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Di Martino G, Cedrone F, D’Addezio M, Odio C, Di Giovanni P, Trebbi E, Tognaccini L, Romano F, Staniscia T. Incidence of Rotavirus-Related Hospitalizations in an Italian Southern Region from 2015 to 2021. Diseases 2024; 12:26. [PMID: 38248377 PMCID: PMC10814902 DOI: 10.3390/diseases12010026] [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: 12/26/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024] Open
Abstract
(1) Background: Rotavirus is one of the leading causes of severe diarrhea and dehydration in infants and young children worldwide. The economic and social burden of rotavirus-related hospitalizations, particularly among children, remains a pressing concern for healthcare systems across the globe. Healthcare infrastructure and access to medical care can vary significantly within the region. Differences in the availability of healthcare facilities and the quality of care may influence the management and outcomes of rotavirus cases. (2) Methods: This was a retrospective study performed in the Abruzzo region, Italy. The study considered all hospitalization due to rotavirus gastroenteritis that occurred in the Abruzzo region from the year 2015 to 2021. Data were extracted from the hospital discharge records. The trend in hospital admissions, hospitalization costs and length of stay were evaluated and analyzed. (3) Results: A total of 664 admissions were reported during the study period. The incident rate grew till year 2019 with an annual percentage change of +13.9% (95%CI 12.6-15.2, p < 0.001). During the pandemic years, the incident rate showed a significant decrease with an annual percentage change of 12.5% (95%CI 15.5-9.3, p = 0.004). The length of stay of admissions was significantly higher among patients aged less than 1 year. (4) Conclusions: Rotavirus admission represents a heavy burden even in a high-income country such as Italy. These findings have the potential to inform targeted public health interventions, including vaccination strategies, and improve the overall well-being of children.
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Affiliation(s)
- Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (P.D.G.); (T.S.)
- Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Michela D’Addezio
- Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Camillo Odio
- Digital Health Unit, Department of Health, Abruzzo Region, 65100 Pescara, Italy;
| | - Pamela Di Giovanni
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (P.D.G.); (T.S.)
| | - Edoardo Trebbi
- Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome, 00100 Rome, Italy; (E.T.); (L.T.); (F.R.)
| | - Livia Tognaccini
- Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome, 00100 Rome, Italy; (E.T.); (L.T.); (F.R.)
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome, 00100 Rome, Italy; (E.T.); (L.T.); (F.R.)
| | - Tommaso Staniscia
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (P.D.G.); (T.S.)
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2
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Bencina G, Costantino C, Mameli C, Sabale U, Murtagh J, Newman R, Ahern A, Bhaila R, Sanchez AO, Martinon-Torres F, Carias C. Real-world impact of rotavirus vaccination in European healthcare settings: a systematic literature review. Expert Rev Vaccines 2022; 21:1121-1136. [PMID: 35708263 DOI: 10.1080/14760584.2022.2075851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Rotavirus is one of the most common pathogens causing diarrhea in children <5 years and has a major impact on childhood morbidity and mortality. Since the implementation of rotavirus vaccines into childhood immunization programs across Europe, there has been a reduction in rotavirus burden, including hospitalizations, outpatient cases, costs, and deaths. AREAS COVERED A systematic literature review identified publications describing the clinical and economic impact of rotavirus vaccinations across Europe, from their introduction in 2006 to the end of 2020. A total of 3,137 articles were identified, of which 46 were included in the review. Included articles reported the impact of rotavirus vaccination on disease in any age group. EXPERT OPINION Rotavirus vaccination has resulted in substantial reductions in hospitalizations and rotavirus-associated costs across Europe, particularly in children <5 years. There is some evidence of herd protection afforded to older age groups where vaccine uptake is high among infants, highlighting the potential for vaccination to confer a greater societal benefit as programs become more established. Increasing vaccination coverage and continuing investment in widespread rotavirus vaccination programs across countries will likely increase the substantial public health benefits associated with vaccination and further reduce the clinical and economic burden of disease.
