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Standaert B. The Economic Value of Rotavirus Vaccination When Optimally Implemented in a High-Income Country. Vaccines (Basel) 2023; 11:vaccines11050917. [PMID: 37243021 DOI: 10.3390/vaccines11050917] [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: 01/24/2023] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Rotavirus vaccination was introduced in high-income countries starting in 2006, with no recommendation for optimal implementation. Economic evaluations were presented before launch projecting potential impacts. Few economic reassessments have been reported following reimbursement. This study compares the short- to long-term economic value of rotavirus vaccination between pre-launch predictions and real-world evidence collected over 15 years, proposing recommendations for optimal vaccine launch. A cost-impact analysis compared rotavirus hospitalisation data after the introduction of vaccination between pre-launch modelled projections and observed data collected in the RotaBIS study in Belgium. A best model fit of the observed data was used to simulate launch scenarios to identify the optimal strategy. Data from other countries in Europe were used to confirm the potential optimal launch assessment. The Belgian analysis in the short term (first 8 years) indicated a more favourable impact for the observed data than predicted pre-launch model results. The long-term assessment (15 years) showed bigger economic disparities in favour of the model-predicted scenario. A simulated optimal vaccine launch, initiating the vaccination at least 6 months prior the next seasonal disease peak with an immediate very high vaccine coverage, indicated important additional potential gains, which would make vaccination very cost impactful. Finland and the UK are on such a route leading to long-term vaccination success, whereas Spain and Belgium have difficulties in achieving optimum vaccine benefits. An optimal launch of rotavirus vaccination may generate substantial economic gains over time. For high-income countries that are considering implementing rotavirus vaccination, achieving an optimal launch is a critical factor for long-term economic success.
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Affiliation(s)
- Baudouin Standaert
- Department Care and Ethics, Faculty of Medicine and Life Sciences, University Hasselt, 3590 Diepenbeek, Belgium
- HEBO bv, 2020 Antwerpen, Belgium
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2
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Costantino C, Conforto A, Bonaccorso N, Cimino L, Sciortino M, Palermo M, Maiolo K, Tina LG, Betta PM, Caracciolo M, Loretta CM, Arco A, Gitto E, Vitaliti SM, Mancuso D, Vitaliti G, Rosella V, Pinello G, Corsello G, Serra G, Gabriele B, Tramuto F, Restivo V, Amodio E, Vitale F. Safety of Rotavirus Vaccination in Preterm Infants Admitted in Neonatal Intensive Care Units in Sicily, Italy: A Multicenter Observational Study. Vaccines (Basel) 2023; 11:vaccines11040718. [PMID: 37112630 PMCID: PMC10145326 DOI: 10.3390/vaccines11040718] [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: 02/13/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Rotavirus (RV) is among the most common vaccine-preventable diseases in children under five years of age. Despite the severity of rotavirus pathology in early childhood, rotavirus vaccination for children admitted to the neonatal intensive care unit (NICU), who are often born preterm and with various previous illnesses, is not performed. This multicenter, 3-year project aims to evaluate the safety of RV vaccine administration within the six main neonatal intensive care units of the Sicilian Region to preterm infants. Methods: Monovalent live attenuated anti-RV vaccination (RV1) was administered from April 2018 to December 2019 to preterm infants with gestational age ≥ 28 weeks. Vaccine administrations were performed in both inpatient and outpatient hospital settings as a post-discharge follow-up (NICU setting) starting at 6 weeks of age according to the official immunization schedule. Any adverse events (expected, unexpected, and serious) were monitored from vaccine administration up to 14 days (first assessment) and 28 days (second assessment) after each of the two scheduled vaccine doses. Results: At the end of December 2019, 449 preterm infants were vaccinated with both doses of rotavirus vaccine within the six participating Sicilian NICUs. Mean gestational age in weeks was 33.1 (±3.8 SD) and the first dose of RV vaccine was administered at 55 days (±12.9 SD) on average. The mean weight at the first dose was 3388 (SD ± 903) grams. Only 0.6% and 0.2% of infants reported abdominal colic and fever above 38.5 °C in the 14 days after the first dose, respectively. Overall, 1.9% EAEs were observed at 14 days and 0.4% at 28 days after the first/second dose administration. Conclusions: Data obtained from this study confirm the safety of the monovalent rotavirus vaccine even in preterm infants with gestational age ≥ 28 weeks, presenting an opportunity to improve the vaccination offer both in Sicily and in Italy by protecting the most fragile infants who are more at risk of contracting severe rotavirus gastroenteritis and nosocomial RV infection.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Arianna Conforto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Nicole Bonaccorso
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Livia Cimino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Martina Sciortino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Mario Palermo
- Regional Health Authority of Sicily, Via Vaccaro 5, 90145 Palermo, Italy
| | - Kim Maiolo
- Neonatal Intensive Care Unit, Garibaldi Hospital, 95124 Catania, Italy
| | | | - Pasqua Maria Betta
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Mariacarmela Caracciolo
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Carmine Mattia Loretta
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Alessandro Arco
- Neonatal Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy
| | - Eloisa Gitto
- Neonatal Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy
| | | | - Domenica Mancuso
- Neonatology Unit, NICU and Creche, ARNAS Civico, 90127 Palermo, Italy
| | - Giuliana Vitaliti
- Neonatology Unit, NICU and Creche, ARNAS Civico, 90127 Palermo, Italy
| | - Vincenzo Rosella
- Neonatal Intensive Care Unit, Maternal and Child Department, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy
| | - Giuseppa Pinello
- Neonatal Intensive Care Unit, Maternal and Child Department, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy
| | - Giovanni Corsello
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Gregorio Serra
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Bruna Gabriele
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Emanuele Amodio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
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3
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Murphy A, Kirby A, De Blasio F. The economic impact of the introduction of universal rotavirus vaccination on rotavirus gastroenteritis related hospitalisations in children in Ireland. Vaccine 2023; 41:2656-2663. [PMID: 36948981 DOI: 10.1016/j.vaccine.2023.03.010] [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: 08/19/2022] [Revised: 02/20/2023] [Accepted: 03/05/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Rotavirus gastroenteritis (RVGE), a vaccine preventable disease, remains a common cause of severe gastroenteritis in children globally. Ireland introduced the universal rotavirus vaccination to the national immunisation programme in 2016. In this paper the economic impact on RVGE related hospitalisations amongst children under 5 years is examined. METHODS Using national data from all Irish public hospitals, an Interrupted Times Series Analysis (ITSA) compares RVGE hospitalisations amongst children under 5 years, pre- and post-vaccine introduction. Costs are estimated and ITSA results are compared to the counterfactual to estimate the economic impact of the vaccine. A probit model examines patient characteristics pre- and post-vaccine introduction. RESULTS Vaccine introduction coincided with lowered RVGE related hospitalisations. While this effect was delayed (1 year) there is evidence of a sustained impact. RVGE patients' post-vaccine introduction were likely to be over 2 years (p = 0.001) and length of stay was lower on average (p = 0.095). The counterfactual analysis revealed 492 RVGE hospitalisations were avoided on average annually since the introduction of the vaccine. This has an estimated economic value of €0.92 million per annum. CONCLUSIONS Following the introduction of the rotavirus vaccine in Ireland, hospitalisations for RVGE decreased significantly and those hospitalised were older and with a reduced length of stay on average. This has the potential for significant cost savings for the Irish healthcare system.
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Affiliation(s)
- Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Ireland
| | - Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, Ireland.
| | - Federica De Blasio
- Department of Economics, Cork University Business School, University College Cork, Ireland
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Mellott CE, Jaworski R, Carrico J, Talbird SE, Dobrowolska I, Golicki D, Bencina G, Clinkscales M, Karamousouli E, Eiden AL, Sabale U. Public health impact and return on investment of the pediatric immunization program in Poland. Expert Rev Vaccines 2023; 22:1114-1125. [PMID: 37909887 DOI: 10.1080/14760584.2023.2275712] [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: 08/03/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND This study aims to evaluate the epidemiological impact and return on investment of the pediatric immunization program (PIP) in Poland from the healthcare-sector and societal perspectives. RESEARCH DESIGN AND METHODS A health-economic model was developed focusing on the nine vaccines, targeting 11 pathogens, recommended by the public health authorities for children aged 0-6 years in Poland. The 2019 birth cohort (388,178) was followed over their lifetime, with the model estimating discounted health outcomes, life-years gained, quality-adjusted life-years, and direct and indirect costs with and without the PIP based on current and pre-vaccine - era disease incidence estimates, respectively. RESULTS Across 11 targeted pathogens, the Polish PIP prevented more than 452,300 cases of disease, 1,600 deaths, 37,900 life-years lost, and 38,800 quality-adjusted life-years lost. The PIP was associated with vaccination costs of €54 million. Pediatric immunization averted €65 million from a healthcare-sector perspective (benefit-cost ratio [BCR], 2.2) and averted €358 million from a societal perspective (BCR, 7.6). The BCRs from both perspectives remained >1.0 in scenario analyses. CONCLUSIONS The Polish PIP, which has not previously been systematically assessed, brings large-scale prevention of disease-related morbidity, premature mortality, and associated costs. This analysis highlights the value of continued investment in pediatric immunization in Poland.
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Affiliation(s)
| | | | | | | | | | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
| | - Goran Bencina
- Center for Observational and Real-World Evidence, (CORE), MSD, Madrid, Spain
| | | | | | - Amanda L Eiden
- Center for Observational and Real-World Evidence (CORE), Merck & Co, Rahway, NJ, USA
| | - Ugne Sabale
- Center for Observational and Real-World Evidence (CORE), MSD, Vilnius, Lithuania
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Verberk JDM, van Dongen JAP, van de Kassteele J, Andrews NJ, van Gaalen RD, Hahné SJM, Vennema H, Ramsay M, Braeckman T, Ladhani S, Thomas SL, Walker JL, de Melker HE, Fischer TK, Koch J, Bruijning-Verhagen P. Impact analysis of rotavirus vaccination in various geographic regions in Western Europe. Vaccine 2021; 39:6671-6681. [PMID: 34635375 DOI: 10.1016/j.vaccine.2021.09.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/30/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Universal mass vaccination (UMV) against rotavirus has been implemented in many but not all European countries. This study investigated the impact of UMV on rotavirus incidence trends by comparing European countries with UMV: Belgium, England/Wales and Germany versus countries without UMV: Denmark and the Netherlands. METHODS For this observational retrospective cohort study, time series data (2001-2016) on rotavirus detections, meteorological factors and population demographics were collected. For each country, several meteorological and population factors were investigated as possible predictors of rotavirus incidence. The final set of predictors were incorporated in negative binomial models accounting for seasonality and serial autocorrelation, and time-varying incidence rate ratios (IRR) were calculated for each age group and country separately. The overall vaccination impact two years after vaccine implementation was estimated by pooling the results using a random effects meta-analyses. Independent t-tests were used to compare annual epidemics in the pre-vaccination and post-vaccination era to explore any changes in the timing of rotavirus epidemics. RESULTS The population size and several meteorological factors were predictors for the rotavirus epidemiology. Overall, we estimated a 42% (95%-CI 23;56%) reduction in rotavirus incidence attributable to UMV. Strongest reductions were observed for age-groups 0-, 1- and 2-years (IRR 0.47, 0.48 and 0.63, respectively). No herd effect induced by UMV in neighbouring countries was observed. In all UMV countries, the start and/or stop and corresponding peak of the rotavirus season was delayed by 4-7 weeks. CONCLUSIONS The introduction of rotavirus UMV resulted in an overall reduction of 42% in rotavirus incidence in Western European countries two years after vaccine introduction and caused a change in seasonal pattern. No herd effect induced by UMV neighbouring countries was observed for Denmark and the Netherlands.
