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Reduction in Severity of All-Cause Gastroenteritis Requiring Hospitalisation in Children Vaccinated against Rotavirus in Malawi

Mandolo, Jonathan J., Henrion, Marc, Mhango, Chimwemwe, Chinyama, End, Wachepa, Richard, Kanjerwa, Oscar, Malamba-Banda, Chikondi, Shawa, Isaac T., Hungerford, Daniel, Kamng’ona, Arox W., Iturriza-Gomara, Miren, Cunliffe, Nigel A. and Jere, Khuzwayo C. (2021) 'Reduction in Severity of All-Cause Gastroenteritis Requiring Hospitalisation in Children Vaccinated against Rotavirus in Malawi'. Viruses, Vol 13, Issue 12, p. 2491.

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Rotavirus is the major cause of severe gastroenteritis in children aged <5 years. Introduction of the G1P[8] Rotarix® rotavirus vaccine in Malawi in 2012 has reduced rotavirus-associated hospitalisations and diarrhoeal mortality. However, the impact of rotavirus vaccine on the severity of gastroenteritis presented in children requiring hospitalisation remains unknown. We conducted a hospital-based surveillance study to assess the impact of Rotarix® vaccination on the severity of gastroenteritis presented by Malawian children. Stool samples were collected from children aged <5 years who required hospitalisation with acute gastroenteritis from December 2011 to October 2019. Gastroenteritis severity was determined using Ruuska and Vesikari scores. Rotavirus was detected using enzyme immunoassay. Rotavirus genotypes were determined using nested RT-PCR. Associations between Rotarix® vaccination and gastroenteritis severity were investigated using adjusted linear regression. In total, 3159 children were enrolled. After adjusting for mid-upper arm circumference (MUAC), age, gender and receipt of other vaccines, all-cause gastroenteritis severity scores were 2.21 units lower (p < 0.001) among Rotarix®-vaccinated (n = 2224) compared to Rotarix®-unvaccinated children (n = 935). The reduction in severity score was observed against every rotavirus genotype, although the magnitude was smaller among those infected with G12P[6] compared to the remaining genotypes (p = 0.011). Each one-year increment in age was associated with a decrease of 0.43 severity score (p < 0.001). Our findings provide additional evidence on the impact of Rotarix® in Malawi, lending further support to Malawi’s Rotarix® programme.

Item Type: Article
Additional Information: This article belongs to the Special Issue Rotavirus and Rotavirus Vaccines
Subjects: QW Microbiology and Immunology > Viruses > QW 160 Viruses (General). Virology
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)
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 312 Diarrheal disorders
Faculty: Department: Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI):
Depositing User: Marie Hatton
Date Deposited: 04 Jan 2022 12:31
Last Modified: 04 Jan 2022 12:31


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