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Affiliation(s)
- Goran Bencina
- Center for Observational and Real-World Evidence (CORE), MSD, Madrid, Spain
| | - Claudio Costantino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Excellence Specialties "G. D'Alessandro," University of Palermo, Palermo, Italy.,Department of Science for Health Promotion and Mother Child Care, University of Palermo, Palermo, Italy
| | - Chiara Mameli
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Ugne Sabale
- Center for Observational and Real-World Evidence (CORE), MSD, Stockholm, Sweden
| | - Janice Murtagh
- Medical Affairs Vaccines, Merck & Co., Inc, Kenilworth, NJ, USA
| | | | | | | | - Alejandro Orrico Sanchez
- Department of Vaccine Research, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Valencia, Spain
| | - Federico Martinon-Torres
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, University of Santiago, Santiago de Compostela, Spain.,Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | - Cristina Carias
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc, Kenilworth, NJ, USA
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Gün E, Kendirli T, Öztürk AG, Botan E, Vatansever G, Arga G, Özdemir İ, Özdemir H, Tekin D, Çiftçi E, İnce E. Clinical Features and Outcomes of Children Admitted to the PICU due to Rotavirus Infection. Turk Arch Pediatr 2022; 56:591-595. [PMID: 35110058 PMCID: PMC8849640 DOI: 10.5152/turkarchpediatr.2021.21140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES In this study, we aimed to evaluate the clinical and laboratory features of the patients with rotavirus (RV) antigen positivity on or following admission to the pediatric intensive care unit (PICU). METHODS Patients admitted to the PICU due to community-acquired rotavirus (CA-RV) or hospital-acquired rotavirus (HA-RV)-induced gastroenteritis between January 1, 2013, and December 31, 2019 were evaluated. RESULTS Thirty-four patients with a mean age of 14.00 ± 19.17 months were enrolled. Fortyfour percent were girls. Twenty (58.8%) patients had a history of chronic diseases. Nine (26.5%) patients had CA-RV and 25 (73.5%) patients had HA-RV infection. RV antigens were simultaneously found in 44.1% (n = 14) of the other patients at the time of diagnosis. In the study sample, 5 patients had hyponatremia, 8 had hypernatremia, 6 had hypokalemia, 4 had hypoalbuminemia, 21 had leukocytosis, 2 had leukopenia and 3 had thrombocytopenia, and 17 had elevatedC-reactive protein (CRP) levels. Three patients had seizures, 1 patient had cardiac arrest, and 2 patients had secondary bacteremia. The mean (SD) PICU length of stay was 6 (6.02) with CA-RV gastroenteritis. All CA-RV patients survived, but 8 of the HA-RV patients succumbed to causes other than RV. CONCLUSION RV-related PICU admission is not rare, and occasional severe clinical consequences occur, especially in young children, with both CA-RV and HA-RV gastroenteritis. Appropriate timely intervention and meticulous follow-up improve survival.
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Affiliation(s)
- Emrah Gün
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Tanıl Kendirli
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Ahmet Gökcan Öztürk
- Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Edin Botan
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Göksel Vatansever
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Gül Arga
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - İhsan Özdemir
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Deniz Tekin
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Ergin Çiftçi
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Erdal İnce
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
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4
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Blumenfeld O, Lawrence G, Shulman LM, Laron Z. Use of the Whole Country Insulin Consumption Data in Israel to Determine the Prevalence of Type 1 Diabetes in Children <5 Years of Age Before and During Rotavirus Vaccination. Pediatr Infect Dis J 2021; 40:771-773. [PMID: 34250976 DOI: 10.1097/inf.0000000000003148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent studies showed that rotavirus vaccination may affect the prevalence of type 1 diabetes (T1D). The aim of the study was to determine the prevalence of early childhood (<5 years) T1D before and during the introduction of rotavirus vaccination in Israel by syndromic surveillance. METHODS Data on insulin purchases reported by Israel's four Health Maintenance Organizations (HMOs) were retrieved from the National Program for Quality Indicators in Community Healthcare. RESULTS During the prevaccination years (2002-2007), a steady increase in insulin purchases was reported in the young (<5 years). The period percent change (PC) of children <5 years old diagnosed with T1D inferred from purchased insulin prescriptions increased by 50.0%, and the annual percent change (APC) increased by 10.0% (p = 0.01). During the period of free, universal Rotavirus vaccination (2011-2018), the PC for T1D diagnoses among children <5 years of age decreased by 3.8% with an APC of -2.5% (p = 0.14). There was a significant difference (p = 0.002) between the increasing trend in insulin use before vaccination versus the decreasing trend after vaccination. CONCLUSION Rotavirus vaccination correlated with attenuation of the increasing rate in the prevalence of T1D in <5-year-old children in Israel.
