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Balachandran N, Mattison CP, Calderwood LE, Burke RM, Schmidt MA, Donald J, Mirza SA. Household Transmission of Viral Acute Gastroenteritis Among Participants Within an Integrated Health Care Delivery System, 2014-2016. Open Forum Infect Dis 2023; 10:ofad619. [PMID: 38156052 PMCID: PMC10753916 DOI: 10.1093/ofid/ofad619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/06/2023] [Indexed: 12/30/2023] Open
Abstract
Background While enteric viruses are highly transmissible, household factors associated with transmission are less well documented. We identified individual- and household-level factors associated with viral acute gastroenteritis (AGE) transmission in a large health care network in the United States. Methods Patients presenting with AGE were enrolled from April 2014 to September 2016. Patients and symptomatic household members were interviewed, and stool specimens were collected and tested for viral pathogens. Within a household, primary cases were those with the earliest symptom onset and a positive viral test result; secondary cases were household contacts (HHCs) with symptom onset 1-7 days from the primary case onset. Transmission households had at least 1 secondary case. Results Our analysis included 570 primary cases with 1479 HHCs. The overall secondary attack rate was 23%. HHCs were likely to become secondary cases (n = 338) if they were <5 years old (adjusted odds ratio [aOR], 1.8; 95% CI, 1.2-2.6). Secondary transmission was likely to occur if the primary case was aged <5 years (aOR, 2.2; 95% CI, 1.4-3.6) or 5 to 17 years (aOR, 3.3; 95% CI, 1.9-5.7), was norovirus positive (aOR, 2.7; 95% CI, 1.9-3.7), had a diapered contact (aOR: 2.2, 95% CI: 1.6-3.2), or reported symptoms for >4 days (aOR, 1.5; 95% CI, 1.1-2.1). Households with ≥3 members (aOR, 2.1; 95% CI, 1.1-4.5) were more likely to experience transmission. Discussion Risk of AGE transmission within households increased if the primary case was younger, was norovirus positive, had a longer symptom duration, or had a diapered contact. Targeted prevention messaging around appropriate cleaning, disinfection, and isolation of persons with AGE should be encouraged.
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Affiliation(s)
- Neha Balachandran
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Cherokee Nation Assurance, Arlington, Virginia, USA
| | - Claire P Mattison
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Cherokee Nation Assurance, Arlington, Virginia, USA
| | - Laura E Calderwood
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Cherokee Nation Assurance, Arlington, Virginia, USA
| | - Rachel M Burke
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark A Schmidt
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Judy Donald
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Sara A Mirza
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Jesudason T, Rodarte A, Tordrup D, Carias C, Chen YH. Systematic review of rotavirus vaccination cost-effectiveness in high income settings utilising dynamic transmission modelling techniques. Vaccine 2023; 41:5221-5232. [PMID: 37479614 DOI: 10.1016/j.vaccine.2023.06.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE This systematic review presents cost-effectiveness studies of rotavirus vaccination in high-income settings based on dynamic transmission modelling to inform policy decisions about implementing rotavirus vaccination programmes. METHODS We searched CEA Registry, MEDLINE, Embase, Health Technology Assessment Database, Scopus, and the National Health Service Economic Evaluation Database for studies published since 2002. Full economic evaluation studies based on dynamic transmission models, focusing on high-income countries, live oral rotavirus vaccine and children ≤ 5 years of age were eligible for inclusion. Included studies were appraised for quality and risk of bias using the Consensus on Health Economic Criteria (CHEC) list and the Philips checklist. The review protocol was prospectively registered with PROSPERO (CRD42020208406). RESULTS A total of four economic evaluations were identified. Study settings included England and Wales, France, Norway, and the United States. All studies compared either pentavalent or monovalent rotavirus vaccines to no intervention. All studies were cost-utility analyses that reported incremental cost per quality-adjusted life year (QALY) gained. Included studies consistently concluded that rotavirus vaccination is cost-effective compared with no vaccination relative to the respective country's willingness to pay threshold when herd protection benefits are incorporated in the modelling framework. CONCLUSIONS Rotavirus vaccination was found to be cost-effective in all identified studies that used dynamic transmission models in high-income settings where child mortality rates due to rotavirus gastroenteritis are close to zero. Previous systematic reviews of economic evaluations considered mostly static models and had less conclusive findings than the current study. This review suggests that modelling choices influence cost-effectiveness results for rotavirus vaccination. Specifically, the review suggests that dynamic transmission models are more likely to account for the full impact of rotavirus vaccination than static models in cost-effectiveness analyses.
