Temporal trends in diarrhea-related hospitalizations and deaths in children under age 5 before and after the introduction of the rotavirus vaccine in four Latin American countries

Burden of Norovirus and Rotavirus in Children After Rotavirus Vaccine Introduction, Cochabamba, Bolivia

“…The literature describing the burden of rotavirus in Bolivia has demonstrated the effectiveness of rotavirus vaccine in the region. 5,6,14,16,17 Seven years before vaccine introduction at this study site, rotavirus was detected by PCR in 24% of 317 children aged < 5 years hospitalized with AGE. 17 Rotavirus prevalence was 36% when children < 2 years were analyzed separately, nearly double the prevalence described here (19%).…”

“…14,15 Reductions in hospitalization due to all-cause AGE have been described in multiple Latin American countries with reductions as high as 18% after vaccine introduction. 6 Reductions in rotavirus prevalence after vaccine introduction has been previously demonstrated by Bolivian investigators. 16 These results may predict norovirus replacing rotavirus as the most prevalent enteropathogen affecting children in Bolivia and similar communities worldwide, where diarrheal disease remains a major cause of morbidity and mortality.…”

“…2 Norovirus and rotavirus are the major causes of diarrheal illness in South American children. [3][4][5][6][7][8][9] Recent data suggest that the relative burden of norovirus versus rotavirus in children with AGE may be changing after widespread adoption of rotavirus vaccine. Relatively little is known of viral etiology of pediatric AGE in low income, high mortality settings after vaccine introduction.…”

“…10,11 Rotarix ™ (GlaxoSmithKline Biologicals, Wavre, Belgium) is a monovalent live-attenuated vaccine whose implementation has resulted in significant reductions in AGE hospitalization and mortality in Latin American countries. 6,12 Rotarix is included in vaccine schedules of 16 Latin American countries and one territory (Bolivia, Brazil, Columbia, Ecuador, Mexico, Cayman Islands territories, Panama, Peru, Paraguay, El Salvador, Guatemala, Honduras, Nicaragua, Guiana, the Dominican Republic, Haiti, and Venezuela) and it was introduced in Bolivia in August 2008. 13 Rotavirus vaccination uptake is high in Bolivia (> 85%, two-dose coverage), and the vaccine has demonstrated high efficacy against rotavirus infection despite fears that the vaccine may be less effective in resource poor settings.…”

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

“…The decline in the underlying rates is likely due to expanded access to preventive treatment and increased quality of care. [116][117][118][119][120] If obesity continues to increase in the future, the consequences for health trends might be greater if the trend in underlying rates attenuates than if it continues to decrease. Although closely linked, we also estimate that the rate of increase in high fasting plasma glucose is slightly higher than that for obesity.…”