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Affiliation(s)
- Orit Blumenfeld
- From the National Diseases Registries Unit, Israel Center for Disease Control, Israel Ministry of Health, Israel
| | - Gabriella Lawrence
- Laboratory of Environmental Virology, Central Virology Laboratory, Public Health Services Israel Ministry of Health, Sheba Medical Center, Tel Hashomer, Israel
| | - Lester M Shulman
- Laboratory of Environmental Virology, Central Virology Laboratory, Public Health Services Israel Ministry of Health, Sheba Medical Center, Tel Hashomer, Israel
| | - Zvi Laron
- Endocrinology and Diabetes Research Unit, Schneider Children's Medical Center, Petah Tikva, Israel
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Whiley DM, Ye S, Tozer S, Clark JE, Bletchly C, Lambert SB, Grimwood K, Nimmo GR. Over-diagnosis of Rotavirus Infection in Infants Due to Detection of Vaccine Virus. Clin Infect Dis 2021; 71:1324-1326. [PMID: 31848594 DOI: 10.1093/cid/ciz1196] [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: 09/04/2019] [Accepted: 12/16/2019] [Indexed: 11/12/2022] Open
Abstract
An accurate rotavirus diagnosis is important for clinical management and monitoring active disease and vaccine effectiveness. Between 2016-2018, rotavirus-positive results in our laboratory were from vaccine virus shedding in 71/152 (46.7%) infants with a request for rotavirus testing. Routine infant diagnostic testing should ideally distinguish vaccine from wild-type viruses.
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Affiliation(s)
- David M Whiley
- Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.,Microbiology Division, Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - Suifang Ye
- Microbiology Division, Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia.,University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah Tozer
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Julia E Clark
- Queensland Children's Hospital, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Cheryl Bletchly
- Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - Stephen B Lambert
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Keith Grimwood
- The School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Departments of Paediatrics and Infectious Diseases, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Graeme R Nimmo
- Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
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Ye S, Whiley DM, Ware RS, Kirkwood CD, Lambert SB, Grimwood K. Multivalent Rotavirus Vaccine and Wild-type Rotavirus Strain Shedding in Australian Infants: A Birth Cohort Study. Clin Infect Dis 2019; 66:1411-1418. [PMID: 29149283 DOI: 10.1093/cid/cix1022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/13/2017] [Indexed: 01/25/2023] Open
Abstract
Background Rotavirus vaccines have reduced moderate-to-severe gastroenteritis episodes in infants and young children. Nevertheless, knowledge gaps exist concerning rotavirus vaccine shedding and vaccine impact upon mild and asymptomatic wild-type infections. Our primary objective was to investigate vaccine shedding in Australian infants where the multivalent human-bovine reassortant rotavirus vaccine, RotaTeq, was part of the routine vaccination schedule. Methods The Observational Research in Childhood Infectious Diseases (ORChID) birth cohort study was conducted in Brisbane, Australia, from September 2010 to October 2014. Newborn infants were enrolled progressively and followed until their second birthday. Parents recorded daily symptoms and mailed weekly stool swab samples from their infants to the laboratory where reverse-transcription polymerase chain reaction testing was performed, and rotavirus-positive samples underwent genotyping to distinguish between vaccine and wild-type strains. Results Rotavirus was detected in 1068 of 11139 (9.6%) stool swabs from 158 infants, and 994 (93.1%) were genotyped. RotaTeq vaccine strains accounted for 951 of 994 (95.7%) typed rotavirus-positive swabs. Proportions of infants shedding RotaTeq after the first, second, and third vaccine doses were 87.0%, 57.4%, and 47.3%, respectively, and median (interquartile range) shedding duration after vaccine doses 1-3 was 3 (1-8), 1.5 (1-3), and 1 (1-2), weeks, respectively. In contrast, the incidence rate of wild-type rotavirus episodes was 10.3 (95% confidence interval, 6.8-15.6) per 100 child-years of observation. Conclusions RotaTeq vaccine virus was detected in stool samples from 47%-87% of infants after each vaccine dose. Genotyping is an essential tool for differentiating between rotavirus vaccine and wild-type strains and monitoring vaccine impact in children. Clinical Trial Registration NCT01304914.