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Affiliation(s)
| | | | | | | | - Yao-Hsuan Chen
- Health Economic and Decision Sciences, MSD (UK) Limited, London, United Kingdom.
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3
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Sifuna P, Shaw AV, Lucas T, Ogutu B, Otieno W, Larsen DA. Deployment of Rotavirus Vaccine in Western Kenya Coincides with a Reduction in All-Cause Child Mortality: A Retrospective Cohort Study. Vaccines (Basel) 2023; 11:1299. [PMID: 37631867 PMCID: PMC10458991 DOI: 10.3390/vaccines11081299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
Rotavirus is an important cause of fatal pediatric diarrhea worldwide. Many national immunization programs began adding rotavirus vaccine following a 2009 World Health Organization recommendation. Kenya added rotavirus vaccine to their immunization program at the end of 2014. From a cohort of 38,463 children in the Kisumu health and demographic surveillance site in western Kenya, we assessed how the implementation of the rotavirus vaccine affected mortality in children under 3 years of age. Following its introduction in late 2014, the span of rotavirus vaccine coverage for children increased to 75% by 2017. Receiving the rotavirus vaccine was associated with a 44% reduction in all-cause child mortality (95% confidence interval = 28-68%, p < 0.0001), but not diarrhea-specific mortality (p = 0.401). All-cause child mortality declined 2% per month following the implementation of the rotavirus vaccine (p = 0.002) among both vaccinated and unvaccinated children, but diarrhea-specific mortality was not associated with the implementation of the rotavirus vaccine independent of individual vaccine status (p = 0.125). The incidence of acute diarrhea decreased over the study period, and the introduction of the rotavirus vaccine was not associated with population-wide trends (p = 0.452). The receipt of the rotavirus vaccine was associated with a 34% reduction in the incidence of diarrhea (95% confidence interval = 24-43% reduction). These results suggest that rotavirus vaccine may have had an impact on all-cause child mortality. The analyses of diarrhea-specific mortality were limited by relatively few deaths (n = 57), as others have found a strong reduction in diarrhea-specific mortality. Selection bias may have played a part in these results-children receiving rotavirus vaccine were more likely to be fully immunized than children not receiving the rotavirus vaccine.
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Affiliation(s)
- Peter Sifuna
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - Andrea V. Shaw
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY 13210, USA;
| | - Tina Lucas
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - Bernards Ogutu
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - Walter Otieno
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - David A. Larsen
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
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4
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Carias C, Hu T, Chen YT. Burden of rotavirus gastroenteritis on caregivers: Findings from a systematic literature review. Hum Vaccin Immunother 2022; 18:2047545. [PMID: 35377826 PMCID: PMC9196848 DOI: 10.1080/21645515.2022.2047545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rotavirus gastroenteritis (RVGE) poses a substantial clinical, economic, and humanistic burden globally. While predominantly affecting children, the burden of RVGE extends to caregivers and families but is often overlooked. In this systematic literature review, we aim to identify and summarize methods and estimates of RVGE associated caregiver burden. Of the 190 publications identified, 10 were included. Four studies used the EuroQoL-5 Dimension instrument and its associated Visual Analog Scale and reported a decrease in caregiver health related quality of life when a child contracted RVGE, with the greatest reduction observed in caregivers of hospitalized children. Other studies utilized surveys to assess impacts on caregivers’ quality of life. Caregivers of RVGE patients experienced multiple impacts beyond financial costs related to productivity and absenteeism, with disruptions to daily routines and anxiety/stress frequently reported. This review highlights the importance of including RVGE caregiver burden when evaluating interventions, such as vaccination, to decrease RVGE burden.