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Affiliation(s)
- J D M Verberk
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - J A P van Dongen
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - J van de Kassteele
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - N J Andrews
- Statistics, Modelling, and Economics Department, Public Health England (PHE), London, United Kingdom
| | - R D van Gaalen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - S J M Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - H Vennema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - M Ramsay
- Statistics, Modelling, and Economics Department, Public Health England (PHE), London, United Kingdom
| | - T Braeckman
- Formerly at Service Epidemiology of Infectious Diseases, Department Public Health and Surveillance, Sciensano Institute, Brussels, Belgium
| | - S Ladhani
- Immunisation Department, Public Health England (PHE), London, United Kingdom
| | - S L Thomas
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - J L Walker
- Immunisation Department, Public Health England (PHE), London, United Kingdom; Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - H E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - T K Fischer
- Virology Surveillance and Research, Department of Virology and Special Microbiology Diagnostics Statens Serum Institut (SSI), Copenhagen, Denmark and University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - J Koch
- Immunization Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
| | - P Bruijning-Verhagen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Cárcamo-Calvo R, Muñoz C, Buesa J, Rodríguez-Díaz J, Gozalbo-Rovira R. The Rotavirus Vaccine Landscape, an Update. Pathogens 2021; 10:520. [PMID: 33925924 PMCID: PMC8145439 DOI: 10.3390/pathogens10050520] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/17/2022] Open
Abstract
Rotavirus is the leading cause of severe acute childhood gastroenteritis, responsible for more than 128,500 deaths per year, mainly in low-income countries. Although the mortality rate has dropped significantly since the introduction of the first vaccines around 2006, an estimated 83,158 deaths are still preventable. The two main vaccines currently deployed, Rotarix and RotaTeq, both live oral vaccines, have been shown to be less effective in developing countries. In addition, they have been associated with a slight risk of intussusception, and the need for cold chain maintenance limits the accessibility of these vaccines to certain areas, leaving 65% of children worldwide unvaccinated and therefore unprotected. Against this backdrop, here we review the main vaccines under development and the state of the art on potential alternatives.
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Affiliation(s)
- Roberto Cárcamo-Calvo
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; (R.C.-C.); (C.M.); (J.B.)
| | - Carlos Muñoz
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; (R.C.-C.); (C.M.); (J.B.)
| | - Javier Buesa
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; (R.C.-C.); (C.M.); (J.B.)
- Instituto de Investigación INCLIVA, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Jesús Rodríguez-Díaz
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; (R.C.-C.); (C.M.); (J.B.)
- Instituto de Investigación INCLIVA, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Roberto Gozalbo-Rovira
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibañez 17, 46010 Valencia, Spain; (R.C.-C.); (C.M.); (J.B.)
- Instituto de Investigación INCLIVA, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
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López-Lacort M, Orrico-Sánchez A, Martínez-Beneito MÁ, Muñoz-Quiles C, Díez-Domingo J. Spatio-temporal impact of self-financed rotavirus vaccination on rotavirus and acute gastroenteritis hospitalisations in the Valencia region, Spain. BMC Infect Dis 2020; 20:656. [PMID: 32894071 PMCID: PMC7487659 DOI: 10.1186/s12879-020-05373-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Several studies have shown a substantial impact of Rotavirus (RV) vaccination on the burden of RV and all-cause acute gastroenteritis (AGE). However, the results of most impact studies could be confused by a dynamic and complex space-time process. Therefore, there is a need to analyse the impact of RV vaccination on RV and AGE hospitalisations in a space-time framework to detect geographical-time patterns while avoiding the potential confusion caused by population inequalities in the impact estimations. METHODS A retrospective population-based study using real-world data from the Valencia Region was performed among children aged less than 3 years old in the period 2005-2016. A Bayesian spatio-temporal model was constructed to analyse RV and AGE hospitalisations and to estimate the vaccination impact measured in averted hospitalisations. RESULTS We found important spatio-temporal patterns in RV and AGE hospitalisations, RV vaccination coverage and in their associated adverted hospitalisations. Overall, ~ 1866 hospital admissions for RV were averted by RV vaccination during 2007-2016. Despite the low-medium vaccine coverage (~ 50%) in 2015-2016, relevant 36 and 20% reductions were estimated in RV and AGE hospitalisations respectively. CONCLUSIONS The introduction of the RV vaccines has substantially reduced the number of RV hospitalisations, averting ~ 1866 admissions during 2007-2016 which were space and time dependent. This study improves the methodologies commonly used to estimate the RV vaccine impact and their interpretation.
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Affiliation(s)
- Mónica López-Lacort
- Vaccine Research Department FISABIO-Public Health, Avenida Cataluña, 21, 46020, Valencia, Spain.
| | | | - Miguel Ángel Martínez-Beneito
- Departament d'Estadística i Investigació Operativa. Universitat de Valencia, Valencia, Spain
- Unitat Mixta de Recerca en Mètodes Estadístics per a Dades Biomédiques i Sanitàries, Valencia, Spain
| | - Cintia Muñoz-Quiles
- Vaccine Research Department FISABIO-Public Health, Avenida Cataluña, 21, 46020, Valencia, Spain
| | - Javier Díez-Domingo
- Vaccine Research Department FISABIO-Public Health, Avenida Cataluña, 21, 46020, Valencia, Spain
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Amadori F, Terracciano E, Gennaio I, Mita V, Gargano D, Zaratti L, Franco E, Arigliani R. Opinions and attitudes of Italian healthcare workers towards recommended but not compulsory rotavirus vaccination. Hum Vaccin Immunother 2020; 17:497-502. [PMID: 32614732 PMCID: PMC7899670 DOI: 10.1080/21645515.2020.1776546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Rotaviruses (RVs) are a leading cause of viral gastroenteritis among children younger than 5. The incidence of RV disease can be reduced through the widespread use of vaccination, but coverage is low in many countries, including Italy. This fact reflects the poor consideration given to the RV vaccine, both by the population and by healthcare workers. Peoples’ opinions are strictly dependent on the attitude of doctors and nurses. The aim of this work is the evaluation of healthcare workers’ knowledge, attitudes and opinions regarding RV vaccination. The results of two surveys were compared; the first was carried out in 2017, soon after the Italian National Immunization Plan introduced the recommendation for the RV vaccine. The second was performed at the end of 2018, approximately 1 year after the adoption of a Law that introduced new compulsory vaccinations, not including the RV vaccine. In 2017, 182 questionnaires were collected, and 111 in 2018. An increase was observed in the percentage of participants who reported recommending the RV vaccine and a significant increase was found in the coverage the participants claimed to reach. Education of healthcare workers after the introduction of compulsory vaccination may prompt them to actively offer also recommended vaccines.
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Affiliation(s)
- F Amadori
- Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata , Rome, Italy
| | - E Terracciano
- Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata , Rome, Italy
| | - I Gennaio
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - V Mita
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - D Gargano
- Nursing Service, Bambino Gesù Children's Hospital, Rome, Italy
| | - L Zaratti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - E Franco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy
| | - R Arigliani
- School of Counselling, Italian Medical Research Institute , Benevento, Italy
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9
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de Waure C, Sarnari L, Chiavarini M, Ianiro G, Monini M, Alunno A, Camilloni B. 10-Year Rotavirus Infection Surveillance: Epidemiological Trends in the Pediatric Population of Perugia Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1008. [PMID: 32033439 PMCID: PMC7036783 DOI: 10.3390/ijerph17031008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/23/2020] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
Rotavirus (RV) infections are a leading cause of severe gastroenteritis in children, and vaccination is currently recommended in Italy, according to the National Immunization Plan 2017-2019. The objective of this study was to describe the epidemiological and molecular RV surveillance in the pediatric population of Perugia province, Umbria. Between September 2007 and August 2018, 663 RV-positive stool specimens were collected from children <15 years of age presenting with gastroenteritis to the emergency room of the Perugia province hospitals who were then hospitalized. Yearly hospitalization rates were expressed per 100,000 persons, and denominators were extrapolated from the National Institute of Statistics. During the 10-year surveillance, the epidemiological trend was fluctuating but slightly decreasing (Max: 89.7 per 100,000 in 2010/2011; Min: 34.8 per 100,000 in 2017/2018). The hospitalization rate was higher in males and in children under five years of age. Among common genotypes, G1P[8] was prevalent most of the years. The uncommon G12P [8] genotype emerged and was the most common in 2012/2013 (58.2%). Afterwards, its circulation remained high. As the Umbria Region started vaccinating from the 2018 birth cohort, our study reviewed pre-vaccination data and will help to assess the protection induced by vaccination and its effect on circulating strains.
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Affiliation(s)
- Chiara de Waure
- Department of Experimental Medicine, University of Perugia, 06132 Perugia, Italy; (C.d.W.); (L.S.)
| | - Laura Sarnari
- Department of Experimental Medicine, University of Perugia, 06132 Perugia, Italy; (C.d.W.); (L.S.)
| | - Manuela Chiavarini
- Department of Experimental Medicine, University of Perugia, 06132 Perugia, Italy; (C.d.W.); (L.S.)
| | - Giovanni Ianiro
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.I.); (M.M.)
| | - Marina Monini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.I.); (M.M.)
| | - Anna Alunno
- Department of Medicine, University of Perugia, 06132 Perugia, Italy; (A.A.); (B.C.)
| | - Barbara Camilloni
- Department of Medicine, University of Perugia, 06132 Perugia, Italy; (A.A.); (B.C.)
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10
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Chen YFE, Lee CC, Chiu CH, Chang YC, Tsai CN, Chao HC, Kong SS, Chen SY. Divergence of group a rotavirus with genetic variations before and after introduction of rotavirus vaccines in northern Taiwan. Medicine (Baltimore) 2020; 99:e19253. [PMID: 32118732 PMCID: PMC7478762 DOI: 10.1097/md.0000000000019253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Despite the development of vaccines in 2006, rotavirus is still a major cause of acute gastroenteritis worldwide. This study was performed to analyze the presence of circulating rotaviruses before and after the introduction of rotavirus vaccines to allow phylogenetic comparisons of vaccine strains in northern Taiwan.Rotavirus genotyping and sequencing of rotavirus VP7 and VP4 PCR products were performed by Reverse Transcriptase Polymerase Chain Reaction and DNA autosequencing. Phylogenies were constructed by the neighbor-joining and maximum-likelihood methods using CLUSTAL W software included in the MEGA software package (version 6.0).Between April 2004 and December 2012, a total of 101 rotavirus specimens from pediatric patients with acute gastroenteritis hospitalized in Chang Gung Children's Hospital were amplified, and their VP4 and VP7 sequences were determined. These 101 specimens consisted of 55 pre-vaccine strains (G1 [13, 23.6%], G2 [12, 21.8%], G3 [16, 29.1%], and G9 [14, 25.5%]) and 46 post-vaccine strains (G1 [25, 54.3%], G2 [12, 26.1%], G3 [5, 10.9%], and G9 [4, 8.7%]). The most common combination of the G and P types was G2P[4], accounting for 36% cases, followed by G9P[8] (25%), G1P[8] (20%), G3P[4] (15%), G3P[8] (10%), G1P[4] (5%), and G2P[8] (5%). Phylogenetic analysis showed that only the G1 and P[8] genotypes clustered in the same lineages with the rotavirus vaccine strains.Based on our results, the inclusion of G9, modified G2 and G3 with target lineages, and the combination G2P[4] and G9P[8] in the rotavirus vaccines in Taiwan is warranted as a vaccination strategy.
