Evidence of the impact of monovalent rotavirus vaccine on childhood acute gastroenteritis hospitalization in Togo

Tsolenyanu, Enyonam; Djadou, K.E.; Fiawoo, Mawouto; Akolly, D.A.E.; Mwenda, Jason M.; Leshem, Eyal; Tate, Jacqueline E.; Aliabadi, Negar; Koudema, W; Guedenon, K.M.; Godonou, M; Dagnra, Anoumou; Gbadoé, Adama Dodji; Boko, Amevegbe; Landoh, Dadja Essoya; Atakouma, Y.D.; Parashar, Umesh D.

doi:10.1016/j.vaccine.2018.01.058

Cited by 9 publications

(6 citation statements)

References 27 publications

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“…The GPP is considered the most reliable and sensitive method for RVA screening [ 29 ]. However, many African countries use ELISA to screen for RVA and evaluate the progress and impact of the rotavirus vaccine [ 11 , 13 , 14 ]. Further investigations are needed to confirm the impact of ELISA false positive in epidemiological studies.…”

Section: Discussionmentioning

confidence: 99%

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Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays

et al. 2021

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Background Despite the global roll-out of rotavirus vaccines (RotaTeq/Rotarix / ROTAVAC/Rotasiil), mortality and morbidity due to group A rotavirus (RVA) remains high in sub-Saharan Africa, causing 104,000 deaths and 600,000 hospitalizations yearly. In Cameroon, Rotarix™ was introduced in March 2014, but, routine laboratory diagnosis of rotavirus infection is not yet a common practice, and vaccine effectiveness studies to determine the impact of vaccine introduction have not been done. Thus, studies examining RVA prevalence post vaccine introduction are needed. The study aim was to determine RVA prevalence in severe diarrhoea cases in Littoral region, Cameroon and investigate the role of other diarrheagenic pathogens in RVA-positive cases. Methods We carried out a study among hospitalized children < 5 years of age, presenting with acute gastroenteritis in selected hospitals of the Littoral region of Cameroon, from May 2015 to April 2016. Diarrheic stool samples and socio-demographic data including immunization and breastfeeding status were collected from these participating children. Samples were screened by ELISA (ProSpecT™ Rotavirus) for detection of RVA antigen and by gel-based RT-PCR for detection of the VP6 gene. Co-infection was assessed by multiplexed molecular detection of diarrheal pathogens using the Luminex xTAG GPP assay. Results The ELISA assay detected RVA antigen in 54.6% (71/130) of specimens, with 45, positive by VP6 RT-PCR and 54, positive using Luminex xTAG GPP. Luminex GPP was able to detect all 45 VP6 RT-PCR positive samples. Co-infections were found in 63.0% (34/54) of Luminex positive RVA infections, with Shigella (35.3%; 12/34) and ETEC (29.4%; 10/34) detected frequently. Of the 71 ELISA positive RVA cases, 57.8% (41/71) were fully vaccinated, receiving two doses of Rotarix. Conclusion This study provides insight on RVA prevalence in Cameroon, which could be useful for post-vaccine epidemiological studies, highlights higher than expected RVA prevalence in vaccinated children hospitalized for diarrhoea and provides the trend of RVA co-infection with other enteric pathogens. RVA genotyping is needed to determine circulating rotavirus genotypes in Cameroon, including those causing disease in vaccinated children.

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Section: Discussionmentioning

confidence: 99%

“…In South Africa, the hospitalization rate dropped by one third during the same period [ 12 , 13 ]. In Togo, the introduction of Rotarix in June 2014 has already shown remarkable results over the past 2 years, with a 53% decrease in RVA related hospitalization [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays

et al. 2021

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“… 10 Surveillance data from Togo demonstrated a 37% decline in all-cause pediatric AGE hospitalizations, with a 52% decline among children aged <12 months, in the second year following rotavirus vaccine introduction. 11 In our analysis, declines in rotavirus positivity were 51% overall and 69% among children aged <12 months, measured over the first 2.5 years after vaccine introduction. These trends are consistent with increases in estimated full-series rotavirus vaccine coverage, which grew from 40% in 2017 to 70% in 2019 7 .…”

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confidence: 60%

“…Median age increased significantly from 7 months in the pre-vaccine period to 11 months in the post vaccine period. An increase in the median age of rotavirus cases following vaccine introduction was also seen in Togo 11 and elsewhere. 12 This pattern may be explained by increasing proportions over time of rotavirus cases occurring among older children, who are less likely to be vaccinated as compared with younger children born after rotavirus vaccine introduction.…”

