Institute for Health Metrics and Evaluation, Seattle, Washington.
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
JAMA Pediatr. 2018 Oct 1;172(10):958-965. doi: 10.1001/jamapediatrics.2018.1960.
Rotavirus infection is the global leading cause of diarrhea-associated morbidity and mortality among children younger than 5 years.
To examine the extent of rotavirus infection among children younger than 5 years by country and the number of deaths averted because of the rotavirus vaccine.
DESIGN, SETTING, AND PARTICIPANTS: This report builds on findings from the Global Burden of Disease Study 2016, a cross-sectional study that measured diarrheal diseases and their etiologic agents. Models were used to estimate burden in data-sparse locations.
Diarrhea due to rotavirus infection.
Rotavirus-associated mortality and morbidity by country and year and averted deaths attributable to the rotavirus vaccine by country.
Rotavirus infection was responsible for an estimated 128 500 deaths (95% uncertainty interval [UI], 104 500-155 600) among children younger than 5 years throughout the world in 2016, with 104 733 deaths occurring in sub-Saharan Africa (95% UI, 83 406-128 842). Rotavirus infection was responsible for more than 258 million episodes of diarrhea among children younger than 5 years in 2016 (95% UI, 193 million to 341 million), an incidence of 0.42 cases per child-year (95% UI, 0.30-0.53). Vaccine use is estimated to have averted more than 28 000 deaths (95% UI, 14 600-46 700) among children younger than 5 years, and expanded use of the rotavirus vaccine, particularly in sub-Saharan Africa, could have prevented approximately 20% of all deaths attributable to diarrhea among children younger than 5 years.
Rotavirus-associated mortality has decreased markedly over time in part because of the introduction of the rotavirus vaccine. This study suggests that prioritizing vaccine introduction and interventions to reduce diarrhea-associated morbidity and mortality is necessary in the continued global reduction of rotavirus infection.
轮状病毒感染是全球 5 岁以下儿童腹泻相关发病率和死亡率的主要原因。
按国家评估 5 岁以下儿童轮状病毒感染的程度，以及轮状病毒疫苗可预防的死亡人数。
设计、地点和参与者：本报告基于 2016 年全球疾病负担研究的结果，这是一项衡量腹泻疾病及其病原体的横断面研究。模型被用于估计数据不足地区的负担。
轮状病毒感染引起的腹泻。
按国家和年份报告轮状病毒相关死亡率和发病率，以及按国家报告轮状病毒疫苗可预防的死亡人数。
2016 年，全球 5 岁以下儿童中估计有 128500 例（95%置信区间[UI]，104500-155600）死于轮状病毒感染，其中撒哈拉以南非洲有 104733 例（95%UI，83406-128842）。2016 年，轮状病毒感染导致 5 岁以下儿童腹泻超过 2.58 亿例（95%UI，1.93 亿至 3.41 亿），发病率为每儿童年 0.42 例（95%UI，0.30-0.53）。估计疫苗使用可使 5 岁以下儿童避免 28000 多例死亡（95%UI，14600-46700），扩大轮状病毒疫苗的使用，特别是在撒哈拉以南非洲，可预防 5 岁以下儿童腹泻相关死亡人数的近 20%。
轮状病毒相关死亡率随着时间的推移而显著下降，部分原因是轮状病毒疫苗的问世。本研究表明，优先考虑引入疫苗和干预措施以减少腹泻相关发病率和死亡率，对于继续减少全球轮状病毒感染是必要的。
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