Hilda A Mujuru1,2, Eleanor Burnett3, Kusum J Nathoo1,2, Ismail Ticklay2,4, Nhamo A Gonah5, Arnold Mukaratirwa6, Chipo Berejena6, Portia Manangazira7, Maxwell Rupfutse8, Goitom G Weldegebriel9, Jason M Mwenda10, Catherine Yen3, Umesh D Parashar3, Jacqueline E Tate3. 1. Harare Central Hospital, University of Zimbabwe, Harare. 2. Department of Paediatrics and Child Health, University of Zimbabwe, Harare. 3. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. 4. Parirenyatwa Group Hospitals, Harare. 5. Chitungwiza Central Hospital, Ministry of Health and Child Care. 6. National Virology Laboratory, Ministry of Health and Child Care. 7. Epidemiology and Disease Control, Ministry of Health and Child Care. 8. World Health Organization (WHO) Country Office. 9. WHO Intercountry Support Team, Harare, Zimbabwe. 10. WHO Regional Office for Africa1, Brazzaville, Republic of Congo.
Abstract
BACKGROUND: Rotavirus is a leading cause of mortality among children <5 years old. We evaluated monovalent rotavirus vaccine effectiveness (VE) under conditions of routine use at 2 surveillance sites in Harare, Zimbabwe, after vaccine introduction in May 2014. METHODS: Children aged <5 years hospitalized or treated in the accident and emergency department (A&E) for acute watery diarrhea were enrolled for routine surveillance. Copies of vaccination cards were collected to document vaccination status. Among children age-eligible to receive rotavirus vaccine, we estimated VE, calculated as 1 - odds ratio, using a test-negative case-control design. RESULTS: We included 903 rotavirus-positive cases and 2685 rotavirus-negative controls in the analysis; 99% had verified vaccination status. Rotavirus-positive children had more severe diarrhea than rotavirus-negative children; 61% of cases and 46% of controls had a Vesikari score ≥11 (P < .01). Among cases and controls, 31% and 37%, respectively, were stunted for their age (P < .01). Among children 6-11 months old, adjusted 2-dose VE against hospitalization or treatment in A&E due to rotavirus of any severity was 61% (95% confidence interval [CI], 21%-81%) and 68% (95% CI, 13%-88%) against severe rotavirus disease. Stratified by nutritional status, adjusted VE was 45% (95% CI, -148% to 88%) among stunted infants and 71% (95% CI, 29%-88%) among infants with a normal height for age. CONCLUSIONS: Monovalent rotavirus vaccine is effective in preventing hospitalizations due to severe rotavirus diarrhea among infants in Zimbabwe, providing additional evidence for countries considering rotavirus vaccine introduction that live, oral rotavirus vaccines are effective in high-child-mortality settings. Published by Oxford University Press for the Infectious Diseases Society of America 2018.
BACKGROUND: Rotavirus is a leading cause of mortality among children <5 years old. We evaluated monovalent rotavirus vaccine effectiveness (VE) under conditions of routine use at 2 surveillance sites in Harare, Zimbabwe, after vaccine introduction in May 2014. METHODS: Children aged <5 years hospitalized or treated in the accident and emergency department (A&E) for acute watery diarrhea were enrolled for routine surveillance. Copies of vaccination cards were collected to document vaccination status. Among children age-eligible to receive rotavirus vaccine, we estimated VE, calculated as 1 - odds ratio, using a test-negative case-control design. RESULTS: We included 903 rotavirus-positive cases and 2685 rotavirus-negative controls in the analysis; 99% had verified vaccination status. Rotavirus-positive children had more severe diarrhea than rotavirus-negative children; 61% of cases and 46% of controls had a Vesikari score ≥11 (P < .01). Among cases and controls, 31% and 37%, respectively, were stunted for their age (P < .01). Among children 6-11 months old, adjusted 2-dose VE against hospitalization or treatment in A&E due to rotavirus of any severity was 61% (95% confidence interval [CI], 21%-81%) and 68% (95% CI, 13%-88%) against severe rotavirus disease. Stratified by nutritional status, adjusted VE was 45% (95% CI, -148% to 88%) among stunted infants and 71% (95% CI, 29%-88%) among infants with a normal height for age. CONCLUSIONS: Monovalent rotavirus vaccine is effective in preventing hospitalizations due to severe rotavirus diarrhea among infants in Zimbabwe, providing additional evidence for countries considering rotavirus vaccine introduction that live, oral rotavirus vaccines are effective in high-child-mortality settings. Published by Oxford University Press for the Infectious Diseases Society of America 2018.
Authors: Paul A Gastañaduy; Andrew P Steenhoff; Margaret Mokomane; Mathew D Esona; Michael D Bowen; Haruna Jibril; Jeffrey M Pernica; Loeto Mazhani; Marek Smieja; Jacqueline E Tate; Umesh D Parashar; David M Goldfarb Journal: Clin Infect Dis Date: 2016-05-01 Impact factor: 9.079
Authors: Nigel A Cunliffe; Desiree Witte; Bagrey M Ngwira; Stacy Todd; Nancy J Bostock; Ann M Turner; Philips Chimpeni; John C Victor; A Duncan Steele; Alain Bouckenooghe; Kathleen M Neuzil Journal: Vaccine Date: 2012-04-27 Impact factor: 3.641
Authors: Minesh P Shah; Jacqueline E Tate; Jason M Mwenda; A Duncan Steele; Umesh D Parashar Journal: Expert Rev Vaccines Date: 2017-09-04 Impact factor: 5.217
Authors: Naor Bar-Zeev; Lester Kapanda; Jacqueline E Tate; Khuzwayo C Jere; Miren Iturriza-Gomara; Osamu Nakagomi; Charles Mwansambo; Anthony Costello; Umesh D Parashar; Robert S Heyderman; Neil French; Nigel A Cunliffe Journal: Lancet Infect Dis Date: 2015-01-29 Impact factor: 25.071
Authors: Naor Bar-Zeev; Khuzwayo C Jere; Aisleen Bennett; Louisa Pollock; Jacqueline E Tate; Osamu Nakagomi; Miren Iturriza-Gomara; Anthony Costello; Charles Mwansambo; Umesh D Parashar; Robert S Heyderman; Neil French; Nigel A Cunliffe Journal: Clin Infect Dis Date: 2016-05-01 Impact factor: 9.079
Authors: Assucênio Chissaque; Rachel M Burke; Esperança L Guimarães; Filomena Manjate; Arsénio Nhacolo; Jorfélia Chilaúle; Benilde Munlela; Percina Chirinda; Jerónimo S Langa; Idalécia Cossa-Moiane; Elda Anapakala; Adilson Fernando Loforte Bauhofer; Marcelino Garrine; Eva D João; Júlia Sambo; Luzia Gonçalves; Goitom Weldegebriel; Keith Shaba; Isah Mohammed Bello; Jason M Mwenda; Umesh D Parashar; Jacqueline E Tate; Inácio Mandomando; Nilsa de Deus Journal: Vaccines (Basel) Date: 2022-03-15