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Affiliation(s)
- Ying-Fang Elaine Chen
- Division of Neonatology, Department of Pediatrics, Taipei Medical University Shuang Ho Hospital, New Taipei City
| | - Chung-Chan Lee
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital
| | - Cheng-Hsun Chiu
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | | | - Chi-Neu Tsai
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Department of Pediatrics, Chang Gung Memorial Hospital
| | - Hsun-Ching Chao
- Division of Pediatric Gastroenterology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan
| | | | - Shih-Yen Chen
- Division of Pediatric Gastroenterology, Department of Pediatrics, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
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Clinical Characteristics of Rotavirus-Induced Gastroenteritis in Infants. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020. [DOI: 10.2478/sjecr-2020-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Rotavirus is the most common cause of acute infectious diarrhea in infants and young children up to the age of five. The disease is characterized by profuse watery diarrhea, vomiting and fever. The major complications of rotavirus gastroenteritis (RVGE) are dehydration, middle ear inflammation and upper respiratory tract infection. The basis of treatment is compensation for fluid loss and administration of probiotics. The aim of this study was to analyze the clinical characteristics of rotavirus gastroenteritis in infants. The study was conducted by the type of retrospective-prospective clinical study on infants with rotavirus gastroenteritis diagnosed on the basis of a positive Rotalex test (Orion Diagnostica Finland) and exclusion of other etiological factors at the University Children's Clinic in Belgrade, from April 2005 to December 2010. In addition to the detailed medical history and clinical examination, relevant laboratory analyzes were performed in all patients. Descriptive and analytical statistical methods were applied in the study. Among the descriptive methods, we used grouping, tabulation, graphing, calculating measures of central tendency, calculating measures of variability and calculating relative numbers. Of the analytical statistical methods, distribution normality testing, χ2 test, Mann-Whitney U test and T test were used. Statistical significance will be taken to mean p < 0.05. The average infant mortality was 6.7 ± 3.7 months. All respondents were divided into two groups according to the age. The first group consisted of infants aged 0 to 5 months (46%), the second group consisted of infants aged 6 to 12 months (54%). The incidence of aqueous diarrhea (100%), vomiting (84%) and fever (74%) in infants suffering from rotavirus gastroenteritis was analyzed. The significance of the age on the symptomatology of rotavirus gastroenteritis as well as on the importance of using probiotics has been demonstrated.
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12
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Moutelíková R, Sauer P, Dvořáková Heroldová M, Holá V, Prodělalová J. Emergence of Rare Bovine-Human Reassortant DS-1-Like Rotavirus A Strains with G8P[8] Genotype in Human Patients in the Czech Republic. Viruses 2019; 11:v11111015. [PMID: 31683946 PMCID: PMC6893433 DOI: 10.3390/v11111015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 01/09/2023] Open
Abstract
Group A Rotaviruses (RVA) are the leading cause of acute gastroenteritis in children and a major cause of childhood mortality in low-income countries. RVAs are mostly host-specific, but interspecies transmission and reassortment between human and animal RVAs significantly contribute to their genetic diversity. We investigated the VP7 and VP4 genotypes of RVA isolated from 225 stool specimens collected from Czech patients with gastroenteritis during 2016–2019. The most abundant genotypes were G1P[8] (42.7%), G3P[8] (11.1%), G9P[8] (9.8%), G2P[4] (4.4%), G4P[8] (1.3%), G12P[8] (1.3%), and, surprisingly, G8P[8] (9.3%). Sequence analysis of G8P[8] strains revealed the highest nucleotide similarity of all Czech G8 sequences to the G8P[8] rotavirus strains that were isolated in Vietnam in 2014/2015. The whole-genome backbone of the Czech G8 strains was determined with the use of next-generation sequencing as DS-1-like. Phylogenetic analysis of all segments clustered the Czech isolates with RVA strains that were formerly described in Southeast Asia, which had emerged following genetic reassortment between bovine and human RVAs. This is the first time that bovine–human DS-1-like G8P[8] strains were detected at a high rate in human patients in Central Europe. Whether the emergence of this unusual genotype reflects the establishment of a new RVA strain in the population requires the continuous monitoring of rotavirus epidemiology.
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Affiliation(s)
| | - Pavel Sauer
- Institute of Microbiology, University Hospital Olomouc and Faculty of Medicine, Palacký University, 77900 Olomouc, Czech Republic.
| | - Monika Dvořáková Heroldová
- Microbiology Institute of Faculty of Medicine, Masaryk University Brno and University Hospital of St. Anne, 65691 Brno, Czech Republic.
| | - Veronika Holá
- Microbiology Institute of Faculty of Medicine, Masaryk University Brno and University Hospital of St. Anne, 65691 Brno, Czech Republic.
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Vontas A, Hadjicristodoulou C, Krikelis V, Petinaki E. The Use of Immunochromatographic Technique for Rotavirus Detection: Experience from a Tertiary Care Hospital in Central Greece. Intervirology 2019; 62:164-168. [PMID: 31487720 DOI: 10.1159/000502007] [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: 02/02/2019] [Accepted: 07/09/2019] [Indexed: 11/19/2022] Open
Abstract
Despite the significant medical advances which have taken place in the last decades, acute diarrhoea cases remain a public health issue of major significance, with gastroenteritis agents being associated with severe symptoms in adults and high morbidity in infants and children. Regarding rotaviruses, while children are the predominant victims of rotavirus infection, adults (often caretakers or parents of these children) may experience the same symptoms of fever, vomiting, and non-bloody diarrhoea. Three different routine schemes for the detection of rotaviruses in archived stool samples were evaluated in terms of diagnostic performance. A total of 640 archived stool samples were included in the study. The samples were screened with three different techniques: a commercial rapid immunochromatographic test, a modified in-house conventional one-step reverse-transcription polymerase chain reaction (PCR) screen protocol, and a com-mer-cial one-step real-time PCR kit. Technical aspects and considerations are discussed.
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Affiliation(s)
- Alexandros Vontas
- Department of Medical Laboratories, Technological Educational Institute of Larrisa, Larissa, Greece,
| | | | - Vasilis Krikelis
- Department of Medical Laboratories, Technological Educational Institute of Larrisa, Larissa, Greece
| | - Efthimia Petinaki
- Department of Microbiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
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14
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Coveney J, Barrett M, Fitzpatrick P, Kandamany N, Mcnamara R, Koe S, Okafor I. National rotavirus vaccination programme implementation and gastroenteritis presentations: the paediatric emergency medicine perspective. Ir J Med Sci 2019; 189:327-332. [PMID: 31197576 DOI: 10.1007/s11845-019-02046-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Throughout the developed world, the introduction of rotavirus vaccination has led to reductions in the incidence and severity of acute gastroenteritis (AGE) in young children and consequently to reductions in paediatric emergency department (PED) attendances with AGE. Rotavirus vaccination was added to the Irish National Immunisation Schedule in November 2016. AIMS To assess the impact of vaccine introduction on citywide PED attendances and hospital admissions with all-cause AGE during rotavirus season. METHODS In an observational study, a retrospective search was performed of electronic records in three independent PEDs in Dublin. Weekly presentations and admissions with AGE in the first 30 weeks (gastroenteritis season) of the years 2012-2018 were counted and stratified by age. RESULTS Median weekly presentations in 2017-2018, 126 (interquartile range (IQR) 103-165) were significantly lower than in 2012-2016, 160 (IQR 128-214) (p < 0.001). A reduction in presentations was seen across the three hospitals and in those aged less than 5 years. In one PED, median admissions in 2017-2018 were 10 (IQR 7-13) in comparison with nine (IQR 7-13) in 2012-2016, (p = 0.463). The emergency department AGE presentations to hospital ward admission rate was 6.7:1. CONCLUSION A reduction in PED presentations with AGE is demonstrated post-rotavirus vaccine introduction into the Irish National Immunisation Schedule. No significant change in paediatric hospital admissions was demonstrated.
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Affiliation(s)
- John Coveney
- Emergency Department, Temple Street Children's University Hospital, Dublin, Ireland.
| | - Michael Barrett
- Emergency Department, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.,Women's & Children's Health, School of Medicine, University College Dublin, Dublin, Ireland.,National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland
| | - Patrick Fitzpatrick
- Emergency Department, Temple Street Children's University Hospital, Dublin, Ireland
| | - Nandini Kandamany
- Emergency Department, Temple Street Children's University Hospital, Dublin, Ireland
| | - Roisin Mcnamara
- Emergency Department, Temple Street Children's University Hospital, Dublin, Ireland
| | - Stanley Koe
- Emergency Department, Incorporating the National Children's Hospital, Tallaght University Hospital, Dublin, Ireland
| | - Ikechukwu Okafor
- Emergency Department, Temple Street Children's University Hospital, Dublin, Ireland
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15
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Berkhout A, Clark JE, Wen SCH. In utero exposure to biologic disease-modifying anti-rheumatic drugs and effects to the infant: infectious complications, vaccine response, and safety of live vaccine administration. Expert Rev Vaccines 2019; 18:495-504. [PMID: 30916600 DOI: 10.1080/14760584.2019.1599286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Biologic disease-modifying anti-rheumatic drugs (bDMARDS) are increasingly used in clinical practice for a variety of conditions. Due to concerns surrounding persistence of drug levels and resulting immunosuppression, current case reports recommend against live vaccine administration in the first year of life for an infant exposed to perinatal bDMARDS. As a result, this significantly impacts receipt of rotavirus vaccination, a vaccine recommended in many countries' national immunization program. Area covered: We have reviewed all available published literature to explore the effect of peripartum bDMARDS exposure on infant immune responses, safety of live vaccines, and vaccine efficacy in the first year of life. Expert opinion: We recommend that otherwise healthy newborns with a history of perinatal exposure to bDMARDS should receive rotavirus vaccinations as per the recommended schedule. Bacille Calmette et Guerin vaccine should be withheld in the first year of life. No additional booster doses of inactivated vaccines are required as they appear to mount adequate immune responses to the routine schedule.
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Affiliation(s)
- Angela Berkhout
- a Infection Management and Prevention Service, Queensland Children's Hospital , University of Queensland , Brisbane , Australia.,b The Queensland Children's Hospital , Brisbane , Australia
| | - Julia E Clark
- a Infection Management and Prevention Service, Queensland Children's Hospital , University of Queensland , Brisbane , Australia.,b The Queensland Children's Hospital , Brisbane , Australia
| | - Sophie Chien-Hui Wen
- a Infection Management and Prevention Service, Queensland Children's Hospital , University of Queensland , Brisbane , Australia.,b The Queensland Children's Hospital , Brisbane , Australia
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16
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El C, Celikkaya ME. Akut viral gastroenteritlerde oral çinko kullanımının hastalığın semptomları ve süresine etkisinin değerlendirilmesi. FAMILY PRACTICE AND PALLIATIVE CARE 2019. [DOI: 10.22391/fppc.471460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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17
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Molecular characterization of human enteric viruses in food, water samples, and surface swabs in Sicily. Int J Infect Dis 2019; 80:66-72. [DOI: 10.1016/j.ijid.2018.12.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 01/09/2023] Open
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18
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Cost-effectiveness estimates of vaccination against rotavirus in Piedmont, Italy. J Infect Public Health 2018; 11:867-872. [DOI: 10.1016/j.jiph.2018.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/29/2018] [Accepted: 07/16/2018] [Indexed: 12/31/2022] Open
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19
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Restivo V, Caracci F, Sannasardo CE, Scarpitta F, Vella C, Ventura G, Tramuto F, Costantino C. Rotavirus gastroenteritis hospitalization rates and correlation with rotavirus vaccination coverage in Sicily. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:437-442. [PMID: 30333453 PMCID: PMC6502119 DOI: 10.23750/abm.v89i3.7578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 01/25/2023]
Abstract
Background and aim of the works:Rotavirus (RV) is considered the main cause of gastroenteritis in children from 0 to 59 months and vaccination represents the only strategy to prevent hospitalizations due to RV. In 2013 Sicilian Region introduced universal RV vaccination for all newborns. The present study aims to estimate the reduction rotavirus gastroenteritis (RVGE) hospitalization rates among Sicilian children and their relations with vaccination coverages of the nine Sicilian Local Health Units (LHUs). Methods: Were analyzed hospital discharge records including a diagnosis of RVGE occurred from January 2009 to December 2017 in hospitalized children aged 0 to 59 months, residents in Sicily. Were reported data on complete RV vaccination cycles among Sicilian children under 12 months of age (vaccination coverage). Results: A 49.2% overall reduction of RVGE hospitalization rates was reported after RV vaccination introduction. A more considerable reduction of hospitalization rates was observed among children aged 0 to 11 months (-61.4%), followed by children aged 12-23 months (-51.2%) and 24-35 months (-48.8%). In all the nine Sicilian Local Health Units (LHUs), a reduction of RVGE hospitalization rates was observed after RV vaccine implementation. Conclusions: This study demonstrated the significant impact of RV vaccination on RVGE hospitalization rates in Sicily, especially among children aged 0 to 23 months. The reduction in RVGE hospitalization rates observed in the Sicilian LHUs after universal vaccination program implementation, were generally higher or consistent with average vaccination coverage reported from 2013 to 2017. (www.actabiomedica.it)
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Affiliation(s)
- Vincenzo Restivo
- University of Palermo - Department of Science for Health Promotion and Mother to Child Care.
