Esparza-Aguilar Marcelino, Gastañaduy Paul A, Sánchez-Uribe Edgar, Desai Rishi, Parashar Umesh D, Richardson Vesta, Patel Manish
National Center for Child and Adolescent Health, Ministry of Health, Mexico City, Mexico .
Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, NE - Mailstop A-47, Atlanta, GA 30333, United States of America (USA).
Bull World Health Organ. 2014 Feb 1;92(2):117-25. doi: 10.2471/BLT.13.125286. Epub 2013 Nov 20.
To assess, by socioeconomic setting, the effect of nationwide vaccination against species A rotavirus (RVA) on childhood diarrhoea-related hospitalizations in Mexico.
Data on children younger than 5 years who were hospitalized for diarrhoea in health ministry hospitals between 1 January 2003 and 31 December 2011 were collected from monthly discharge reports. Human development indexes were used to categorize the states where hospitals were located as having generally high, intermediate or low socioeconomic status. Annual rates of hospitalization for diarrhoea--per 10,000 hospitalizations for any cause--were calculated. Administrative data were used to estimate vaccine coverage.
In the states with high, intermediate and low socioeconomic status, coverage with a two-dose monovalent RVA vaccine--among children younger than 5 years--had reached 93%, 86% and 71%, respectively, by 2010. The corresponding median annual rates of hospitalization for diarrhoea--per 10,000 admissions--fell from 1001, 834 and 1033 in the "prevaccine" period of 2003-2006, to 597, 497 and 705 in the "postvaccine" period from 2008 to 2011, respectively. These decreases correspond to rate reductions of 40% (95% confidence interval, CI: 38-43), 41% (95% CI: 38-43) and 32% (95% CI: 29-34), respectively. Nationwide, RVA vaccination appeared to have averted approximately 16,500 hospitalizations for childhood diarrhoea in each year of the postvaccine period.
Monovalent RVA vaccination has substantially reduced childhood diarrhoea-related hospitalizations for four continuous years in discretely different socioeconomic populations across Mexico.
按社会经济背景评估墨西哥全国范围内接种A组轮状病毒（RVA）疫苗对儿童腹泻相关住院率的影响。
从月度出院报告中收集2003年1月1日至2011年12月31日期间在卫生部医院因腹泻住院的5岁以下儿童的数据。使用人类发展指数将医院所在州分为社会经济地位普遍较高、中等或较低的类别。计算腹泻的年度住院率——每10000例因任何原因住院的病例中腹泻的住院例数。利用行政数据估算疫苗接种覆盖率。
到2010年，在社会经济地位高、中、低的州，5岁以下儿童中两剂单价RVA疫苗的接种覆盖率分别达到了93%、86%和71%。相应的腹泻年度住院率中位数——每10000例入院病例中——从2003 - 2006年“疫苗接种前”时期的1001、834和1033，分别降至2008年至2011年“疫苗接种后”时期的597、497和705。这些下降分别对应着40%（95%置信区间，CI：38 - 43）、41%（95% CI：38 - 43）和32%（95% CI：29 - 34）的降幅。在全国范围内，RVA疫苗接种在疫苗接种后的每年似乎避免了约16500例儿童腹泻住院病例。
单价RVA疫苗在墨西哥不同社会经济人群中连续四年大幅降低了儿童腹泻相关住院率。