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Affiliation(s)
- Cristina Carias
- Center for Observational and Real-world Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Tianyan Hu
- Center for Observational and Real-world Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Ya-Ting Chen
- Center for Observational and Real-world Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
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5
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Hemming-Harlo M, Gylling A, Herse F, Haavisto I, Nuutinen M, Pasternack M, Kanibir MN, Hartwig S, Carias C. Long-term surveillance of rotavirus vaccination after implementation of a national immunization program in Finland (2008-2018). Vaccine 2022; 40:3942-3947. [PMID: 35641360 DOI: 10.1016/j.vaccine.2022.04.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/27/2022] [Accepted: 04/30/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rotavirus (RV) vaccination was included in the Finnish National immunization Program (NIP) in 2009. RotaTeq (RV5) has been used exclusively with a national average vaccination coverage rate (VCR) of > 90%. While previous studies have demonstrated that inpatient rotavirus gastroenteritis (RVGE) admissions declined by as much as 96% in Finnish children ≤ 5 years old following RV vaccination introduction, no study has evaluated long-term protection after vaccination in Finland. In this study, we analyze incidence of hospital outpatient visits and inpatient admissions of gastroenteritis in children up to 7 years of age. METHODS We first describe the incidence of RVGE, viral gastroenteritis (VGE), and acute gastroenteritis (AGE) for all Finnish children born during 2008-2011. Children were stratified by the year of birth into not-eligible, partially eligible and rotavirus vaccine-eligible (born in 2008, 2009, 2010 and 2011, respectively). Hospital inpatient and outpatient data was collected from the National Care Register for all children from birth until December 31st, 2018. We also studied RVGE incidence during 2014-2017 for children<3 years of age in municipalities with VCRs of 90% and above and municipalities with VCRs below 90%. RESULTS RVGE incidence decreased significantly soon after implementation of RV vaccination in the NIP. In vaccine-eligible cohorts, no clear peak incidence in the youngest age groups could be observed, and no RVGE cases were observed beyond 6 years after vaccination, in contrast to vaccine ineligible and partially eligible cohorts. Despite an overall high VCR in Finland, regions with high VCR had lower incidence of RVGE than regions with lower VCR. CONCLUSION Incidence of RVGE has remained low in all age groups during the 10 years following introduction of RV vaccine in the Finnish NIP. Differences in RVGE incidence were observed in regions with high as compared with lower VCR, highlighting the importance of maintaining high vaccination coverage.
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Affiliation(s)
- Maria Hemming-Harlo
- Centre for Child Health Research, Tampere University and University Hospital, Elämänaukio 2, 33520 Tampere, Finland; University of Helsinki and Helsinki University Hospital, Children's Hospital and Pediatric Research Center, Stenbäckinkatu 9, 00290 Helsinki, Finland.
| | | | - Fredrik Herse
- NHG Finland, Vattuniemenranta 2, 00210 Helsinki, Finland.
| | - Ira Haavisto
- NHG Finland, Vattuniemenranta 2, 00210 Helsinki, Finland.
| | - Mikko Nuutinen
- NHG Finland, Vattuniemenranta 2, 00210 Helsinki, Finland.
| | | | - M Nabi Kanibir
- MSD International Business GmbH, Tribschenstrasse 60, CH-6005 Lucerne, Switzerland.
| | | | - Cristina Carias
- Merck & Co., Inc., 90 E Scott Ave, Rahway, NJ 07065, United States.
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6
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Miller AC, Arakkal AT, Sewell DK, Segre AM, Pemmaraju SV, Polgreen PM. Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members. Emerg Infect Dis 2022; 28:932-939. [PMID: 35447064 PMCID: PMC9045444 DOI: 10.3201/eid2805.212023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We evaluated whether hospitalized patients without diagnosed Clostridioides difficile infection (CDI) increased the risk for CDI among their family members after discharge. We used 2001–2017 US insurance claims data to compare monthly CDI incidence between persons in households with and without a family member hospitalized in the previous 60 days. CDI incidence among insurance enrollees exposed to a recently hospitalized family member was 73% greater than enrollees not exposed, and incidence increased with length of hospitalization among family members. We identified a dose-response relationship between total days of within-household hospitalization and CDI incidence rate ratio. Compared with persons whose family members were hospitalized <1 day, the incidence rate ratio increased from 1.30 (95% CI 1.19–1.41) for 1–3 days of hospitalization to 2.45 (95% CI 1.66–3.60) for >30 days of hospitalization. Asymptomatic C. difficile carriers discharged from hospitals could be a major source of community-associated CDI cases.
