University Teaching Hospital, Department of Paediatrics and Child Health, Lusaka, Zambia.
University Teaching Hospital, Virology Laboratory, Lusaka, Zambia.
Vaccine. 2018 Nov 12;36(47):7165-7169. doi: 10.1016/j.vaccine.2018.02.077. Epub 2018 May 21.
Monovalent rotavirus vaccine (RV1) was introduced in Lusaka in February 2012 and rolled out countrywide in November 2013 in the routine Expanded Programme on Immunisation and administered at 6 and 10 weeks with no catch up dose. Reported here is the monitoring of rotavirus acute gastroenteritis hospitalisations at the University Teaching Hospital, Lusaka, Zambia as part of efforts to document the impact of rotavirus vaccine.
Children <5 years hospitalised for acute gastroenteritis (AGE) from January 2009 to December 2016 were recruited into the rotavirus disease burden active surveillance and had their stools tested for rotavirus by enzyme immunoassay. We compared rotavirus-associated AGE hospitalisations of the pre-vaccine era (2009-2011) with the post-rotavirus vaccine introduction period (2013-2016).
With the increase in RV1 coverage in Lusaka, rotavirus AGE declined significantly from 40% of diarrhoea hospitalisation in the pre-vaccine era to 29% of diarrhoea hospitalisation in the post-vaccine era (p < 0.001) in children <5 years. After a decreasing trend in rotavirus positivity from 2013 to 2015, positivity increased to 37% in 2016. However, the post-vaccine years (2012-2016) saw substantial decline in the number tested (median decline: 34% (range: 20-43%)) and the number of positive results (median decline: 52% (range: 30-65%).
A sustained and significant decline in rotavirus AGE hospitalisations was observed in children <5 years since the introduction of RV1 in Lusaka, Zambia. Despite an increase in rotavirus positivity in 2016, the total number of children enrolled and the number of rotavirus positive children remained below baseline. The reason for the increase in rotavirus positivity in 2016 is unknown but could be due to an accumulation of susceptible children and the shifting of disease to children of older age groups. This finding underscores the need for continued monitoring of rotavirus vaccine impact.
单价轮状病毒疫苗（RV1）于 2012 年 2 月在卢萨卡推出，并于 2013 年 11 月在全国扩大免疫规划中推出，分别于 6 周和 10 周龄时接种，没有补种剂量。这里报告的是在赞比亚卢萨卡教学医院监测轮状病毒急性胃肠炎住院情况，作为记录轮状病毒疫苗影响的努力的一部分。
2009 年 1 月至 2016 年 12 月期间，因急性胃肠炎（AGE）住院的<5 岁儿童被纳入轮状病毒疾病负担主动监测，并通过酶免疫测定检测其粪便中的轮状病毒。我们比较了疫苗引入前时期（2009-2011 年）与轮状病毒疫苗引入后时期（2013-2016 年）的轮状病毒相关 AGE 住院情况。
随着卢萨卡 RV1 覆盖率的增加，轮状病毒 AGE 从疫苗引入前时期的 40%<5 岁儿童腹泻住院率显著下降到疫苗引入后时期的 29%（p<0.001）。在 2013 年至 2015 年期间，轮状病毒阳性率呈下降趋势后，2016 年阳性率上升至 37%。然而，在疫苗接种后年份（2012-2016 年），检测数量大幅下降（中位数下降：34%（范围：20-43%）），阳性结果数量下降（中位数下降：52%（范围：30-65%））。
自赞比亚卢萨卡引入 RV1 以来，<5 岁儿童的轮状病毒 AGE 住院率持续显著下降。尽管 2016 年轮状病毒阳性率有所增加，但入组儿童总数和轮状病毒阳性儿童数量仍低于基线。2016 年轮状病毒阳性率增加的原因尚不清楚，但可能是由于易感儿童的积累和疾病向年龄较大的儿童群体转移。这一发现强调了需要继续监测轮状病毒疫苗的影响。
