Effectiveness of a monovalent rotavirus vaccine in infants in Malawi after programmatic roll-out: an observational and case-control study.
Bottom Line: In the first half of 2012, incidence of rotavirus hospital admission was 269 per 100,000 infants compared with 284 in the same months of 2013 (rise of 5·8%, 95% CI -23·1 to 45·4; p=0·73) and 153 in these months in 2014 (a reduction from the prevaccine period of 43·2%, 18·0-60·7; p=0·003).The point estimate of effectiveness was higher against genotype G1 than against G2 and G12.Routine use of RV1 reduced hospital admissions for several genotypes of rotavirus in children younger than 5 years, especially in infants younger than 1 year.
Affiliation: Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.Show MeSH
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Mentions: Before vaccine introduction (Jan 1, 2012, to Oct 28, 2012), we collected 419 stool samples, of which 185 (44%) were positive for rotavirus (figure 1). After vaccine introduction (Oct 29, 2012, to June 30, 2014), we collected 998 stool samples, of which 318 (32%) were rotavirus positive (figure 1, appendix). Of 472 rotaviruses we examined from Jan 1, 2012, to June 30, 2014, prevalent genotypes included G2P (117; 25%), G1P (101; 21%), G12P (48; 10%), and G2P (47; 10%). 122 (26%) rotaviruses contained mixed G or P types or both (appendix). Genotype G1 was most common in the first year after the introduction of the vaccine, whereas genotype G2 dominated in the second year (figure 2).
Affiliation: Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.