Kelly Matthew J, Foley David, Blackmore Timothy K
Department of Medicine, Hutt Hospital, Hutt Valley District Health Board, High St, Lower Hutt 5010, New Zealand.
Wellington SCL Microbiology Laboratory, Wellington Hospital, Riddiford St, Wellington 6010, New Zealand.
Vaccine. 2017 Aug 16;35(35 Pt B):4578-4582. doi: 10.1016/j.vaccine.2017.07.018. Epub 2017 Jul 15.
To assess the impact of the introduction of rotavirus vaccination in New Zealand at a regional and national level, underlining the utility of a passively collected laboratory dataset.
Retrospective laboratory data for rotavirus testing from Wellington and Hutt Hospitals from 1 January 2010 to 31 December 2016, matched with hospital admissions data of children under 5years of age with gastroenteritis primary and secondary coded admissions. The second part of the study examined the national dataset of primary coded hospital gastroenteritis admissions from the same period.
Rotavirus testing was performed in 1054 (64.1%) of the 1645 gastroenteritis admissions to Wellington and Hutt Hospitals. Four hundred and nine of these tests (38.8%) were positive. Children who were not given a primary code of gastroenteritis accounted for 5.7% of rotavirus admissions. The estimated annual rotavirus hospitalisation rate in the Hutt and Wellington regions for children under 5years during the pre-vaccination period was 427.1 per 100,000. In the post-vaccination period (2015-2016), there was a 94.6% reduction in confirmed rotavirus gastroenteritis hospitalisations with only 8 confirmed cases. The total number of gastroenteritis admissions declined by 51.4%. On a national scale, there was a decline of 34.4% in the average annual number of gastroenteritis admissions and the number of coded rotavirus admissions was 87.1% lower than the pre-vaccination average.
The non-restrictive continuous approach to rotavirus testing has provided a detailed description of the epidemiology of rotavirus gastroenteritis hospitalisations in the Wellington and Hutt regions. Rotavirus vaccination introduced on the crest of a peak in rotavirus cases has lead to a marked reduction in the number of admissions with gastroenteritis in New Zealand in the two years following vaccine introduction. The national figures likely underestimate the impact of the vaccine.
评估在新西兰地区和国家层面引入轮状病毒疫苗的影响，强调被动收集的实验室数据集的实用性。
回顾性分析2010年1月1日至2016年12月31日惠灵顿和哈特医院轮状病毒检测的实验室数据，并与5岁以下患肠胃炎且主要和次要编码入院的儿童的住院数据相匹配。研究的第二部分检查了同期全国主要编码的医院肠胃炎入院数据集。
惠灵顿和哈特医院1645例肠胃炎入院病例中，1054例（64.1%）进行了轮状病毒检测。其中409例检测（38.8%）呈阳性。未被列为主要肠胃炎编码的儿童占轮状病毒入院病例的5.7%。疫苗接种前，哈特和惠灵顿地区5岁以下儿童的估计年度轮状病毒住院率为每10万人427.1例。在疫苗接种后时期（2015 - 2016年），确诊的轮状病毒肠胃炎住院病例减少了94.6%，仅8例确诊病例。肠胃炎入院总数下降了51.4%。在全国范围内，肠胃炎入院的年均数量下降了34.4%，编码的轮状病毒入院病例数量比疫苗接种前的平均水平低87.1%。
对轮状病毒检测采取的非限制性连续方法详细描述了惠灵顿和哈特地区轮状病毒肠胃炎住院的流行病学情况。在轮状病毒病例高峰时引入轮状病毒疫苗，导致疫苗引入后的两年里新西兰肠胃炎入院人数显著减少。全国数据可能低估了疫苗的影响。