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Affiliation(s)
- Suifang Ye
- University of Queensland Centre for Clinical Research, University of Queensland, Brisbane.,Microbiology Division, Pathology Queensland Central Laboratory, Brisbane
| | - David M Whiley
- University of Queensland Centre for Clinical Research, University of Queensland, Brisbane.,Microbiology Division, Pathology Queensland Central Laboratory, Brisbane
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Gold Coast.,UQ Child Health Research Centre, University of Queensland, Brisbane
| | - Carl D Kirkwood
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation, Seattle, Washington
| | - Stephen B Lambert
- UQ Child Health Research Centre, University of Queensland, Brisbane.,Communicable Diseases Branch, Queensland Health, Brisbane
| | - Keith Grimwood
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Queensland, Australia.,Departments of Paediatrics and Infectious Diseases, Gold Coast Health, Queensland, Australia
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7
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Heggie R, Murdoch H, Cameron C, Smith-Palmer A, McIntosh E, Bouttell J. Cost-impact study of rotavirus vaccination programme in Scotland. Hum Vaccin Immunother 2018; 15:1265-1271. [PMID: 30395774 DOI: 10.1080/21645515.2018.1543522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Aim: In July 2013, the Scottish Government introduced a rotavirus vaccination programme into the childhood immunisation schedule. The aim of this research was to estimate the cost-impact of this programme. Methods: Data for rotavirus-related resource use were identified including laboratory reports, hospitalisations, attendances at accident and emergency departments (A&E), general practice consultations (GP), calls to the National Health Service telephone helpline (NHS24) and prescriptions for common rehydration treatments. We used an interrupted time series analysis approach to assess the impact on resource utilisation in all categories. Appropriate costs were added to the models and predicted pre-and post-vaccination mean annual costs were estimated. The cost of the vaccination programme was estimated using costs from the literature. Results: The vaccination programme was associated with a reduction in utilisation in all measured healthcare resource categories. These reductions were all statistically significant (at the 95% level) with p-values less than 0.001. Reductions ranged from 18% in calls to NHS24 to 73% in positive laboratory reports. The vaccination programme was associated with a reduction in annual healthcare resource costs of 38% (£595,000 per 100,000 infants < 5 years old) in our measured categories (including £495,000 from a reduction in hospital stays). The annual overall cost-impact of the rotavirus vaccination programme (the cost of delivering the programme minus the reduction in resource costs) was estimated at approximately £435,000 per 100,000 infants < 5 years old. Conclusion: The rotavirus vaccination programme was associated with a reduction in all measured categories of rotavirus-related resource use by infants < 5 years old.
