Hegazi Moustafa Abdelaal, Sayed Mohamed Hesham, Sindi Haifa Hasan, Bekhit Osama Elsayed, El-Deek Basem Salama, Alshoudri Faisal M Yaqoub, Noorelahi Amroo Khaled
Department of Pediatrics, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia Department of Pediatrics, Mansoura University Children's Hospital, Mansoura, Egypt Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt Department of Pediatrics, Maternity and Children Hospital (Al-Mossadia), Jeddah, Saudi Arabia Department of Pediatrics, Faculty of Medicine, Fayoum University, Egypt Department of Pediatrics, Hai Al-Jameah Hospital, Jeddah, Saudi Arabia Department of Community Medicine and Public Health, Mansoura Faculty of Medicine, Mansoura, Egypt Department of Community Medicine and Public Health, King Abdulaziz University, Jeddah, Saudi Arabia.
Medicine (Baltimore). 2017 Apr;96(15):e6574. doi: 10.1097/MD.0000000000006574.
Previous studies in Jeddah, western Saudi Arabia, showed rotavirus (RV) prevalence around 40% in pediatric inpatients with gastroenteritis (GE) with a maximum level during cooler months. Currently, there are no data on impact of rotavirus vaccine (RVV) on RV-GE in Saudi Arabia. Therefore, this study was conducted to assess impact of RVV on incidence and severity of RV-GE in hospitalized pediatric patients; 3 years after introduction of RVV in Saudi immunization program (SIP) in January, 2013.This cross-sectional observational study included GE cases under 5 years of age admitted to 2 tertiary hospitals, in Jeddah, from October to December, 2015. All included GE-cases had RV antigen detection in stool by immunochromatographic assay, complete data collection including RVV status and severity assessment (Vesikari score) in initial admission.During study period, a total of 359 GE cases in children under 5 years of age were hospitalized with 14 (3.9%) RV-GE confirmed cases. Mean age of RV-GE patients was 13.10 ± 5.70 months. All RV cases had severe GE and 1 case received RVV. Among other 345 GE cases, 35.7% did not receive RVV and 46.1% had severe GE. Severe GE (Vesikari score > 11) was more significantly identified among RV-GE cases than in other all-cause GE (P < .001). During same period of this study in 2012, 369 RV-GE out of 1193 total GE cases (31%) were hospitalized at 2 hospitals, so, number of hospitalized pediatric patients for all-cause and RV-GE in children under 5 years of age decreased significantly in 2015 RV season (compared to 2015 RV season, odds ratio for RV-GE in 2012: 11.04, 95% CI: 6.38-19.09).Logistic regression analysis of variables of this cross-sectional, hospital-based study in Jeddah, Saudi Arabia, 3 years after introduction of RVV in SIP, showed that among the studied variables, RVV was associated with remarkable reduction of hazard of all-cause and RV-GE in vaccinated and even in unvaccinated children under 5 years of age possibly by RVV herd effect. However, RV was still associated with severe GE-related hospitalizations in unvaccinated children against RV who were younger than 2 years and particularly in the 1st year of life, indicating need for more optimum rate of RVV coverage. Hopefully, further improvement in RVV coverage rate may make RV-GE a disease of the past in Saudi children.
先前在沙特阿拉伯西部吉达开展的研究表明，在患有肠胃炎（GE）的儿科住院患者中，轮状病毒（RV）感染率约为40%，在较凉爽的月份达到最高水平。目前，尚无关于轮状病毒疫苗（RVV）对沙特阿拉伯RV-GE影响的数据。因此，本研究旨在评估RVV对住院儿科患者RV-GE发病率和严重程度的影响；这是在2013年1月沙特免疫计划（SIP）引入RVV三年后进行的。这项横断面观察性研究纳入了2015年10月至12月在吉达两家三级医院住院的5岁以下GE病例。所有纳入的GE病例均通过免疫层析法检测粪便中的RV抗原，在初次入院时完成包括RVV状态和严重程度评估（韦西卡里评分）在内的数据收集。在研究期间，共有359例5岁以下儿童因GE住院，其中14例（3.9%）确诊为RV-GE病例。RV-GE患者的平均年龄为13.10±5.70个月。所有RV病例均患有严重GE，1例接受了RVV。在其他345例GE病例中，35.7%未接种RVV，46.1%患有严重GE。与其他所有病因的GE相比，RV-GE病例中严重GE（韦西卡里评分>11）的确诊率更高（P< .001）。在本研究的同一时期，2012年两家医院共1193例GE病例中有369例（31%）因RV-GE住院，因此，2015年RV流行季5岁以下儿童因各种病因和RV-GE住院的患儿数量显著减少（与2012年RV流行季相比，2012年RV-GE的优势比：11.04，95%CI：6.38-19.09）。在SIP引入RVV三年后，对沙特阿拉伯吉达这项基于医院的横断面研究的变量进行逻辑回归分析表明，在研究的变量中，RVV与接种疫苗以及未接种疫苗的5岁以下儿童中各种病因和RV-GE风险的显著降低相关，这可能是由于RVV的群体效应。然而，对于未接种RV疫苗的2岁以下儿童，尤其是在生命的第一年，RV仍与严重GE相关住院有关，这表明需要提高RVV的覆盖率。有望进一步提高RVV覆盖率，使RV-GE在沙特儿童中成为过去式。