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7
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Burke RM, Groom HC, Naleway AL, Katz EM, Salas B, Mattison CP, Donald J, Tsaknaridis L, Biggs C, Bowen MD, Tate JE, Parashar UD, Schmidt M, Hall AJ. Rotavirus Vaccine Is Effective Against Rotavirus Gastroenteritis Resulting in Outpatient Care: Results From the Medically Attended Acute Gastroenteritis (MAAGE) Study. Clin Infect Dis 2021; 72:2000-2005. [PMID: 32322882 DOI: 10.1093/cid/ciaa466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/20/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Rotavirus is a common cause of severe pediatric acute gastroenteritis. Two vaccines are licensed in the United States and have demonstrated high effectiveness against moderate to severe disease. However, fewer data are available on rotavirus vaccine effectiveness (VE) against milder disease. METHODS We leveraged active surveillance data from Kaiser Permanente Northwest to calculate rotavirus VE against medically attended rotavirus illness among age-eligible children. We utilized a test-negative case-control design and applied 4 distinct case definitions based on reverse transcription-quantitative real-time PCR (qRT-PCR) assay and enzyme immunoassay (EIA) test results. VE was calculated as 100 × (1 - odds ratio), and models were adjusted for age group. RESULTS The VE analysis population comprised 842 children, 799 (95%) of whom had mild disease requiring at most a clinic visit and 698 (83%) of whom were fully vaccinated against rotavirus. Age-adjusted VE was 70% (95% confidence interval [CI], 37-86%) against disease defined solely by qRT-PCR results, 72% (95% CI, 31-89%) against disease as defined by qRT-PCR with a quantification cycle (C q ) value <27, 73% (95% CI, 32-90%) against disease that was qRT-PCR positive but EIA negative, and 62% (95% CI, -20-88%) against disease defined solely by EIA. Results were similar when restricting to disease resulting in at most an ambulatory clinic or emergency department visit. CONCLUSIONS These results support the effectiveness of rotavirus vaccination in protecting US children from mild to moderate and severe disease. Our findings are also useful to show the effectiveness of rotavirus vaccination against qRT-PCR-defined illness.
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Affiliation(s)
- Rachel M Burke
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Holly C Groom
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Allison L Naleway
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Eric M Katz
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Cherokee Nation Assurance, Contracting Agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Arlington, Virginia, USA
| | - Bianca Salas
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Claire P Mattison
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Judy Donald
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | | | | | - Michael D Bowen
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jacqueline E Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Umesh D Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark Schmidt
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Aron J Hall
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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8
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Carias C, Starnino S, Das R, Petigara T, Kanibir MN. Letter to the editor in response to: Rotavirus vaccine administration patterns in Italy: potential impact on vaccine coverage, compliance and adherence. Hum Vaccin Immunother 2021; 17:3638-3640. [PMID: 34170202 PMCID: PMC8437518 DOI: 10.1080/21645515.2021.1929791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Cristina Carias
- Merck Research Laboratories, Merck & Co., Inc, Kenilworth, NJ, USA
| | | | - Rituparna Das
- Merck Research Laboratories, Merck & Co., Inc, Kenilworth, NJ, USA
| | - Tanaz Petigara
- Merck Research Laboratories, Merck & Co., Inc, Kenilworth, NJ, USA
| | - M Nabi Kanibir
- Global Medical and Scientific Affairs, MSD International GmbH, Luzern, Switzerland
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9
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Qiu CY, Guo ZX, Zhang GH, Feng YH, Deng YY, Chen XJ, Wu XD, Huang SW. Study on the effectiveness and safety of Xingpi Yanger granule combined with Saccharomyces boulardii for rotavirus enteritis in children: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25593. [PMID: 33879721 PMCID: PMC8078475 DOI: 10.1097/md.0000000000025593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND To systematically evaluate the effectiveness and safety of traditional Chinese medicine preparation XPYEG combined with SBI and SBI alone in the treatment of REC, and to provide the reference in drugs for the clinical treatment of children with rotavirus enteritis. METHODS Retrieving the English databases: PubMed, Cochrane Library and Embase; Chinese databases: CNKI, CBM and WANFANG Data. Retrieving a randomized controlled trial of XPYEG and SBI in the treatment of REC. The retrieval time is from the above database until September 2020. The retrieval strategy of combining free words and subject words is adopted, and the references included in the literature are searched manually in accordance with the literature studied in this paper and not included in the above database. Two researchers screen the literature according to the literature inclusion and exclusion criteria, extract valid data and evaluate the quality of the literature, and cross-check it. Using the RevMan 5.3 software to conduct the meta-analysis on the main outcome and secondary outcome indicators of the included literature, while assessing the evidence quality of included study. RESULTS The effectiveness and safety of XPYEG and SBI in the treatment of REC are presented through the main and secondary outcome indicators. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/3QSZG. CONCLUSION This study will conclude whether the combination of XPYEG and SBI is more effective than SBI alone in the treatment of REC, and whether the medication increases the risk of adverse reactions compared with single medication. ETHICS AND DISSEMINATION This study does not involve the specific patients, and all research data comes from publicly available professional literature, so an ethics committee is not required to conduct an ethical review and approval of the study.
