aracaju and (ii) state and national level.

Results: 1841 children were enrolled and 231 (12.5%) had rotavirus. Rotavirus was less frequent from January-June than from July-December (9.4% versus 20.9%, p<0.01), but the seasonal variation was less defined after 2009. Very few rotavirus cases (8-3.9%) were detected in 2011, with an increase in 2012 (13-18.5%). In 2006, unvaccinated children were more likely to have rotavirus, but thereafter unvaccinated and vaccinated children had equally low incidence. Older children and those with rotavirus were more likely to have severe diarrhea episodes. The most frequent genotype from 2006 to 2010 was G2P[4]; except in 2009, when most cases were G1P[8]. Very few G2P[4] were detected from 2011 and 50% cases in 2012 were G8P[4]. Diarrhoea-hospitalizations decreased nationally from 89,934 (2003) to 53,705 (2012; 40.3% reduction) and in the state from 1729 to 748 (56.7% reduction). Diarrhoea-deaths decreased nationally from 4368 in 1999 to 697 in 2012 (84% reduction, p<0.001) and in the state from 132 to 18 (86% reduction). These changes were much larger after vaccine introduction.

Conclusions: The vaccine was associated with substantial reductions in rotavirus incidence and diarrhoea-hospitalizations and deaths. The G2P[4] genotype predominance disappeared over time and may be replaced by other heterotypic genotypes.

Show MeSH
Related in: MedlinePlus