Limits...
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.

Show MeSH

Related in: MedlinePlus

Proportion of (a) non-vaccinated and (b) vaccinated children attending the hospital with rotavirus, by age and year.Percentages for 2012 are incomplete (to March, represented by a dotted line). Arrows illustrate the vaccine introduction.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4215980&req=5

pone-0110217-g002: Proportion of (a) non-vaccinated and (b) vaccinated children attending the hospital with rotavirus, by age and year.Percentages for 2012 are incomplete (to March, represented by a dotted line). Arrows illustrate the vaccine introduction.

Mentions: The proportion of children with rotavirus by age and vaccination status is shown in figure 2. In 2006, unvaccinated children <24 months were more likely to have rotavirus than unvaccinated children ≥24 months old. Vaccinated children were also less likely to have rotavirus than unvaccinated children. This pattern changed after 2006, as a low percentage of both vaccinated and unvaccinated children had rotavirus. The change was observed in all age groups. The proportion of children with severe episodes increased with age in both children with and without rotavirus (p<0.001 for both) and children with rotavirus had more severe episodes than children without rotavirus, as shown in Figure 3. Generally, vaccinated children had less severe episodes than unvaccinated children, but this difference was only statistically significant in children <6 months.


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)

Proportion of (a) non-vaccinated and (b) vaccinated children attending the hospital with rotavirus, by age and year.Percentages for 2012 are incomplete (to March, represented by a dotted line). Arrows illustrate the vaccine introduction.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0110217-g002: Proportion of (a) non-vaccinated and (b) vaccinated children attending the hospital with rotavirus, by age and year.Percentages for 2012 are incomplete (to March, represented by a dotted line). Arrows illustrate the vaccine introduction.
Mentions: The proportion of children with rotavirus by age and vaccination status is shown in figure 2. In 2006, unvaccinated children <24 months were more likely to have rotavirus than unvaccinated children ≥24 months old. Vaccinated children were also less likely to have rotavirus than unvaccinated children. This pattern changed after 2006, as a low percentage of both vaccinated and unvaccinated children had rotavirus. The change was observed in all age groups. The proportion of children with severe episodes increased with age in both children with and without rotavirus (p<0.001 for both) and children with rotavirus had more severe episodes than children without rotavirus, as shown in Figure 3. Generally, vaccinated children had less severe episodes than unvaccinated children, but this difference was only statistically significant in children <6 months.

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