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Affiliation(s)
- Cheng-Ying Qiu
- Department of Pediatrics, Sanya People 's Hospital, No. 558 Jiefang Road, Tianya District, Sanya City
| | - Zao-Xia Guo
- Department of Internal Medicine of Traditional Chinese Medicine, Danzhou Hospital of Traditional Chinese Medicine, No. 30–20 Zhongxing Avenue, Danzhou City
| | - Gui-Hua Zhang
- Department of Neonatology, Haikou Hospital of the Matemal and Child Health, NO.6 Wentan Road, Guoxing Avenue, Qiongshan District, Haikou City
| | - Yong-Hong Feng
- Department of Neonatology, Haikou Hospital of the Matemal and Child Health, NO.6 Wentan Road, Guoxing Avenue, Qiongshan District, Haikou City
| | - Ying-Yun Deng
- Department of Pediatrics, Sanya People 's Hospital, No. 558 Jiefang Road, Tianya District, Sanya City
| | - Xian-Jia Chen
- Department of Spleen-Stomach Diseases, Danzhou Hospital of Traditional Chinese Medicine, No. 30-20 Zhongxing Avenue, Danzhou City
| | - Xiao-Dong Wu
- Department of Geriatrics, Danzhou Hospital of Traditional Chinese Medicine, No. 30-20 Zhongxing Avenue, Danzhou City
| | - Shan-Wen Huang
- Department of Pediatrics, Haikou Hospital of the Matemal and Child Health, NO.6 Wentan Road, Guoxing Avenue, Qiongshan District, Haikou City, Hainan Province, China
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10
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de Lusignan S, Sherlock J, Ferreira F, O'Brien S, Joy M. Household presentation of acute gastroenteritis in a primary care sentinel network: retrospective database studies. BMC Public Health 2020; 20:445. [PMID: 32248812 PMCID: PMC7132989 DOI: 10.1186/s12889-020-08525-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/13/2020] [Indexed: 12/27/2022] Open
Abstract
Background Acute gastroenteritis (AGE) is a highly transmissible condition spreading rapidly between individuals and within households. Rotavirus vaccination was introduced in the UK in 2013. The study objectives were to investigate how acute gastroenteritis incidence changed over 25 years and household incidence of AGE since 2013. Methods Repeated cross-sectional study of Royal College of General Practitioners Research and Surveillance Centre network. We used a negative binomial model to report incidence rate ratio (IRR) using the last 5 years data. We also conducted a retrospective cohort analysis, using a shared gamma frailty model (2013–2017). We explored the impact of child under 5- years, household size, socioeconomic status quintile, and rurality. Results In the cross-sectional analysis, the IRR of AGE in households with a child of under 5 years was 12.20 (95%CI 11.08–13.45-, p < 0.001) compared with households without; the IRR fell across IMD quintiles, for example there is a 37% decrease in incidence comparing IMD quintile 1 to quintile 5 (95%CI -0.52-0.76, p < 0.001), The cohort study revealed that the presence of an under 5 in the household was associated with a higher risk of household presentation (HR = 6.29, 95% CI 5.61–7.06, p < 0.001). In addition, we observe a reduction in risk of presentation from the most to the least deprived socioeconomic quintile (second quintile: HR = 0.74 (95%CI 0.59–0.92), to least deprived quintile, HR = 0.55 (95%CI 0.41–0.74). We saw a lower association with male gender, white ethnicity and living outside London, but an increased association with increasing household size. Conclusions The incidence of AGE has changed over time: pre-school children, larger households, and living in London were associated with higher rates, and male gender and higher economic status associated with lower rates.
