Program for Appropriate Technology in Health, Managua, Nicaragua.
Int J Infect Dis. 2010 Jul;14(7):e592-5. doi: 10.1016/j.ijid.2009.08.014. Epub 2009 Dec 22.
In October 2006, a rotavirus vaccine was introduced in Nicaragua for routine immunization of all children. We document the baseline diarrheal disease burden in Nicaragua prior to the vaccine program to facilitate future studies to measure vaccine impact.
We analyzed national data for 2001-2005 on total acute gastroenteritis healthcare visits, hospitalizations, and mortality in Nicaraguan children aged <5 years.
Prior to vaccine introduction, by age 5 years, one in four Nicaraguan children required an outpatient consultation, one in 34 were hospitalized, and one in 2487 died from rotavirus-associated diarrhea, representing approximately 41,122 outpatient visits, 4460 hospitalizations, and 60 deaths per year that are preventable through vaccination. Almost half of the total acute gastroenteritis burden was in children <1 year of age. Two distinct seasonal peaks were noted in acute gastroenteritis hospitalizations and deaths.
Existing data sources on all-cause acute gastroenteritis could be useful for establishing diarrhea disease burden and monitoring trends after vaccine introduction. Blunting of winter season peaks in rates of diarrhea, particularly among children aged <1-2 years, would be a useful indicator of impact from rotavirus vaccination.
2006 年 10 月，尼加拉瓜引入了轮状病毒疫苗，用于所有儿童的常规免疫。我们记录了疫苗计划前尼加拉瓜的基线腹泻病负担，以便将来研究测量疫苗的影响。
我们分析了 2001-2005 年尼加拉瓜 5 岁以下儿童的总急性肠胃炎医疗就诊、住院和死亡率的国家数据。
在疫苗引入之前，每四个尼加拉瓜儿童中就有一个需要门诊咨询，每 34 个儿童中就有一个住院，每 2487 个儿童中就有一个死于轮状病毒相关腹泻，这代表了每年约 41122 次门诊就诊、4460 次住院和 60 例死亡是可以通过疫苗接种预防的。近一半的总急性肠胃炎负担发生在 1 岁以下的儿童中。急性肠胃炎住院和死亡有两个明显的季节性高峰。
现有的全因急性肠胃炎数据来源可以用于确定腹泻病负担，并在疫苗引入后监测趋势。轮状病毒疫苗接种对腹泻的影响的一个有用指标是减轻冬季腹泻率高峰，特别是在 1-2 岁以下的儿童中。