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20
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Ledent E, Arlegui H, Buyse H, Basile P, Karkada N, Praet N, Nachbaur G. Benefit Versus Risk Assessment of Rotavirus Vaccination in France: A Simulation and Modeling Analysis. BioDrugs 2018; 32:139-152. [PMID: 29589230 PMCID: PMC5878204 DOI: 10.1007/s40259-018-0273-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction Two vaccines against rotavirus gastroenteritis (RVGE) in young children, Rotarix and RotaTeq, have been available in Europe since 2006. Vaccination against rotaviruses significantly reduces the burden of RVGE, but it is also associated with a very small increased risk of intussusception. In a benefit–risk analysis, the prevented RVGE burden is weighed against the possible excess of intussusception. Purpose The aim was to compare the estimated benefits and risks of Rotarix vaccination in France. Methods We estimated the benefits (vaccine-preventable RVGE hospitalizations and deaths) and risks (vaccine-caused intussusception hospitalizations and deaths) following two doses of Rotarix in a birth cohort of 791,183 followed for 3–5 years in France. We used data from peer-reviewed clinical and epidemiological studies or publications, and government statistics. Results Within the total number of French children below 5 years of age, we estimate vaccination could prevent a median 11,132 [95% credible interval (CI) 7842–14,408] RVGE hospitalizations and 7.43 (95% CI 3.27–14.68) RVGE deaths. At the same time, vaccination could cause an average of 6.86 (95% CI 2.25–38.37) intussusception hospitalizations and 0.0099 (95% CI 0.0024–0.060) intussusception deaths in the entire French birth cohort of infants below 1 year of age. Therefore, for every intussusception hospitalization and every intussusception death caused by vaccination, 1624 (95% CI 240–5243) RVGE hospitalizations and 743 (95% CI 93–3723) RVGE deaths are prevented, respectively, by vaccination. Conclusions The vaccine-prevented RVGE hospitalizations and deaths (benefit) greatly outweigh the excess potentially vaccination-related cases of intussusception (risk), indicating a favorable benefit–risk balance for Rotarix in France. Electronic supplementary material The online version of this article (10.1007/s40259-018-0273-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Hugo Arlegui
- Clinical Research, NPI and Academic Alliances, Laboratoire GSK, Rueil-Malmaison, France
| | - Hubert Buyse
- Clinical Safety and Pharmacovigilance, GSK, Wavre, Belgium
| | - Peter Basile
- Clinical Safety and Pharmacovigilance, GSK, Wavre, Belgium
| | | | - Nicolas Praet
- Clinical Research and Development, GSK, Wavre, Belgium
| | - Gaëlle Nachbaur
- Pharmaco-Epidemiology and Health Outcomes Research, Laboratoire GSK, Rueil-Malmaison, France
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21
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Costantino C, Restivo V, Tramuto F, Casuccio A, Vitale F. Universal rotavirus vaccination program in Sicily: Reduction in health burden and cost despite low vaccination coverage. Hum Vaccin Immunother 2018; 14:2297-2302. [PMID: 29757707 PMCID: PMC6183134 DOI: 10.1080/21645515.2018.1471306] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Rotavirus is considered the main cause of severe gastroenteritis and nosocomial infections in Pediatric units, especially during late winter and early spring season in temperate region. In 2013 Sicilian Region, for the first time in Italy, introduced universal Rotavirus vaccination. This study aims to estimate health and economic impact on rotavirus Gastroenteritis (RVGE) among children aged 0–59 months in Sicily, after rotavirus vaccine introduction. We analyzed hospital discharge records including a diagnosis of RVGE occurred from 1st January 2009 to 31st December 2016 among hospitalized children aged 0 to 59 months, residents in Sicily. RVGEs were defined as all hospitalizations with an ICD-9-CM diagnosis code of 008.61 on first or any diagnosis position. Also an economic impact analysis on Health Regional System was conducted. We observed a consistent decline of hospitalization after rotavirus vaccination introduction from 394 per 100,000 in 2009–2012 to 220 per 100,000 in 2013–2016. We found a change in the peak of reported cases by at least one month from March-April in the pre-vaccination period to May-June in the post-vaccination period. Since 2013, we estimated that the annual average cost saved is 1,134,056 € when considering direct and indirect costs to health care as well as vaccination costs. Our study is the first analysis conducted as far as we are aware in a high-income setting with poor coverage (lower than 50%), demonstrating a significant reduction of RVGE hospitalizations in Sicily after vaccine introduction. Moreover, was observed a consistent impact of vaccination on health care cost saving.
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Affiliation(s)
- Claudio Costantino
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy
| | - Vincenzo Restivo
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy
| | - Fabio Tramuto
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy
| | - Alessandra Casuccio
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy
| | - Francesco Vitale
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy
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Torres L, Sánchez M, Cid B, Vicente E, Velasco R. A higher level of ketonaemia does not predict oral rehydration failure in vomiting paediatric patients and routine measurement is unnecessary. Acta Paediatr 2018; 107:714-717. [PMID: 29194756 DOI: 10.1111/apa.14173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/29/2017] [Accepted: 11/28/2017] [Indexed: 11/26/2022]
Abstract
AIM This study determined if blood levels of beta-hydroxybutyrate were associated with the rate of failure in oral rehydration in paediatric patients with vomiting. METHODS This was a prospective observational study that was carried out from December 1, 2015 to November 30, 2016 in the Rio Hortega University Hospital, Valladolid, Spain. The study cohort were patients up to 14 years old who attended the emergency department with three or more vomiting episodes in the last four hours and glycaemia higher than 45 mg/dL. Blood was measured for beta-hydroxybutyrate levels prior to the administration of oral rehydration solution for 90 minutes. Two or more vomiting episodes during this period were considered failed oral rehydration. RESULTS We analysed 248 patients, with a median age of four years and 7.5 months and 233 (94%) of the parents took part. The median number of vomiting episodes in the previous four hours was five and oral rehydration was successful in 183 (78.5%) patients. The multivariate analysis showed that the initial beta-hydroxybutyrate blood level was not associated with the failure of oral rehydration. CONCLUSION Blood levels of beta-hydroxybutyrate had no predictive value for oral rehydration failure in young patients with vomiting and this routine measurement is unnecessary.
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Affiliation(s)
- Lucía Torres
- Pediatric Emergency Unit; Pediatrics Department; Rio Hortega Universitary Hospital; Valladolid Spain
| | - Marina Sánchez
- Pediatric Emergency Unit; Pediatrics Department; Rio Hortega Universitary Hospital; Valladolid Spain
| | - Blanca Cid
- Pediatric Emergency Unit; Pediatrics Department; Rio Hortega Universitary Hospital; Valladolid Spain
| | - Eva Vicente
- Pediatric Emergency Unit; Pediatrics Department; Rio Hortega Universitary Hospital; Valladolid Spain
| | - Roberto Velasco
- Pediatric Emergency Unit; Pediatrics Department; Rio Hortega Universitary Hospital; Valladolid Spain
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23
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Karampatsas K, Osborne L, Seah ML, Tong CYW, Prendergast AJ. Clinical characteristics and complications of rotavirus gastroenteritis in children in east London: A retrospective case-control study. PLoS One 2018; 13:e0194009. [PMID: 29565992 PMCID: PMC5863974 DOI: 10.1371/journal.pone.0194009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/22/2018] [Indexed: 12/22/2022] Open
Abstract
Background Rotavirus is the leading cause of acute gastroenteritis in children and is associated with neurological complications such as seizures and encephalopathy. The aim of this study was to investigate the presentation and complications of rotavirus compared to non-rotavirus gastroenteritis in UK children. Methods This was a retrospective, case-control, hospital-based study conducted at three sites in east London, UK. Cases were children aged 1 month to 16 years diagnosed with acute gastroenteritis between 1 June 2011 and 31 December 2013, in whom stool virology investigations confirmed presence of rotavirus by PCR. They were matched by age, gender and month of presentation to controls with rotavirus-negative gastroenteritis. Results Data were collected from 116 children (50 cases and 66 controls). Children with rotavirus gastroenteritis tended to present more frequently with metabolic acidosis (pH 7.30 vs 7.37, P = 0.011) and fever (74% versus 46%; P = 0.005) and were more likely to require hospitalisation compared to children with non-rotavirus gastroenteritis (93% versus 73%; P = 0.019). Neurological complications were the most common extra-intestinal manifestations, but did not differ significantly between children with rotavirus-positive gastroenteritis (RPG) and rotavirus-negative gastroenteritis (RNG) (24% versus 15%, respectively; P = 0.24). Encephalopathy occurred only in children with rotavirus infection (n = 3, 6%). Conclusion Rotavirus causes longer and more severe disease compared to other viral pathogens. Seizures and milder neurological signs were surprisingly common and associated with multiple pathogens, but encephalopathy occurred only in children with rotavirus gastroenteritis. Rotavirus vaccination may reduce seizures and presentation to hospital, but vaccines against other pathogens causing gastroenteritis are required.
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Affiliation(s)
- Konstantinos Karampatsas
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
- * E-mail:
| | - Leanne Osborne
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - May-Li Seah
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Cheuk Y. W. Tong
- Department of Virology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Andrew J. Prendergast
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
- Blizard Institute, Queen Mary University of London, London, United Kingdom
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Poelaert D, Pereira P, Gardner R, Standaert B, Benninghoff B. A review of recommendations for rotavirus vaccination in Europe: Arguments for change. Vaccine 2018; 36:2243-2253. [PMID: 29576308 DOI: 10.1016/j.vaccine.2018.02.080] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 02/15/2018] [Accepted: 02/19/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND More than 10 years after the authorisation of two rotavirus vaccines of demonstrated efficacy and with a strongly positive benefit-risk profile, uptake in Europe remains low. Only 13 countries in Europe provide a fully-funded rotavirus universal mass vaccination (UMV) programme, three provide a partially-funded programme, and one provides full funding for a reduced programme targeting at-risk infants. Around 40% of countries in Europe currently have no existing recommendations for rotavirus vaccine use in children from the national government. METHODS We provide an overview of the status of rotavirus vaccine recommendations across Europe and the factors impeding uptake. We consider the evidence for the benefits and risks of vaccination, and argue that cost-effectiveness and cost-saving benefits justify greater access to rotavirus vaccines for infants living in Europe. RESULTS Lack of awareness of the direct and indirect burden caused by rotavirus disease, potential cost-saving from rotavirus vaccination including considerable benefits to children, families and society, and government/insurer cost constraints all contribute to complacency at different levels of health policy in individual countries. CONCLUSIONS More than 10 years after their introduction, available data confirm the benefits and acceptable safety profile of infant rotavirus UMV programmes. Europe serves to gain considerably from rotavirus UMV in terms of reductions in healthcare resource utilization and related costs in both vaccinated subjects and their unvaccinated siblings through herd protection.
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Health-related quality of life of the parents of children hospitalized due to acute rotavirus infection: a cross-sectional study in Latvia. BMC Pediatr 2018; 18:114. [PMID: 29544465 PMCID: PMC5856199 DOI: 10.1186/s12887-018-1086-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 03/07/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Rotavirus is the leading cause of severe diarrhea in young children and infants worldwide, representing a heavy public health burden. Limited information is available regarding the impact of rotavirus gastroenteritis on the quality of life of affected children and their families. The objectives of study were to estimate the impact of rotavirus infection on health-related quality of life (HRQL), to assess the social and emotional effects on the families of affected children. METHODS This study enrolled all (n = 527) RotaStrip®-positive (with further PCR detection) cases (0-18 years of age) hospitalized from April 2013 to December 2015 and their caregivers. A questionnaire comprising clinical (filled-in by the medical staff) and social (filled by the caregivers) sections was completed per child. RESULTS Main indicators of emotional burden reported by caregivers were compassion (reported as severe/very severe by 91.1% of parents), worry (85.2%), stress/anxiety (68.0%). Regarding social burden, 79.3% of caregivers reported the need to introduce changes into their daily routine due to rotavirus infection of their child. Regarding economic burden, 55.1% of parents needed to take days off work because of their child's sickness, and 76.1% of parents reported additional expenditures in the family's budget. Objective measures of their child's health status were not associated with HRQL of the family, as were the parent's subjective evaluation of their child's health and some sociodemographic factors. Parents were significantly more worried if their child was tearful (p = 0.006) or irritable (p < 0.001). Parents were more stressful/anxious if their child had a fever (p = 0.003), was tearful (p < 0.001), or was irritable (p < 0.001). Changes in parents' daily routines were more often reported if the child had a fever (p = 0.02) or insufficient fluid intake (p = 0.04). CONCLUSION Objective health status of the child did not influence the emotional, social or economic burden, whereas the parents' subjective perception of the child's health status and sociodemographic characteristics, were influential. A better understanding of how acute episodes affect the child and family, will help to ease parental fears and advise parents on the characteristics of rotavirus infection and the optimal care of an infected child.