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Affiliation(s)
- R Heggie
- a Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing , University of Glasgow , UK
| | - H Murdoch
- b Health Economics and Health Technology Assessment , Institute of Health and Wellbeing , Glasgow , UK
| | - C Cameron
- b Health Economics and Health Technology Assessment , Institute of Health and Wellbeing , Glasgow , UK
| | - A Smith-Palmer
- b Health Economics and Health Technology Assessment , Institute of Health and Wellbeing , Glasgow , UK
| | - E McIntosh
- a Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing , University of Glasgow , UK
| | - J Bouttell
- a Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing , University of Glasgow , UK
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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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Yoshikawa T, Matsuki T, Sato K, Mizuno M, Shibata M, Hasegawa S, Morita M, Iwasa M, Gopala K, Holl K. Impact of rotavirus vaccination on the burden of acute gastroenteritis in Nagoya city, Japan. Vaccine 2017; 36:527-534. [PMID: 29248263 DOI: 10.1016/j.vaccine.2017.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 11/16/2017] [Accepted: 12/01/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND In Nagoya city, Japan, rotavirus (RV) vaccination has been available since 2011 with estimated coverage reaching 92% by 2015 after the introduction of a public subsidy in 2012. This study assessed the impact of vaccination on the RV gastroenteritis (RVGE) burden in children aged <5 years old (y) by comparing RVGE hospitalizations and outpatient visits during pre-vaccination (2007-2011), transition (2011-2012) and subsidization (2012-2016) periods. METHODS All hospitalizations and outpatient visits in children aged <5 y from 2 administrative districts of Nagoya city were identified from the hospital-based electronic databases of 4 hospitals. RVGE cases were identified by diagnostic code and/or positive results of diagnostic kits. RESULTS Compared to the pre-vaccination period, there was a decrease in RVGE hospitalizations for children <5 y from 5.59 per 1000 person-year (kPY) to 3.65/kPY in the subsidization period (i.e. 34.69%). In children <1 y, the incidence of RVGE hospitalizations decreased continuously from 6.62/kPY in the pre-vaccination period to 1.84/kPY in the subsidization period (i.e. 72.19%). The highest decrease was observed in the subsidization season i.e. when high coverage was reached: 69% and 75.57% in the 2013/2014 season for 2-3 y and 3-4 y, and 74.03% in the 2014/2015 season for 4-5 y, respectively. Proportion of RVGE outpatient visits decreased by 87.44% for children <1 y and 57.05% for <5 y from the pre-vaccination to the subsidization period. This decrease started the first year of subsidization for children <1 y, 1-2 y and 2-3 y (78.89%, 18.86% and 5.80%) and the second year (2013/2014 season) for children 3-4 y and 4-5 y (87.73% and 51.78%). CONCLUSIONS Although yearly fluctuations have been observed, the introduction of vaccination significantly decreased pediatric RVGE hospitalizations and outpatient visits, especially in the age group eligible for vaccination. During the second and third year of subsidization, we observed a herd protection effect on other age groups <5 y who were not eligible for vaccination. Clinicaltrial.gov.registered#:NCT01733862.
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Affiliation(s)
- Tetsushi Yoshikawa
- Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
| | - Taizo Matsuki
- GSK, 1-8-1 Akasaka, Minato-ku, Tokyo 107-0052, Japan.
| | - Keiko Sato
- GSK, 1-8-1 Akasaka, Minato-ku, Tokyo 107-0052, Japan.
| | - Mihoko Mizuno
- Daido Hospital, 9 Hakusui-cho, Minami-ku, Nagoya, Aichi 457-8511, Japan.
| | - Motohiro Shibata
- Japan Community Healthcare Organization Chukyo Hospital, 1-1-10, Sanjo, Minami-ku, Nagoya, Aichi 457-8510, Japan.
| | - Shinji Hasegawa
- Nagoya Memorial Hospital, 4-305, Hirabari, Tempaku-ku, Nagoya, Aichi 468-8520, Japan.
| | - Makoto Morita
- Nagoya Memorial Hospital, 4-305, Hirabari, Tempaku-ku, Nagoya, Aichi 468-8520, Japan.
| | - Mitsuji Iwasa
- Japanese Red Cross Nagoya Daini Hospital, 2-9, Myomi-cho, Showa-ku, Nagoya, Aichi 466-8650, Japan.
| | - Kusuma Gopala
- GSK, #5, Embassy Links, Cunningham Road, SRT Road, Bangalore 560052, India.
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