Reduction in morbidity and mortality from childhood diarrhoeal disease after species A rotavirus vaccine introduction in Latin America : a review

Abstract

Countries in Latin America were among the first to implement routine vaccination against species A rotavirus (RVA). We evaluate data from Latin America on reductions in gastroenteritis and RVA disease burden following the introduction of RVA vaccine. Published literature was reviewed to identify case-control studies of vaccine effectiveness and population-based studies examining longitudinal trends of diarrhoeal disease reduction after RVA vaccine introduction in Latin American countries. RVA vaccine effectiveness and impact on gastroenteritis mortality and hospitalization rates and RVA hospitalization rates are described. Among middle-income Latin American countries with published data (Mexico, Brazil, El Salvador and Panama), RVA vaccine contributed to a gastroenteritis-associated mortality reduction of 22-41%, a gastroenteritis-associated hospitalization reduction of 17-51% and a RVA hospitalization reduction of 59-81% among children younger than five years of age. In Brazil and El Salvador, case-control studies demonstrated that a full RVA vaccination schedule was 76-85% effective against RVA hospitalization; a lower effectiveness of 46% was seen in Nicaragua, the only low-income country with available data. A growing body of literature offers convincing evidence of "real world" vaccine program successes in Latin American settings, which may be expanded as more countries in the region include RVA vaccine in their immunization programs

Risk Factors for Diarrhea in Children Under Five Years of Age Residing in Peri-urban Communities in Cochabamba, Bolivia

“…54,55 The Bolivian Ministry of Health introduced rotavirus vaccine in 2008. 56 Unfortunately, in this study systematic data on rotavirus vaccination was not collected. Future studies should evaluate how rotavirus vaccination impacts risk factors for diarrhea in low income country settings.…”

Effectiveness of pneumococcal conjugate vaccine and rotavirus vaccine introduction into the South African public immunisation programme

“…These data corroborate the findings of a review on the public health impact of RV in middle-income Latin American countries. [28] Observations from the review included that RV immunisation was associated with a 22 -41% reduction in gastroenteritis-associated mortality, a 17 -51% reduction in all-cause gastroenteritis-associated hospitalisation, and a 59 -81% reduction in rotavirus-specific gastroenteritis hospitalisation among children younger than 5 years of age. [28] Additionally, an ecological study is underway to establish the effectiveness of PCV against IPD, for which there has been surveillance for more than a decade before vaccine introduction in SA.…”

“…[28] Observations from the review included that RV immunisation was associated with a 22 -41% reduction in gastroenteritis-associated mortality, a 17 -51% reduction in all-cause gastroenteritis-associated hospitalisation, and a 59 -81% reduction in rotavirus-specific gastroenteritis hospitalisation among children younger than 5 years of age. [28] Additionally, an ecological study is underway to establish the effectiveness of PCV against IPD, for which there has been surveillance for more than a decade before vaccine introduction in SA. [29,30] Provisional data up to the end of 2011, during which time 7-valent PCV was being used, showed a 79% reduction in vaccine-serotype IPD and a 28% decline in non-vaccine-serotype IPD in SA when comparing 2005 -2008 with 2011.…”

Diarrhoea-related hospitalizations in children before and after implementation of monovalent rotavirus vaccination in Mexico

“…5,26 Four Latin American countries recorded declines of 17 to 51% in gastroenteritis hospitalizations in the first two years after an RVA vaccine was introduced. 27 Since about 40% of Mexican children who were hospitalized with diarrhoea in the prevaccine period were found to be infected with RVA, 18 a 40% reduction in diarrhoea-related hospitalizations after an RVA vaccine is introduced is, presumably, the best result for Mexico that might be expected.…”