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Plaza-Díaz J, Ruiz-Ojeda FJ, Gil-Campos M, Gil A. Immune-Mediated Mechanisms of Action of Probiotics and Synbiotics in Treating Pediatric Intestinal Diseases. Nutrients 2018; 10:nu10010042. [PMID: 29303974 PMCID: PMC5793270 DOI: 10.3390/nu10010042] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 12/24/2017] [Accepted: 01/03/2018] [Indexed: 12/21/2022] Open
Abstract
The pediatric population is continually at risk of developing infectious and inflammatory diseases. The treatment for infections, particularly gastrointestinal conditions, focuses on oral or intravenous rehydration, nutritional support and, in certain case, antibiotics. Over the past decade, the probiotics and synbiotics administration for the prevention and treatment of different acute and chronic infectious diseases has dramatically increased. Probiotic microorganisms are primarily used as treatments because they can stimulate changes in the intestinal microbial ecosystem and improve the immunological status of the host. The beneficial impact of probiotics is mediated by different mechanisms. These mechanisms include the probiotics' capacity to increase the intestinal barrier function, to prevent bacterial transferation and to modulate inflammation through immune receptor cascade signaling, as well as their ability to regulate the expression of selected host intestinal genes. Nevertheless, with respect to pediatric intestinal diseases, information pertaining to these key mechanisms of action is scarce, particularly for immune-mediated mechanisms of action. In the present work, we review the biochemical and molecular mechanisms of action of probiotics and synbiotics that affect the immune system.
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Affiliation(s)
- Julio Plaza-Díaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain.
- Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Armilla, 18016 Granada, Spain.
- Instituto de Investigación Biosanitaria ibs GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain.
| | - Francisco Javier Ruiz-Ojeda
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain.
- Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Armilla, 18016 Granada, Spain.
- Instituto de Investigación Biosanitaria ibs GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain.
| | - Mercedes Gil-Campos
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition CB12/03/30028), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Pediatric Research and Metabolism Unit, Reina Sofia University Hospital, Maimonides Institute for Biomedical Research (IMIBIC), Av. Menendez Pidal s/n, 14010 Córdoba, Spain.
| | - Angel Gil
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain.
- Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Armilla, 18016 Granada, Spain.
- Instituto de Investigación Biosanitaria ibs GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain.
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition CB12/03/30028), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Pellegrinelli L, Ianiro G, Pariani E, Monini M, Ruggeri FM, Binda S. Molecular characterization of rotavirus disclosed the first introduction of G12P[8] strain in northern Italy. Future Virol 2018. [DOI: 10.2217/fvl-2017-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: This paper discusses the unexpected findings from the RotaNet-Italy hospital-based surveillance study carried out in northern Italy. Materials & methods: From September 2015 to August 2016, 51 rotavirus-A (RVA) positive fecal samples were collected from children aged less than 15 years, who were hospitalized for acute gastroenteritis in Lombardy, northern Italy. Results: Molecular characterization revealed the predominance of the uncommon G12P[8] RVA strain, which was detected in 49% of cases. Phylogenetic analysis showed that these G12 strains clustered into lineage 3. Conclusion: To our knowledge, this is the first study on the G12P[8] genotype’s introduction in northern Italy. Our findings emphasize the importance of the surveillance of RVA gastroenteritis with the aim of obtaining new insight into the unusual newly emerging RVA strains.
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Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giovanni Ianiro
- Department of Veterinary Public Health & Food Safety, Istituto Superiore di Sanità, Rome, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Marina Monini
- Department of Veterinary Public Health & Food Safety, Istituto Superiore di Sanità, Rome, Italy
| | - Franco Maria Ruggeri
- Department of Veterinary Public Health & Food Safety, Istituto Superiore di Sanità, Rome, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Abstract
OBJECTIVES Oral rehydration is the standard in most current guidelines for young children with acute gastroenteritis (AGE). Failure of oral rehydration can complicate the disease course, leading to morbidity due to severe dehydration. We aimed to identify prognostic factors of oral rehydration failure in children with AGE. METHODS A prospective, observational study was performed at the Emergency department, Erasmus Medical Centre, Rotterdam, The Netherlands, 2010-2012, including 802 previously healthy children, ages 1 month to 5 years with AGE. Failure of oral rehydration was defined by secondary rehydration by a nasogastric tube, or hospitalization or revisit for dehydration within 72 hours after initial emergency department visit. RESULTS We observed 167 (21%) failures of oral rehydration in a population of 802 children with AGE (median 1.03 years old, interquartile range 0.4-2.1; 60% boys). In multivariate logistic regression analysis, independent predictors for failure of oral rehydration were a higher Manchester Triage System urgency level, abnormal capillary refill time, and a higher clinical dehydration scale score. CONCLUSIONS Early recognition of young children with AGE at risk of failure of oral rehydration therapy is important, as emphasized by the 21% therapy failure in our population. Associated with oral rehydration failure are higher Manchester Triage System urgency level, abnormal capillary refill time, and a higher clinical dehydration scale score.
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Rotavirus epidemiology and vaccine demand: considering Bangladesh chapter through the book of global disease burden. Infection 2017; 46:15-24. [DOI: 10.1007/s15010-017-1082-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/11/2017] [Indexed: 01/12/2023]
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Zaraket H, Charide R, Kreidieh K, Dbaibo G, Melhem NM. Update on the epidemiology of rotavirus in the Middle East and North Africa. Vaccine 2017; 35:6047-6058. [PMID: 28986034 DOI: 10.1016/j.vaccine.2017.09.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/07/2017] [Accepted: 09/22/2017] [Indexed: 12/16/2022]
Abstract
Rotavirus (RV) is the leading cause of severe acute gastroenteritis (AGE) worldwide. Consequently, we conducted a systematic literature review on articles studying RV in the 25 countries of the MENA region during the past 15years (2000-2015). The methods and reporting were set according to the 2015 preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) and based on the elements from the international prospective register of systematic reviews (PROSPERO). Our literature search identified 169 studies meeting our predefined inclusion criteria. Studies reporting on RV were conducted in 19 out of the 24 countries of the MENA region. The largest number of studies was reported in Turkey (n=32), Iran (n=31), Saudi Arabia (n=19) and Egypt (n=17). The majority of studies reporting on RV gastroenteritis rates were clinical observational studies. In 115 studies out of 169, RV was reported among in-patients whereas 35 studies reported RV among outpatients. The predominantly reported RV genotype in the region was G1[P8] followed by G2[P4] and G9[P8]. The majority of studies (n=108) were conducted among children less than 5years of age whereas the remaining studies reported on AGE among other age groups and rarely adults. In MENA countries, RV infection was reported all year round with peaks described in cold as well as hot months. This systematic review provides a current update on the epidemiology of RV-associated gastroenteritis in countries of the MENA region and draws attention to the major gaps existing in the continuous monitoring of RV.
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Affiliation(s)
- Hassan Zaraket
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rana Charide
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Khalil Kreidieh
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon; Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nada M Melhem
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
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Zaki A, Abousekkien M, Alkholy UM, Eid A. Effectiveness and impact of rotavirus vaccines in Saudi Arabia: A single hospital-based study. Arab J Gastroenterol 2017; 18:140-143. [DOI: 10.1016/j.ajg.2017.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 05/26/2017] [Accepted: 09/10/2017] [Indexed: 10/18/2022]
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Sabbe M, Berger N, Blommaert A, Ogunjimi B, Grammens T, Callens M, Van Herck K, Beutels P, Van Damme P, Bilcke J. Sustained low rotavirus activity and hospitalisation rates in the post-vaccination era in Belgium, 2007 to 2014. ACTA ACUST UNITED AC 2017; 21:30273. [PMID: 27418466 DOI: 10.2807/1560-7917.es.2016.21.27.30273] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 10/02/2015] [Indexed: 01/25/2023]
Abstract
In 2006, Belgium was the first country in the European Union to recommend rotavirus vaccination in the routine infant vaccination schedule and rapidly achieved high vaccine uptake (86-89% in 2007). We used regional and national data sources up to 7 years post-vaccination to study the impact of vaccination on laboratory-confirmed rotavirus cases and rotavirus-related hospitalisations and deaths. We showed that (i) from 2007 until 2013, vaccination coverage remained at 79-88% for a complete course, (ii) in children 0-2 years, rotavirus cases decreased by 79% (95% confidence intervals (CI): 68--89%) in 2008-2014 compared to the pre-vaccination period (1999--2006) and by 50% (95% CI: 14-82%) in the age group ≥ 10 years, (iii) hospitalisations for rotavirus gastroenteritis decreased by 87% (95% CI: 84-90%) in 2008--2012 compared to the pre-vaccination period (2002--2006), (iv) median age of rotavirus cases increased from 12 months to 17 months and (v) the rotavirus seasonal peak was reduced and delayed in all post-vaccination years. The substantial decline in rotavirus gastroenteritis requiring hospitalisations and in rotavirus activity following introduction of rotavirus vaccination is sustained over time and more pronounced in the target age group, but with evidence of herd immunity.
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Affiliation(s)
- Martine Sabbe
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
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Hegazi MA, Sayed MH, Sindi HH, Bekhit OE, El-Deek BS, Alshoudri FMY, Noorelahi AK. Is rotavirus still a major cause for diarrheal illness in hospitalized pediatric patients after rotavirus vaccine introduction in the Saudi national immunization program? Medicine (Baltimore) 2017; 96:e6574. [PMID: 28403085 PMCID: PMC5403082 DOI: 10.1097/md.0000000000006574] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Previous studies in Jeddah, western Saudi Arabia, showed rotavirus (RV) prevalence around 40% in pediatric inpatients with gastroenteritis (GE) with a maximum level during cooler months. Currently, there are no data on impact of rotavirus vaccine (RVV) on RV-GE in Saudi Arabia. Therefore, this study was conducted to assess impact of RVV on incidence and severity of RV-GE in hospitalized pediatric patients; 3 years after introduction of RVV in Saudi immunization program (SIP) in January, 2013.This cross-sectional observational study included GE cases under 5 years of age admitted to 2 tertiary hospitals, in Jeddah, from October to December, 2015. All included GE-cases had RV antigen detection in stool by immunochromatographic assay, complete data collection including RVV status and severity assessment (Vesikari score) in initial admission.During study period, a total of 359 GE cases in children under 5 years of age were hospitalized with 14 (3.9%) RV-GE confirmed cases. Mean age of RV-GE patients was 13.10 ± 5.70 months. All RV cases had severe GE and 1 case received RVV. Among other 345 GE cases, 35.7% did not receive RVV and 46.1% had severe GE. Severe GE (Vesikari score > 11) was more significantly identified among RV-GE cases than in other all-cause GE (P < .001). During same period of this study in 2012, 369 RV-GE out of 1193 total GE cases (31%) were hospitalized at 2 hospitals, so, number of hospitalized pediatric patients for all-cause and RV-GE in children under 5 years of age decreased significantly in 2015 RV season (compared to 2015 RV season, odds ratio for RV-GE in 2012: 11.04, 95% CI: 6.38-19.09).Logistic regression analysis of variables of this cross-sectional, hospital-based study in Jeddah, Saudi Arabia, 3 years after introduction of RVV in SIP, showed that among the studied variables, RVV was associated with remarkable reduction of hazard of all-cause and RV-GE in vaccinated and even in unvaccinated children under 5 years of age possibly by RVV herd effect. However, RV was still associated with severe GE-related hospitalizations in unvaccinated children against RV who were younger than 2 years and particularly in the 1st year of life, indicating need for more optimum rate of RVV coverage. Hopefully, further improvement in RVV coverage rate may make RV-GE a disease of the past in Saudi children.