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Affiliation(s)
- Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, UK. .,Department of Clinical & Experimental Medicine, University of Surrey, The Leggett Building, Daphne Jackson Rd, Guildford, UK. .,Royal College of General Practitioners Research and Surveillance Centre, 30 Euston Square, London, UK.
| | - Julian Sherlock
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, UK.,Department of Clinical & Experimental Medicine, University of Surrey, The Leggett Building, Daphne Jackson Rd, Guildford, UK
| | - Filipa Ferreira
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, UK.,Department of Clinical & Experimental Medicine, University of Surrey, The Leggett Building, Daphne Jackson Rd, Guildford, UK
| | - Sarah O'Brien
- Department of Public Health and Policy, Institute of population Health Sciences, University of Liverpool, Liverpool, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, UK.,Department of Clinical & Experimental Medicine, University of Surrey, The Leggett Building, Daphne Jackson Rd, Guildford, UK
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11
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Martinez-Gutierrez M, Arcila-Quiceno V, Trejos-Suarez J, Ruiz-Saenz J. Prevalence and molecular typing of rotavirus in children with acute diarrhoea in Northeastern Colombia. Rev Inst Med Trop Sao Paulo 2019; 61:e34. [PMID: 31269110 PMCID: PMC6609135 DOI: 10.1590/s1678-9946201961034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/26/2019] [Indexed: 12/15/2022] Open
Abstract
After the introduction of the rotavirus vaccine, the number of
rotavirus-associated deaths and the predicted annual rotavirus detection rate
had slightly declined worldwide. Taking in account that in Colombia, Rotarix
vaccine was introduced in 2009, the purpose of this study was to evaluate the
presence of rotavirus A in children under five years who were treated for acute
diarrhoea in Bucaramanga, Colombia and, moreover, to determine the genotypes of
rotavirus present in those children. We performed an analytical cross-sectional
study of rotavirus A in faecal samples from children up to five years of age.
Stool samples were screened for rotavirus A using a lateral-flow
immunochromatographic assay and confirmed using a VP6 sandwich ELISA. Genotyping
of rotavirus A-positive samples was performed by PCR and sequencing of VP7 and
VP4 genes. The overall prevalence of rotavirus was 30.53% (95% confidence
interval [CI] 21.2 - 39.7). Most of the children with rotavirus (86.2%) had
received two doses of the rotavirus vaccine. G3 strains accounted for the vast
majority of cases (82.8%), followed by G12 strains (13.8%) and G3/G9
coinfections (3.4%). Among the P genotypes, P[8] was the most prevalent (69%),
followed by P[9] (31%). The most common G[P] genotype combination was G3P[8],
followed by G3P[9]. The main finding in this study was that rotavirus, in a
Colombian region, is still an important pathogen in children under five years
old, previously vaccinated. The results showed that different factors, such as
kindergarten attendance, could explain the epidemiology and transmission of
rotavirus in Bucaramanga.
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Affiliation(s)
- Marlen Martinez-Gutierrez
- Universidad Cooperativa de Colombia, Grupo de Investigación en Ciencias Animales, Bucaramanga, Colombia
| | - Victor Arcila-Quiceno
- Universidad Cooperativa de Colombia, Grupo de Investigación en Ciencias Animales, Bucaramanga, Colombia
| | - Juanita Trejos-Suarez
- Universidad de Santander, Facultad de Ciencias de la Salud, Programa de Bacteriología y Laboratorio Clínico, Grupo de Investigación en Manejo Clínico, Bucaramanga, Colombia
| | - Julian Ruiz-Saenz
- Universidad Cooperativa de Colombia, Grupo de Investigación en Ciencias Animales, Bucaramanga, Colombia
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