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confidence: 77%

Impact of rotavirus vaccine introduction in Abidjan, Côte d’Ivoire

Mlan

Burke

Koné³

et al. 2023

Human Vaccines & Immunotherapeutics

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Côte d’Ivoire introduced rotavirus vaccine in March 2017. Rotavirus surveillance is conducted at Centre Hospitalier Universitaire de Yopougon in Abidjan, the capital city. Children <5 years of age are enrolled in rotavirus surveillance if admitted to the hospital with acute gastroenteritis. We used sentinel surveillance data from 2014 through mid-2019 to compare trends in rotavirus pediatric gastroenteritis hospitalizations before and after rotavirus vaccine introduction. We used Poisson regression to analyze changes in rotavirus prevalence, adjusting for calendar month and accounting for total monthly admissions; January 2014 – December 2016 was considered “pre-vaccine,” and January 2017 – June 2019 was considered “post-vaccine.” Age distribution and severity were compared between periods using the Mann-Whitney U test. Rotavirus-positive admissions declined 51% (95% CI: 28%-67%), from 31.5% pre-vaccine to 14.9% afterward. The median age of rotavirus-positive children increased from 7 months (interquartile range [IQR]: 5–11) in the pre-vaccine period to 11 months (IQR: 7–18, p = .005) in the post-vaccine period. The median severity score decreased from 11 to 9 ( p = .008) among all children, and from 12 pre- to 10.5 post-vaccine ( p = .35) among rotavirus-positive children. Our findings suggest that rotavirus vaccine introduction contributed to reduced rotavirus hospitalization in Abidjan and possibly more broadly.

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“…14 Despite these shortcomings, the rotavirus vaccine does still have significant impact on prevention of hospitalisation and mortality in these lowincome countries such as those in sub-Saharan Africa. [33][34][35][36][37] In the children with diarrhoea reported in 2013 in KZN, 55% of cases were caused by rotavirus 10 and most of these were of the G2P [4] (54%; 72/134) and G9P [8] (39%; 52/134). 10 This is despite the introduction of rotavirus vaccination four years earlier.…”

Section: Discussionmentioning

confidence: 99%

Influence of vaccination status and clinical, seasonal and sociodemographic factors on rotavirus prevalence in KwaZulu-Natal, South Africa

Asowata

Ashiru

Mahomed

et al. 2018

Southern African Journal of Infectious Diseases

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Human rotavirus infection is the leading cause of diarrhoea in infants and young children worldwide. In South Africa, diarrhoea is a major cause of childhood morbidity and mortality in children less than five years old, and before the vaccine was introduced rotavirus had been reported as causing one-third of all diarrhoeal related hospital admissions. This study assessed factors influencing the prevalence of rotavirus in children aged five years and under in KwaZulu-Natal, South Africa between June 2014 and June 2015. In addition, genotypes of the rotaviruses were determined. A stool specimen was collected from children presenting with diarrhoea to a regional hospital. Clinical, vaccination status, seasonal and sociodemographic information was collected using a structured questionnaire. ELISA (enzyme linked immunosorbent assay) was performed to detect rotavirus antigen in the stool. Rotavirus from selected positives specimens were genotyped using RT–PCR (reverse transcriptase polymerase chain reaction). The data were analysed using SPSS. In total, 365 stool specimens were collected. Rotavirus antigen was detected in 83 (23%) patients. The prevalence of rotavirus was not affected by vaccination status (p = 0.3; OR 1.5; CI 0.7–3.1), HIV status (p = 0.2; OR 0.6; CI 0.2–1.5), breastfeeding (p = 0.9; OR 1.1; CI 0.5–2.5) and administration of anti-helminth treatment (p = 0.6; OR 0.8; CI 0.3–1.9). The highest rotavirus prevalence was observed in the winter season (p 0.001; OR 43.3; CI 14.9–125.0). The G9P[8] was the most prevalent genotype (21%) followed by G9P[4] (14%). Rotavirus remains a major contributor to childhood diarrhoeal aetiology and hospitalisation in KwaZulu-Natal. Further investigation is needed to better understand the key drivers of rotavirus infection despite a successful vaccination programme in South Africa.

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Evidence of the impact of monovalent rotavirus vaccine on childhood acute gastroenteritis hospitalization in Togo

Cited by 9 publications

References 27 publications

Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays

Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays

Impact of rotavirus vaccine introduction in Abidjan, Côte d’Ivoire

Influence of vaccination status and clinical, seasonal and sociodemographic factors on rotavirus prevalence in KwaZulu-Natal, South Africa

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