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Affiliation(s)
- Moustafa Abdelaal Hegazi
- Department of Pediatrics, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pediatrics, Mansoura University Children's Hospital, Mansoura, Egypt
| | - Mohamed Hesham Sayed
- Department of Pediatrics, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Haifa Hasan Sindi
- Department of Pediatrics, Maternity and Children Hospital (Al-Mossadia), Jeddah, Saudi Arabia
| | - Osama Elsayed Bekhit
- Department of Pediatrics, Faculty of Medicine, Fayoum University, Egypt
- Department of Pediatrics, Hai Al-Jameah Hospital, Jeddah, Saudi Arabia
| | - Basem Salama El-Deek
- Department of Community Medicine and Public Health, Mansoura Faculty of Medicine, Mansoura, Egypt
- Department of Community Medicine and Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Amroo Khaled Noorelahi
- Department of Pediatrics, Maternity and Children Hospital (Al-Mossadia), Jeddah, Saudi Arabia
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Abstract
Foodborne viral illness, resulting from the consumption of contaminated food or water containing pathogenic viruses, remains a major public health problem globally with substantial economic impact. Major challenges regarding recognizing, detecting, characterizing, and effectively responding to foodborne viral threats to health exist. Adequate health crisis management is largely dependent on early detection of potential public health threats, which is hampered by changing trends in disease outbreaks, from localized clusters of disease in confined populations to dispersed outbreaks with excellent opportunity for further transmission. In addition, no precise and consistent global baseline syndrome and diagnostic surveillance information exists. An integrated multidisciplinary approach with a combination of sustained pathogen syndrome and diagnostic surveillance, genomics-based, and standardized global analytical networks gathering clinical, epidemiological and genetic data alike would be required to understand the dynamics of foodborne viral infection and to mitigate potential effects of future threats. A huge global effort in virus syndrome and diagnostic surveillance may be justified in the light of global health impact in general, and timely with the development of new metagenomics tools that hold the promise of not only identifying viral pathogens, but possibly the complete microbiome in a single assay.
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Marchetti F, Bonati M, Maestro A, Zanon D, Rovere F, Arrighini A, Barbi E, Bertolani P, Biban P, Da Dalt L, Guala A, Mazzoni E, Pazzaglia A, Perri PF, Reale A, Renna S, Urbino AF, Valletta E, Vitale A, Zangardi T, Clavenna A, Ronfani L. Oral Ondansetron versus Domperidone for Acute Gastroenteritis in Pediatric Emergency Departments: Multicenter Double Blind Randomized Controlled Trial. PLoS One 2016; 11:e0165441. [PMID: 27880811 PMCID: PMC5120790 DOI: 10.1371/journal.pone.0165441] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/07/2016] [Indexed: 01/28/2023] Open
Abstract
The use of antiemetics for vomiting in acute gastroenteritis in children is still a matter of debate. We conducted a double-blind randomized trial to evaluate whether a single oral dose of ondansetron vs domperidone or placebo improves outcomes in children with gastroenteritis. After failure of initial oral rehydration administration, children aged 1–6 years admitted for gastroenteritis to the pediatric emergency departments of 15 hospitals in Italy were randomized to receive one oral dose of ondansetron (0.15 mg/kg) or domperidone (0.5 mg/kg) or placebo. The primary outcome was the percentage of children receiving nasogastric or intravenous rehydration. A p value of 0.014 was used to indicate statistical significance (and 98.6% CI were calculated) as a result of having carried out two interim analyses. 1,313 children were eligible for the first attempt with oral rehydration solution, which was successful for 832 (63.4%); 356 underwent randomization (the parents of 125 children did not give consent): 118 to placebo, 119 to domperidone, and 119 to ondansetron. Fourteen (11.8%) needed intravenous rehydration in the ondansetron group vs 30 (25.2%) and 34 (28.8%) in the domperidone and placebo groups, respectively. Ondansetron reduced the risk of intravenous rehydration by over 50%, both vs placebo (RR 0.41, 98.6% CI 0.20–0.83) and domperidone (RR 0.47, 98.6% CI 0.23–0.97). No differences for adverse events were seen among groups. In a context of emergency care, 6 out of 10 children aged 1–6 years with vomiting due to gastroenteritis and without severe dehydration can be managed effectively with administration of oral rehydration solution alone. In children who fail oral rehydration, a single oral dose of ondansetron reduces the need for intravenous rehydration and the percentage of children who continue to vomit, thereby facilitating the success of oral rehydration. Domperidone was not effective for the symptomatic treatment of vomiting during acute gastroenteritis.
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Affiliation(s)
- Federico Marchetti
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo”, Trieste, Italy
| | - Maurizio Bonati
- Laboratory for Mother and Child Health, Department of Public Health, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Alessandra Maestro
- Pharmacy and Clinical Pharmacology, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo”, Trieste, Italy
| | - Davide Zanon
- Pharmacy and Clinical Pharmacology, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo”, Trieste, Italy
| | - Francesca Rovere
- Pharmacy and Clinical Pharmacology, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo”, Trieste, Italy
| | - Alberto Arrighini
- Pediatric Emergency Department, Presidio Ospedale dei Bambini, A.O. Spedali Civili, Brescia, Italy
| | - Egidio Barbi
- Pediatric Emergency Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo”, Trieste, Italy
| | - Paolo Bertolani
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Paolo Biban
- Pediatric Emergency Department, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Andrea Guala
- Department of Pediatrics, Ospedale Castelli, Verbania, Italy
| | - Elisa Mazzoni
- Department of Pediatrics, Ospedale Maggiore, Bologna, Italy
| | - Anna Pazzaglia
- Emergency Department, Pediatric Hospital A. Meyer, Firenze, Italy
| | | | - Antonino Reale
- Emergency Department, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italy
| | - Salvatore Renna
- Emergency Room and Emergency Medicine Division, G. Gaslini Institute, Genova, Italy
| | | | - Enrico Valletta
- Department of Pediatrics, Ospedale G.B. Morgagni - L. Pierantoni, Forlì, Italy
| | - Antonio Vitale
- Department of Pediatrics and Pediatric Emergency, "San Giuseppe Moscati" National Hospital (AORN), Avellino, Italy
| | - Tiziana Zangardi
- Pediatric Emergency Department, Azienda Ospedaliera - University of Padova, Padova, Italy
| | - Antonio Clavenna
- Laboratory for Mother and Child Health, Department of Public Health, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo”, Trieste, Italy
- * E-mail:
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Marinosci A, Doit C, Koehl B, Belhacel K, Mariani Kurkdjian P, Melki I, Renaud A, Lemaitre C, Ammar Khodja N, Blachier A, Bonacorsi S, Faye A, Lorrot M. [Nosocomial rotavirus gastroenteritis]. Arch Pediatr 2016; 23:1118-1123. [PMID: 27642146 DOI: 10.1016/j.arcped.2016.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 06/22/2016] [Accepted: 07/07/2016] [Indexed: 11/16/2022]
Abstract
Rotavirus is the most common cause of gastroenteritis in children requiring hospitalization. It is a very resistant and contagious virus causing nosocomial gastroenteritis. In France, the vaccine against rotavirus has been available since 2006, but the vaccine is not recommended for infant vaccination. The aim of this retrospective study was to describe nosocomial rotavirus gastroenteritis (NRGE) and to assess its impact on children hospitalized in the General Pediatrics Department of Robert-Debré Hospital (Paris) between 1 January 2009 and 31 December 2013. We analyzed the demographic characteristics of children (age, term birth, underlying diseases) and the severity of the NRGE (oral or intravenous hydration), and assessed whether these children could benefit from vaccination against rotavirus. RESULTS One hundred thirty-six children presented nosocomial rotavirus infection, with an incidence of 2.5 NRGE per 1000 days of hospitalization. The incidence of NRGE was stable between 2009 and 2013 despite the introduction of specific hygiene measures. The average age of the children was 7 months (range: 0.5-111 months). Most often NRGE occurred in children hospitalized for respiratory diseases (65% of cases) and requiring prolonged hospitalization (median: 18 days). One-third of children were born premature (25%). Hydration was oral in 80 patients (59%), by intravenous infusion in 18 patients (13%), and intraosseous in one patient. Half of the patients were aged less than 5 months and could benefit from the protection afforded by vaccination. CONCLUSION NRGE are common. Rotavirus mass vaccination should have a positive impact on the incidence of NRGE by reducing the number of children hospitalized for gastroenteritis, therefore indirectly reducing the number of hospital cross-infections of hospitalized children who are too young to be vaccinated.
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Affiliation(s)
- A Marinosci
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - C Doit
- Service de microbiologie, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Équipe d'hygiène hospitalière, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - B Koehl
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France
| | - K Belhacel
- Équipe d'hygiène hospitalière, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | | | - I Melki
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France
| | - A Renaud
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - C Lemaitre
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France
| | - N Ammar Khodja
- Équipe d'hygiène hospitalière, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - A Blachier
- Département d'informatique médical (DIM), hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - S Bonacorsi
- Service de microbiologie, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France; Inserm, IAME, UMR 1137, 75018 Paris, France
| | - A Faye
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France; Inserm, ECEVE UMRS 1123, 75019 Paris, France
| | - M Lorrot
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France; Inserm, ECEVE UMRS 1123, 75019 Paris, France.
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Amodio E, Tabacchi G, Cracchiolo M, Sciuto V, Vitale F. Hospitalisation of children aged 0-59 months with rotavirus gastro-enteritis before the introduction of routine vaccination (Sicily 2003-2012). Paediatr Int Child Health 2016; 35:319-23. [PMID: 26744156 DOI: 10.1080/20469047.2015.1109228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Recent evidence demonstrates that rotavirus vaccination is the best strategy for reducing rotavirus gastro-enteritis (RVGE) in young children. AIMS This study describes the epidemiology of RVGE hospitalisation of Sicilian children before universal rotavirus vaccination was introduced into the regional immunisation programme in January 2013. METHODS An observational study was undertaken by analyzing data obtained from the Regional Hospital Discharge database, including hospitalisation from 2003 to 2012 of subjects aged 0-59 months who lived in Sicily. Children discharged with the rotavirus-specific ICD-9-CM code of 008·61 on first or any diagnosis stage were considered to be RVGE cases. RESULTS From 2003 to 2012, 9317 children (median age 19 months, M/F ratio 1·19) were hospitalised with a diagnosis of RVGE. During the study period, annual rates of hospitalisation were between 2·64 and 4·68 cases/1000 children (mean 3·74 cases). Incidence rates were higher in children aged 6-11 months (8·85/1,000 children/year), decreasing significantly with age (P<0·001). RVGE hospitalisation peaked during winter and spring with a statistically significant downward trend throughout summer and autumn. CONCLUSION During the study period, the cumulative risk of hospitalisation with RVGE was determined to be about one in 54 Sicilian children in the 1st 5 years of life. Although the present study cannot be considered a proper pharmaco-economic evaluation, the findings suggest that in Sicily the health and economic burden of RVGE hospitalisation strongly supports the introduction of rotavirus vaccination into the regional immunisation programme as a probably cost-saving intervention.
