Incidence of Rotavirus and All-Cause Diarrhea in Northeast Brazil Following the Introduction of a National Vaccination Program

Gurgel, Ricardo Queiróz; Bohland, Anna Klara; Vieira, Sarah Cristina Fontes; Oliveira, Débora M.P.; Fontes, P. B.; Barros, Viviane F; Ramos, Marcela F; Dove, Winifred; Nakagomi, Toyoko; Nakagomi, Osamu; Correia, Jailson de Barros; Cunliffe, Nigel A.; Cuevas, Luís E.

doi:10.1053/j.gastro.2009.07.046

Cited by 88 publications

(95 citation statements)

References 15 publications

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“…In addition to the low incidence of all-cause diarrhoea, very few children had documented rotavirusborne diarrhoea during the two years this study was conducted. This observation is in agreement with the lower incidence of rotavirus infections reported in SE after the vaccine was introduced (Gurgel et al 2009) and may also reflect the location of the study, as the proportion of rotavirus cases in community-based studies is characteristically lower than in hospital-based studies (Vernacchio et al 2006, Gurgel et al 2008b). Interestingly, all-cause gastroenteritis in young children and rotavirus episodes in children of all ages were less severe in children who had recently received the rotavirus vaccine (i.e., children < 12 months old), while older children who had received the vaccine 18 or more months earlier (i.e., more than 24 months old) had more severe episodes than the unvaccinated controls.…”

Section: Discussionsupporting

confidence: 79%

“…Similar to hospital-based reports from this region (Gurgel et al 2007(Gurgel et al , 2009G2 was the only genotype identified. It remains unclear whether the continued predominance of this strain can be attributed to vaccine-induced selective immune pressure or to the well-understood natural fluctuation in rotavirus genotypes (Gurgel et al 2008a).…”

Section: Discussionsupporting

confidence: 71%

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Acute diarrhoea in a community cohort of children who received an oral rotavirus vaccine in Northeast Brazil

Vieira

Gurgel

Kirby

et al. 2011

Mem. Inst. Oswaldo Cruz

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Rotavirus is an important cause of childhood diarrhoea. A monovalent rotavirus vaccine (Rotarix ® ) was introduced into the Immunization Program of Brazil in 2006. In this study, we describe the incidence and burden of disease of rotavirus diarrhoea in two cohorts of children (vaccinated and unvaccinated). We followed two groups of 250 children under one year old, who were enrolled in December 2006 from a low-income residential area inNortheast Brazil. The children were monitored every two weeks for two years. Stool samples from children with diarrhoea were examined for the presence of rotavirus. Rotaviruses were genotyped using real time-polymerase chain reaction. The mean numbers of all-cause diarrhoea episodes/child (adjusted for age) in the first year were 0. 87 and 0.84, in vaccinated and unvaccinated children, respectively. During the second year, the number of episodes/ child decreased to 0.52 and 0.42. Only 16 (4.9%) of 330 stool samples were rotavirus-positive (10 vaccinated and 6 unvaccinated children) and only P[4]G2 rotaviruses were identified. All-cause diarrhoea episodes were more severe in unvaccinated children in the first year of age (p < 0.05), while vaccinated children had more severe episodes 18 months after vaccination. Rotavirus diarrhoea incidence was very low in both groups. Key words: diarrhoea -rotavirus -vaccine -cohort -children -BrazilRotavirus diarrhoea in vaccinated children • Sarah Cristina Fontes Vieira et al. 331ties were visited at home in 2006 and their parents were invited to enrol their children in the study, independent of their vaccination status. The parents of the first 250 children who had received two oral doses of the Rotarix ® vaccine (GlaxoSmithKline Biologicals, Rixensart, Belgium) at two and four months of age (vaccinated cohort) were invited to participate and a further 250 children who had not received the vaccine comprised the unvaccinated cohort. Vaccination status was verified using the child's vaccination card and the Health Centre's databases. The youngest unvaccinated children registered were selected, despite the fact that the two groups could not be matched by age, as unvaccinated children had to be ineligible for vaccination at the time of enrolment, and therefore at least four months of age. Unvaccinated children serving as the control group were not offered the vaccine due to EPI guidelines that exclude children greater than or e�ual to four months of age to avoid the risk of intussusception among older infants (WHO 2007).After obtaining informed parental consent, all children were visited at home for the following two years, independently of their age at the time of enrolment. Visits were conducted every two weeks by three trained interviewers who in�uired as to whether or not the child had experienced diarrhoea episodes during the previous twoweek period. If the parent indicated that the child had diarrhoea, the interviewer collected information regarding the date of the episode and clinical presentation. The severity of the diarrhoea episodes wa...

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 71%

Acute diarrhoea in a community cohort of children who received an oral rotavirus vaccine in Northeast Brazil

Vieira

Gurgel

Kirby

et al. 2011

Mem. Inst. Oswaldo Cruz

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“…Although our data suggests an annual increase in the proportion of cases, similar detection rates had been reported from Chile, India and Nicaragua prior to rotavirus vaccine introduction [18][19][20]. This relative increase may also be due to the decrease of number of rotavirus-related hospitalizations [10,11] and all-cause diarrhoea cases due to the effectiveness of the rotavirus vaccine [21] and the herd effect of the vaccine that has resulted in an overall and not a real increase in the overall number of NoV cases. The increasing trend reported here however is rare and could be an early indication of changes in the epidemiology of the pathogen in a population with a high rotavirus vaccination coverage.…”

Section: Discussionmentioning

confidence: 60%

“…For logistical reasons, only children attending between 8 am and 4 pm from Monday to Friday were included. Due to funding constraints, data for NoV was analysed from October 2006 to September 2009 and from July 2011 to January 2013, but data collection used the same methods and protocols over the study period [10]. After obtaining written parental consent, children were assessed to establish the medical history and clinical presentation and parents were asked for the child vaccination cards.…”

Section: 1study Population and Sample Collectionmentioning

confidence: 99%

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Acute norovirus gastroenteritis in children in a highly rotavirus-vaccinated population in Northeast Brazil

Santos

Gurgel

Cavalcante

et al. 2017

Journal of Clinical Virology

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Running title: Norovirus diarrhoea in children in BrazilWord count: Abstract: 199. Manuscript: 2255. Highlights Gastroenteritis is one of the most important causes of morbidity and mortality in children.  Noroviruses are a leading cause of sporadic cases and outbreaks of acute gastroenteritis.  Norovirus annual detection rates increased over the study period.  The detection of norovirus was higher among young children. AbstractBackground: Gastroenteritis is one of the most important causes of morbidity and mortality

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Infectious Diarrhea

Fitzwater

Chandran

Kosek³

et al. 2011

Water and Sanitation‐Related Diseases and the Environment

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Incidence of Rotavirus and All-Cause Diarrhea in Northeast Brazil Following the Introduction of a National Vaccination Program

Cited by 88 publications

References 15 publications

Acute diarrhoea in a community cohort of children who received an oral rotavirus vaccine in Northeast Brazil

Acute diarrhoea in a community cohort of children who received an oral rotavirus vaccine in Northeast Brazil

Acute norovirus gastroenteritis in children in a highly rotavirus-vaccinated population in Northeast Brazil

Infectious Diarrhea

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