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Impact of a twelve-year rotavirus vaccine program on acute diarrhea mortality and hospitalization in Brazil

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De Jesus, Myrela Conceição Santos, Santos, Victor Santana, Storti-Melo, Luciane Moreno, Freire de Souza, Carlos Dornels, de Carvalho Barreto, Íkaro Daniel, Costa Paes, Marcelo Vitor, Silva Lima, Pablo Amércio, Bohland, Anna Klara, Berezin, Eitan N, Dantas Machado, Ricardo Luiz, Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 and Gurgel, Ricardo Quieroz (2020) 'Impact of a twelve-year rotavirus vaccine program on acute diarrhea mortality and hospitalization in Brazil'. Expert Review of Vaccines, Vol 19, Issue 6, pp. 585-593.

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Abstract

Background
Monitoring the impact of vaccine programs is necessary to identify changes in vaccine efficacy. We report the impact of the 12-year rotavirus vaccine program on diarrhea mortality and hospitalizations and their correlation to socioeconomic indicators.

Methods
this ecological study describes diarrhea hospitalizations and deaths from 2006 to 2018 in Brazil and correlates rotavirus vaccine coverage, hospitalizations and deaths to socioeconomic indicators and social vulnerability index (SVI) by state and region. Hospitalizations, deaths, and vaccine coverage trends were analyzed using Joinpoint regression models. Associations between hospitalizations, mortality and rotavirus vaccination coverage and socioeconomic and SVI indicators were established using Ordinary Least Square regressions.

Results
Rotavirus vaccine coverage remained stable between 2006 and 2018 (annual percentage changes (APC) [95%CI]: 4.4% [−0.3%, 9.2%]). Diarrhea hospitalization rates decreased 52.5% (−5.7% [−7.5%, −3.8%]), from 68.4 to 32.5 hospitalizations per 10,000 children <5 years-old between 2006 and 2018, with significant decreases in diarrhea mortality (−9.8% [−11.2%, −8.5%]). The Northeast region experienced the largest reductions (−13.9% [−15.7%, −12.2%]). Vaccination coverage and diarrhea-mortality were inversely correlated with the SVI.

Conclusion
The burden of childhood diarrhea has decreased over an extended period. States with high SVI, but high vaccination coverage had the largest reductions in hospitalizations and deaths.

Item Type: Article
Subjects: QW Microbiology and Immunology > Viruses > QW 160 Viruses (General). Virology
QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 806 Vaccination
WA Public Health > Preventive Medicine > WA 115 Immunization
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Virus Diseases > General RNA Virus Infections > WC 501 RNA virus infections (General or not elsewhere classified)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1080/14760584.2020.1775081
Depositing User: Stacy Murtagh
Date Deposited: 19 Jun 2020 18:06
Last Modified: 12 Aug 2020 10:36
URI: https://archive.lstmed.ac.uk/id/eprint/14516

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