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Affiliation(s)
- Emanuele Amodio
- Department of Sciences for Health Promotion and Mother-Child Care G. d'Alessandro , Palermo, Italy
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Arístegui J, Ferrer J, Salamanca I, Garrote E, Partidas A, San-Martin M, San-Jose B. Multicenter prospective study on the burden of rotavirus gastroenteritis in children less than 3 years of age in Spain. BMC Infect Dis 2016; 16:549. [PMID: 27724892 PMCID: PMC5057213 DOI: 10.1186/s12879-016-1890-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 10/01/2016] [Indexed: 12/16/2022] Open
Abstract
Background Rotavirus is acknowledged as an important cause of paediatric gastroenteritis worldwide. In Spain, comprehensive data on the burden of rotavirus disease was lacking. Methods A prospective, multicenter, observational study was carried out, during the winter season, from October to April 2014 in selected areas of Spain (Catalonia, Basque Country, Andalusia) to estimate the frequency and characteristics of acute gastroenteritis (AGE) and rotavirus gastroenteritis (RVGE) in children ≤3 years of age seeking medical care in primary care and emergency department centres. Results Of the 1087 episodes of AGE registered, 33.89 % were RVGE positive. The estimated incidence of RVGE, was 40.3 (95 % CI 36.1–44.8) episodes per 10,000 child-months in children ≤ 3 years of age and the 5-month (December-April) seasonal RVGE incidence rate was 2.01 [1.81–2.24] per 100 children. No vaccination and attending a day care centre were the main risk factors for RV infection. RVGE infected children presented more frequently with fever (63.9 % vs. 45.1 %, p = 0.009), vomiting (61.2 % vs. 44.3 %, p = 0.015), suffered more dehydration, and were hospitalised and went to the emergency room more often (41.7 % vs. 15.7 %, p <0.001) than non-RVGE infected ones. Children were usually more tired (77.5 % vs. 54.2 %, p <0.001), tearful, (47.2 % vs. 34.8 %, p <0.001), and easily irritated (76.5 % vs. 59.8 %, p <0.001), and parents were more concerned (41.7 % vs. 15.7 %, p <0.001) and suffered more working rhythm disturbances (39.0 % vs. 22.9 %, p <0.001). The cost for families of RVGE cases was significantly higher than the cost of non-RVGE infected ones (47.3 vs 36.7 euros, p = 0.011). Vaccinated children suffered less clinical symptoms and no hospitalization. Therefore, vaccination decreases the psychosocial stressors caused by the disease in the family. Conclusions Rotavirus infections are responsible for a substantial proportion of AGE cases in children ≤3 years of age in Spain attended at primary care visits. RVGE episodes are associated with greater clinical severity, greater alterations in the child´s behaviour, and higher parental distress. The outcomes of the present study recommend that routine rotavirus vaccination in infants ≤3 years of age could considerably reduce the serious burden of this potentially serious childhood disease. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1890-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J Arístegui
- Unidad de Infectología Pediátrica, Hospital de Basurto, Universidad del País Vasco (UPV/EHU), Avenida de Montevideo 18, 48013, Bilbao, Vizcaya, Spain.
| | - J Ferrer
- Pediatría, CAP Roquetes Canteres, Barcelona, Spain
| | - I Salamanca
- Pediatría, Instituto Hispalense de Pediatría,, Sevilla, Spain
| | - E Garrote
- Unidad de Infectología Pediátrica, Hospital de Basurto, Universidad del País Vasco (UPV/EHU), Avenida de Montevideo 18, 48013, Bilbao, Vizcaya, Spain
| | - A Partidas
- Unidad de Infectología Pediátrica, Hospital de Basurto, Universidad del País Vasco (UPV/EHU), Avenida de Montevideo 18, 48013, Bilbao, Vizcaya, Spain
| | - M San-Martin
- Medical Department. Sanofi Pasteur MSD, Madrid, Spain
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Tichopád A, Müllerová J, Jackowska T, Nemes E, Pazdiora P, Sloesen B, Štefkovičová M. Cost Burden of Severe Community-Acquired Rotavirus Gastroenteritis Requiring Hospitalization in the Czech Republic, Slovakia, Poland, and Hungary: A Retrospective Patient Chart Review. Value Health Reg Issues 2016; 10:53-60. [PMID: 27881278 DOI: 10.1016/j.vhri.2016.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To provide valuable local data on the economic burden of rotavirus gastroenteritis (RVGE) for decision making on introduction of rotavirus vaccination in Central European countries. METHODS We conducted a retrospective patient hospital chart review during the winter RVGE peak in the Czech Republic (n = 109), Hungary (n = 109), Poland, (n = 112), and Slovakia (n = 115) to estimate resource use and associated costs from the payer's perspective in children younger than 5 years with severe RVGE requiring hospitalization. Microcosting analysis was used to estimate the average costs of treating RVGE inpatients including pre- and posthospitalization costs. RESULTS The average cost of treatment was €476, €316, €741, and €594 in the Czech Republic, Hungary, Poland, and Slovakia, respectively. Extrapolating these costs to the total number of RVGE hospitalizations gives annual cost estimates of €2.1 million, €1.5 million, €13.2 million, and €1.5 million, respectively. The main component of expenditure in all the four countries is the hospital stay, but wide variation among countries was observed (total cost of treating RVGE in hospital was almost 2.5-fold higher in Poland than in Hungary). In countries with diagnosis related group (DRG) costs available, the best agreement between real resource-use-driven costs and the DRG cost was found in the Czech Republic and Hungary, with differences of only €22 and €33, respectively. In Poland, the microcosting indicated higher overall costs incurred in hospital than the DRG cost, with a difference exceeding €190. CONCLUSIONS Hospitalization of children with RVGE represents a substantial economic burden for the national health systems in these countries.
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Affiliation(s)
| | | | - Teresa Jackowska
- Department of Pediatrics, the Center of Postgraduate Medical Education, Warsaw, Poland
| | - Eva Nemes
- Department of Pediatrics, Clinical Center, University of Debrecen, Debrecen, Hungary
| | - Petr Pazdiora
- Department of Epidemiology of Medical Faculty, Charles University, Pilsen, Czech Republic
| | | | - Mária Štefkovičová
- Faculty of Health Care, Alexander Dubček University of Trenčín, Trenčín, Slovakia
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Yamin D, Atkins KE, Remy V, Galvani AP. Cost-Effectiveness of Rotavirus Vaccination in France-Accounting for Indirect Protection. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:811-819. [PMID: 27712709 DOI: 10.1016/j.jval.2016.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 04/14/2016] [Accepted: 05/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Vaccination against rotavirus has shown great potential for reducing the primary cause of severe childhood gastroenteritis. Previous economic evaluations of rotavirus vaccination in France have not modeled the potential impact of vaccines on disease burden via reduced transmission. OBJECTIVE To determine the cost-effectiveness of the introduction of pentavalent rotavirus vaccination into the French infant vaccination schedule. METHODS We developed an age-structured model of rotavirus transmission calibrated to 6 years of French gastroenteritis incidence and vaccine clinical trial data. We evaluated the cost-effectiveness of pentavalent rotavirus vaccination considering that 75% of infants would receive the three-dose vaccine course. RESULTS Our model predicts that rotavirus vaccination will decrease rotavirus gastroenteritis incidence and associated clinical outcomes in vaccinated and unvaccinated individuals, delay the seasonal peak of infection, and increase the age of infection. From the societal perspective, our base-case scenario predicts that vaccination coverage would be cost-effective at €115 or €135 per vaccine course at €28,500 and €39,500/quality-adjusted life-year (QALY) gained, respectively, and suggests that almost 95% of the financial benefits will be recouped within the first 5 years following vaccination implementation. From the third-party payer perspective, incremental cost-effectiveness ratios ranged from €12,500 to €20,000/QALY, respectively. Our uncertainty analysis suggests that findings were sensitive to various assumptions including the number of hospitalizations, outpatient visits, and the extent of QALY losses per rotavirus episode. CONCLUSIONS Introducing pentavalent rotavirus vaccination into the French infant vaccination schedule would significantly reduce the burden of rotavirus disease in children, and could be cost-effective under plausible conditions.
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Affiliation(s)
- Dan Yamin
- Department of Industrial Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel; Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA.
| | - Katherine E Atkins
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA; Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA
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Ali Z, Harastani H, Hammadi M, Reslan L, Ghanem S, Hajar F, Sabra A, Haidar A, Inati A, Rajab M, Fakhouri H, Ghanem B, Baasiri G, Gerbaka B, Zaraket H, Matar GM, Dbaibo G. Rotavirus Genotypes and Vaccine Effectiveness from a Sentinel, Hospital-Based, Surveillance Study for Three Consecutive Rotavirus Seasons in Lebanon. PLoS One 2016; 11:e0161345. [PMID: 27571515 PMCID: PMC5003350 DOI: 10.1371/journal.pone.0161345] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/03/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction Globally, rotavirus (RV) is the leading cause of gastroenteritis (GE) in children. Longitudinal data about changes in RV genotype distribution and vaccine effectiveness (VE) are scarce. This study was conducted in Lebanon over 3 consecutive RV seasons to estimate the rate of RVGE hospitalization, identify RV genotypes, determine the seasonal and geographical variations, and calculate RV VE. Materials and Methods This prospective, multicenter, hospital-based surveillance study was conducted between 2011 and 2013 and enrolled children (<5 years) admitted for GE. Socio-demographic and clinical data about the current episode of GE at admission were collected. Genotypes were determined from stool samples testing positive for RV by PCR. Results Of 1,414 cases included in the final analysis, 83% were <2 years old and 55.6% were boys. Median duration of hospitalization was 4 days and 91.6% of GE cases were severe (Vesikari score ≥11). PCR testing showed that 30.3% of subjects were RV-positive of which 62.1% had fever versus 71.1% of RV-negative subjects (P = 0.001). RV was predominantly detected in the cold season from November till March (69.9%). G and P genotype pairs for all RV-positive stool specimens showed a predominance of G1P[8] in 36% (n = 154) of specimens, G9P[8] in 26.4% (n = 113), and G2P[4] in 17.8% (n = 76). RV-negative subjects were more likely to be RV-vaccinated (21%) compared to the RV-positive subjects (11.3%) (P<0.001), with a vaccine breakthrough rate of 18.8%. The ratio of RV1-vaccinated for each RV5-vaccinated subject was 7.8 and VE against RV disease was 68.4% (95%CI, 49.6%-80.2%). Conclusion RV is a major cause of GE requiring hospitalization of children under 5 years of age in Lebanon. A few genotypes predominated over the three RV seasons studied. Mass RV vaccination will likely decrease the burden of hospitalization due to RV. VE is similar to what has been observed for other middle-income countries.
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Affiliation(s)
- Zainab Ali
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Houda Harastani
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Moza Hammadi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Lina Reslan
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Soha Ghanem
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Farah Hajar
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Ahmad Sabra
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Amjad Haidar
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Adlette Inati
- Department of Pediatrics, Nini Hospital, Tripoli, Lebanon
| | - Mariam Rajab
- Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon
| | - Hassan Fakhouri
- Department of Pediatrics, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Bassam Ghanem
- Department of Pediatrics, Nabatieh Governmental Hospital, Nabatieh, Lebanon
| | | | - Bernard Gerbaka
- Department of Pediatrics, Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Hassan Zaraket
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan M. Matar
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan Dbaibo
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- * E-mail: ;
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Mrozek-Budzyn D, Kieltyka A, Majewska R, Augustyniak M. The effectiveness of rotavirus vaccine in preventing acute gastroenteritis during rotavirus seasons among Polish children. Arch Med Sci 2016; 12:614-20. [PMID: 27279856 PMCID: PMC4889696 DOI: 10.5114/aoms.2016.59935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/30/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Rotavirus is the main etiological cause of intestinal infections in children. Voluntary rotavirus vaccines were included in the Polish vaccination schedule in 2007. The aim of this study was to assess the effectiveness of a completed rotavirus vaccination course in preventing acute gastroenteritis in Polish infants during their first five years of life. MATERIAL AND METHODS This was a retrospective cohort study conducted in Lesser Poland (Malopolska Province). The sample population included a group of 303 children who received the completed rotavirus vaccination course and 303 children not vaccinated against rotavirus. The date of the child's acute gastroenteritis diagnosis and his or her vaccination history were extracted from the physicians' records. Each kind of diagnosed acute gastroenteritis during winter-spring rotavirus seasons was treated as the endpoint. The relative risk of having gastrointestinal infection was assessed using the hazard ratio from the Cox proportional hazards regression model. RESULTS In the examined group, 96 (15.8%) children had winter-spring gastrointestinal infections. In the non-vaccinated children, the cumulative incidence of these infections in the first 5 years of life was 20.8%, whereas in the children vaccinated with Rotarix it was only 10.9%. Those who were vaccinated with Rotarix had a 44% reduction in the risk of a winter-spring acute gastroenteritis infection compared to those not vaccinated with Rotarix (p = 0.005). Birth weight less than 2500 g increased the risk of the infection twofold and also reached statistical significance (p = 0.044). CONCLUSIONS The results showed that Rotarix is effective in preventing acute gastroenteritis in Polish children during rotavirus seasons.
