Wandera Ernest Apondi, Mohammad Shah, Bundi Martin, Komoto Satoshi, Nyangao James, Kathiiko Cyrus, Odoyo Erick, Miring'u Gabriel, Taniguchi Koki, Ichinose Yoshio
KEMRI/Nagasaki University, Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya; Graduate School of Biomedical Sciences, Nagasaki University, Japan.
KEMRI/Nagasaki University, Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya.
Vaccine. 2017 Sep 12;35(38):5217-5223. doi: 10.1016/j.vaccine.2017.07.096. Epub 2017 Aug 2.
A monovalent rotavirus vaccine (RV1) was introduced into the National Immunization Program in Kenya in July 2014. We examined the impact of the vaccine on hospitalization for all-cause acute gastroenteritis (AGE) and rotavirus-specific AGE and strain distribution at a large referral hospital which serves a predominantly peri-urban population in Central Kenya. Data on rotavirus AGE and strain distribution were derived from ongoing hospital-based AGE surveillance. Hospital administrative data were used to compare trends in all-cause AGE. Pre-vaccine (July 2009-June 2014) and post-vaccine (July 2014-June 2016) periods were compared for changes in hospitalization for all-cause AGE and rotavirus AGE and strain distribution. Following the vaccine introduction, the proportion of children aged <5years hospitalized for rotavirus declined by 30% (95% CI: 19-45%) in the first year and 64% (95% CI: 49-77%) in the second year. Reductions in rotavirus positivity were most pronounced among the vaccine-eligible group (<12months) in the first year post-vaccination at 42% (95% CI: 28-56%). Greater reductions of 67% (95% CI: 51-79%) were seen in the second year in the 12-23months age group. Similarly, hospitalizations for all-cause AGE among children <5years of age decreased by 31% (95% CI: 24-40%) in the first year and 58% (95% CI: 49-67%) in the second year of vaccine introduction. Seasonal peaks of rotavirus and all-cause AGE were reduced substantially. There was an increased detection of G2P[4], G3P[6] and G3P[8], which coincided temporally with the timing of the vaccine introduction. Thus, introducing the rotavirus vaccine into the routine immunization program in Kenya has resulted in a notable decline in rotavirus and all-cause AGE hospitalizations in Central Kenya. This provides early evidence for public health policy makers in Kenya to support the sustained use of the rotavirus vaccine in routine immunizations.
2014年7月，一种单价轮状病毒疫苗（RV1）被引入肯尼亚国家免疫规划。我们在一家大型转诊医院研究了该疫苗对因各种原因导致的急性胃肠炎（AGE）住院治疗以及轮状病毒特异性AGE和毒株分布的影响，这家医院主要服务肯尼亚中部以城郊人口为主的地区。轮状病毒AGE和毒株分布的数据来自正在进行的基于医院的AGE监测。医院管理数据用于比较各种原因导致的AGE的趋势。比较了疫苗接种前（2009年7月至2014年6月）和疫苗接种后（2014年7月至2016年6月）期间因各种原因导致的AGE住院治疗情况以及轮状病毒AGE和毒株分布的变化。疫苗引入后，5岁以下儿童因轮状病毒住院的比例在第一年下降了30%（95%置信区间：19 - 45%），第二年下降了64%（95%置信区间：49 - 77%）。接种疫苗后第一年，在符合接种条件的组（<12个月）中轮状病毒阳性率的降低最为明显，为42%（95%置信区间：28 - 56%）。在第二年，12 - 23个月年龄组的降低幅度更大，为67%（95%置信区间：51 - 79%）。同样，5岁以下儿童因各种原因导致的AGE住院治疗在疫苗引入后的第一年下降了31%（95%置信区间：24 - 40%），第二年下降了58%（95%置信区间：49 - 67%）。轮状病毒和各种原因导致的AGE的季节性高峰大幅降低。G2P[4]、G3P[6]和GIP[8]的检测有所增加，这与疫苗引入的时间在时间上相吻合。因此，将轮状病毒疫苗引入肯尼亚的常规免疫规划已导致肯尼亚中部轮状病毒和各种原因导致的AGE住院治疗显著下降。这为肯尼亚的公共卫生政策制定者提供了早期证据，以支持在常规免疫中持续使用轮状病毒疫苗。
