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Effectiveness of rotavirus vaccines against rotavirus infection and hospitalization in Latin America: systematic review and meta-analysis

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Santos, Victor S, Marques, Daniella P, Martins-Filho, Paulo R S, Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 and Gurgel, Ricardo Q (2016) 'Effectiveness of rotavirus vaccines against rotavirus infection and hospitalization in Latin America: systematic review and meta-analysis'. Infectious Diseases of Poverty, Vol 5, Issue 83.

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Abstract

Background
Rotavirus was the leading cause of childhood diarrhoea-related hospitalisations and death before the introduction of rotavirus vaccines.

Methods
We describe the effectiveness of rotavirus vaccines to prevent rotavirus infections and hospitalizations and the main rotavirus strains circulating before and after vaccine introduction through a systematic review and meta-analysis of studies published between 1990 and 2014. 203 studies were included to estimate the proportion of infections due to rotavirus and 10 to assess the impact of the vaccines. 41 of 46 studies in the post-vaccination period were used for meta-analysis of genotypes, 20 to calculate VE against infection, eight for VE against hospitalisation and seven for VE against severe rotavirus-diarrhoea.

Results
24.3 % (95 % CI 22.1–26.5) and 16.1 % (95 % CI 13.2–19.3) of cases of diarrhoea were due to rotavirus before and after vaccine introduction, respectively. The most prevalent G types after vaccine introduction were G2 (51.6 %, 95 % CI 38–65), G9 (14.5 %, 95 % CI 7–23) and G1 (14.2 %, 95 % CI 7–23); while the most prevalent P types were P[4] (54.1 %, 95 % CI 41–67) and P[8] (33 %, 95 % CI 22–46). G2P[4] was the most frequent genotype combination after vaccine introduction. Effectiveness was 53 % (95 % CI 46–60) against infection, 73 % (95 % CI, 66–78) against hospitalisation and 74 % (95 % CI, 68.0–78.0) against severe diarrhoea. Reductions in hospitalisations and mortality due to diarrhoea were observed in countries that adopted universal rotavirus vaccination.

Conclusions
Rotavirus vaccines are effective in preventing rotavirus-diarrhoea in children in Latin America. The vaccines were associated with changes in genotype distribution.

Item Type: Article
Subjects: QW Microbiology and Immunology > Viruses > QW 160 Viruses (General). Virology
QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 805 Vaccines. Antitoxins. Toxoids
WC Communicable Diseases > Virus Diseases > General RNA Virus Infections > WC 501 RNA virus infections (General or not elsewhere classified)
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 312 Diarrheal disorders
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s40249-016-0173-2
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 05 Oct 2016 15:29
Last Modified: 06 Feb 2018 13:13
URI: https://archive.lstmed.ac.uk/id/eprint/6139

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