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Affiliation(s)
- Dorota Mrozek-Budzyn
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Kieltyka
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Majewska
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Malgorzata Augustyniak
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
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Gervasi G, Capanna A, Mita V, Zaratti L, Franco E. Nosocomial rotavirus infection: An up to date evaluation of European studies. Hum Vaccin Immunother 2016; 12:2413-8. [PMID: 27185183 PMCID: PMC5027725 DOI: 10.1080/21645515.2016.1183858] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Rotavirus (RV) is worldwide considered as the most important viral agent of acute gastroenteritis in children less than 5 y. Since 2006, the availability of anti-RV vaccines has deeply modified the incidence and economic burden of RV infection. In Europe, some countries have introduced an anti-RV vaccination program in the last 10 y. Although community acquired RV (CARV) disease is the most studied condition of RV infection, recently some authors have highlighted the importance of nosocomial RV (nRV) disease as an emerging public health issue. The aim of this review is to summarize the epidemiology of both CARV and nRV, in order to discuss the difficulty of a clear evaluation of the burden of the disease in absence of comparable data. In particular, we focused our attention to European studies regarding nRV in terms of divergences related to definition, report of incidence rate and methodological issues.
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Affiliation(s)
- G Gervasi
- a Specialization School for Hygiene and Preventive Medicine , University of Rome Tor Vergata , Rome , Italy
| | - A Capanna
- a Specialization School for Hygiene and Preventive Medicine , University of Rome Tor Vergata , Rome , Italy
| | - V Mita
- b Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
| | - L Zaratti
- b Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
| | - E Franco
- b Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
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Giménez Sánchez F, Nogueira EJ, Sánchez Forte M, Ibáñez Alcalde M, Cobo E, Angulo R, Garrido Fernández P. Impact of vaccination uptake on hospitalizations due to rotavirus acute gastroenteritis in 2 different socioeconomic areas of Spain. Hum Vaccin Immunother 2016; 12:1035-9. [PMID: 26810147 PMCID: PMC4962960 DOI: 10.1080/21645515.2015.1118592] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/19/2015] [Accepted: 11/06/2015] [Indexed: 12/22/2022] Open
Abstract
Rotavirus is the leading cause of hospitalization due to acute gastroenteritis (AGE) in infants and toddlers. However, rotavirus vaccination has been associated with a decline in hospitalization rates due to rotavirus AGE. A descriptive retrospective study was conducted to analyze the impact of rotavirus vaccination on the rate of hospitalizations due to AGE among children ≤2 years old in 2 areas of the province of Almería, Spain. After eight years of rotavirus vaccination, rates of hospitalizations due to rotavirus AGE are diminished. This decline is closely related to vaccine coverage in the studied areas.
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Affiliation(s)
- Francisco Giménez Sánchez
- Instituto Balmis de Vacunas, Unidad de Infectología Pediátrica, Hospital Torrecárdenas, Almería, Spain
- Institiuto Hispalense de Pediatria, Granada, Spain
| | | | | | | | - Elvira Cobo
- Department of Pediatrics, Hospital Torrecárdenas, Almería, Spain
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Community-Acquired Rotavirus Gastroenteritis Compared with Adenovirus and Norovirus Gastroenteritis in Italian Children: A Pedianet Study. Int J Pediatr 2016; 2016:5236243. [PMID: 26884770 PMCID: PMC4738938 DOI: 10.1155/2016/5236243] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/06/2015] [Accepted: 12/13/2015] [Indexed: 11/17/2022] Open
Abstract
Background. Rotavirus (RV) is the commonest pathogen in the hospital and primary care settings, followed by Adenovirus (AV) and Norovirus (NV). Only few studies that assess the burden of RV gastroenteritis at the community level have been carried out. Objectives. To estimate incidence, disease characteristics, seasonal distribution, and working days lost by parents of RV, AV, and NV gastroenteritis leading to a family pediatrician (FP) visit among children < 5 years. Methods. 12-month, observational, prospective, FP-based study has been carried out using Pedianet database. Results. RVGE incidence was 1.04 per 100 person-years with the highest incidence in the first 2 years of life. Incidences of AVGEs (1.74) and NVGEs (1.51) were slightly higher with similar characteristics regarding age distribution and symptoms. Risk of hospitalisation, access to emergency room (ER), and workdays lost from parents were not significantly different in RVGEs compared to the other viral infections. Conclusions. Features of RVGE in terms of hospitalisation length and indirect cost are lower than those reported in previous studies. Results of the present study reflect the large variability of data present in the literature. This observation underlines the utility of primary care networks for AGE surveillance and further studies on community-acquired gastroenteritis in children.
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Mattei A, Sbarbati M, Fiasca F, Angelone AM, Mazzei MC, di Orio F. Temporal trends in hospitalization for rotavirus gastroenteritis: A nationwide study in Italy, 2005-2012. Hum Vaccin Immunother 2016; 12:534-9. [PMID: 26337458 PMCID: PMC5049727 DOI: 10.1080/21645515.2015.1081726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/14/2015] [Accepted: 08/06/2015] [Indexed: 11/07/2022] Open
Abstract
AGE severity is linked to etiology, and Rotavirus (RV) accounts for most of severe cases. In 2009 the World Health Organization recommended RV vaccination for all children. Worldwide a number of Countries implemented RV vaccination in their pediatric immunisation programmes, but only a limited number in Europe. This study was designed to estimate the proportion of RVGE among children aged <6 y who were diagnosed with AGE and admitted to hospitals in Italy during the years 2005-2012. A total of 334,982 hospital discharge forms were collected, being 79,344 hospitalizations associated with RV. The average hospitalization rate (HR) was 146/100,000 children for RVGE in primary diagnosis (PD) and 150/100,000 children for RVGE in secondary diagnosis (SD). Since 2008 the RVGE hospitalization figures and rates (HRs) in SD exceed those in PD. The majority of RVGE hospitalizations (33.67%) were reported among children aged ≤ 2 years. Despite some limitations due to the hospital discharge database (HDD) synthetic contents and low potential for clinical interpretation, the analysis of national HDD, including PD and SD, documents that RV still represents a consistent cause of pediatric hospitalizations in Italy.
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Affiliation(s)
- Antonella Mattei
- Medical Statistics; Section of Public Health; Department of Life, Health and Environmental Sciences; University of L'Aquila; L'Aquila, Italy
| | - Margherita Sbarbati
- Department of Maternal and Child Health; Local Health Unit of Rieti; Rieti, Italy
| | - Fabiana Fiasca
- Clinical Medicine and Public Health; Department of Life, Health and Environmental Sciences; University of L'Aquila; L'Aquila, Italy
| | - Anna Maria Angelone
- Department of Life, Health and Environmental Sciences; University of L'Aquila; L'Aquila, Italy
| | - Maria Chiara Mazzei
- Epidemiology, Prevention, and Rehabilitation of Chronic-Degenerative Diseases; Department of Life, Health and Environmental Sciences; University of L'Aquila; L'Aquila, Italy
| | - Ferdinando di Orio
- General and Applied Hygiene; Section of Public Health; Department of Life, Health and Environmental Sciences; University of L'Aquila; L'Aquila, Italy
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Karmann A, Jurack A, Lukas D. Recommendation of rotavirus vaccination and herd effect: a budget impact analysis based on German health insurance data. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2015; 16:719-31. [PMID: 25135769 PMCID: PMC4534507 DOI: 10.1007/s10198-014-0624-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 08/05/2014] [Indexed: 05/25/2023]
Abstract
The objective of this study was to assess the budget impact and health effects of introducing rotavirus (RV) vaccination in Saxony, Germany, from a health insurance perspective. Special emphasis is given to the herd effect. We analyzed direct medical and non-medical costs of RV infection for Social Health Insurance between 2007 and 2010 based on 360,000 routine data observations from the AOK PLUS for children below 5 years of age. We compared the actual annual number of RV cases (vaccination scenario) with the number derived from 2005 (no vaccination, base case scenario). The vaccination coverage rate has increased from 5% to 61% between 2007 and 2010. The number of RV cases decreased by 21% from 32,274 in 2007 to 25,614 in 2010. Based on vaccination coverage, the total cost savings per 1,000 children due to RV vaccination was estimated to be 39,686 Euros. The overall share of outpatient costs was 60%. Mean gross cost savings were expected to be 304 Euros per avoided case. The net cost savings were expected to be 19 Euros per avoided case. About 59% of total savings was due to herd protection resulting from increasing vaccine rates. The herd effect per avoided case increased with increasing vaccine coverage. Incidence of RV cases, vaccination costs and days absent from work were sensitive parameters. This retrospective analysis showed that the increase in RV vaccination coverage in Saxony has been budget neutral if not cost saving for sick funds.
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Affiliation(s)
- Alexander Karmann
- Fakultät Wirtschaftswissenschaften, Gesundheitsökonomisches Zentrum, TU Dresden, 01062 Dresden, Germany
| | - Andrea Jurack
- Lehrstuhl für Allokationstheorie, Fakultät Wirtschaftswissenschaften, TU Dresden, 01062 Dresden, Germany
| | - Daniel Lukas
- Lehrstuhl für Wirtschaftsforschung und Wirtschaftspolitik, Fakultät Wirtschaftswissenschaften, TU Dresden, 01062 Dresden, Germany
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48
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Rotavirus vaccines: a story of success. Clin Microbiol Infect 2015; 21:735-43. [DOI: 10.1016/j.cmi.2015.01.027] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 11/19/2022]
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Standaert B, Van de Mieroop E, Nelen V. Exploring the potential impact of rotavirus vaccination on work absenteeism among female administrative personnel of the City of Antwerp through a retrospective database analysis. BMJ Open 2015; 5:e007453. [PMID: 26129633 PMCID: PMC4486949 DOI: 10.1136/bmjopen-2014-007453] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Rotavirus vaccination has been reimbursed in Belgium since November 2006 with a high uptake (>85%). Economic analyses of the vaccine have been reported, including estimates of indirect cost gain related to the reduction in work absenteeism. The objective of this study was to evaluate the latter parameter using real-life data. DESIGN AND SETTING A simple model estimated the reduction in absent workdays per working mother with a firstborn baby after the introduction of the rotavirus vaccine. Next, data on work absences were retrospectively analysed (from 2003 to 2012) using a database of administrative employees (n=11,600 working women per year) in the City of Antwerp. Observed reductions in absenteeism after the introduction of the vaccine were compared with the results from the model. These reductions would most likely be observed during the epidemic periods of rotavirus (from January to the end of May) for short-duration absences of ≤ 5 days. We compared data from outside epidemic periods (from June to December), expecting no changes over time prevaccine and postvaccine introduction, as well as with a control group of women aged 30-35 years with no first child. RESULTS Model estimates were 0.73 working days gained per working mother. In the database of the City of Antwerp, we identified a gain of 0.88 working days during the epidemic period, and an accumulated gain of 2.24 days over a 3-year follow-up period. In the control group, no decrease in absenteeism was measured. Giving vaccine access to working mothers resulted in an estimated accumulated net cost gain of €187 per mother. CONCLUSIONS Reduction in absenteeism among working mothers was observed during periods of the epidemic after the introduction of the rotavirus vaccine in Belgium. This reduction is in line with estimates of indirect cost gains used in economic evaluations of the rotavirus vaccine. TRIAL REGISTRATION NUMBER HO-12-12768.
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Affiliation(s)
| | - Els Van de Mieroop
- Department of Public Health, Provincial Institute of Hygiene, Antwerp, Belgium
| | - Vera Nelen
- Department of Public Health, Provincial Institute of Hygiene, Antwerp, Belgium
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50
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O’Ryan M, Giaquinto C, Benninghoff B. Human rotavirus vaccine (Rotarix): focus on effectiveness and impact 6 years after first introduction in Africa. Expert Rev Vaccines 2015; 14:1099-112. [DOI: 10.1586/14760584.2015.1059282] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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