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Background and aim: The introduction of rotavirus vaccine (RVV) in the universal immunization program of India is a big feat as it became the first nation in the World Health Organization (WHO) Southeast Asia region to do so. The involvement of huge numbers of frontline workers in introducing new vaccines in India and the underlined deficits in skills and knowledge require efficient capacity building programs. In view of this, limited research is available on the effectiveness of capacity-building interventions for healthcare workers. There is a dearth of studies from India measuring the “on-spot” impact of immunization trainings on healthcare workers. This study aims to assess the effectiveness of training in RVV introduction in enhancing the knowledge of the participants. Methods: The study was conducted among the participants attending two training workshops for the introduction of RVV: a state workshop in Pune and a regional workshop in Guwahati. The participants who attended the workshops and participated in both the pre- and post-test were included in the study. Real-time data was collected via Google forms pre- and post-training sessions. Results: In both workshops, a comparison of pre- and post-test scores of all questions taken together showed a significant increase in the knowledge level of the participants (p < 0.05). In Guwahati, the knowledge of the participants regarding doses of RVV, inadequate dosing, vaccine vial monitor (VVM), open vial policy, operationalization of RVV and monetary incentive increased significantly. In Pune, the knowledge of the participants regarding doses of RVV, bundling approach, schedule and dose, storage temperature for RVV, VVM, open vial policy, vaccine delivery and operationalization of RVV increased significantly after the training. Conclusion: A pre-planned and well-designed knowledge assessment tool can be used to understand the impact of training workshops in enhancing the knowledge and practical skills of the participants prior to the introduction of a new vaccine.
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Objective:To evaluate the difference in safety and immunogenicity of live rotavirus vaccine (oral) and measles, mumps and rubella (MMR) vaccine immunized alone or in combination.Methods:This study recruited 1 752 children aged 8-9 months who had not been vaccinated with live rotavirus vaccine (oral) or MMR vaccine after birth. The subjects were divided into three groups: study group (652 subjects, immunized with live rotavirus vaccine and MMR vaccine), control group 1 (723 subjects, immunized with live rotavirus vaccine) and control group 2 (377 subjects, immunized with MMR vaccine). Local and systemic adverse reactions within 30 d after vaccination were recorded. Serum samples were collected before and 35-42 d after immunization for analyzing the changes in antibodies.Results:Immunization alone or in combination with live rotavirus vaccine (oral) and MMR vaccine achieved similar results in the positive rates and concentrations of antibodies against rotavirus, measles and rubella viruses ( P>0.05). Moreover, the positive rates and the concentrations of the three antibodies were increased after vaccination. Compared with the control group 2, the concentration of antibody against mumps virus in the study group was increased ( P<0.05), but no significant difference in the positive rate of antibody against mumps virus was found between the two groups ( P>0.05). The positive rate and the concentration of antibody against mumps virus were increased after combined immunization or immunization with MMR vaccine alone. The overall incidence of fever and diarrhea was 1.54% (27/1 752) and 0.63% (11/1 752). No other abnormal reactions, incidental reactions or adverse reactions of any clinical significance were observed. Conclusions:Live rotavirus vaccine (oral) and MMR vaccine immunized alone or in combination showed good immunogenicity and safety.
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Group A rotavirus (RV) is one of the major pathogens that cause severe acute gastroenteritis and death in children under 5 years old in China. RV vaccination is the most effective measure for prevention and control of rotavirus gastroenteritis (RVGE). This consensus is developed by reviewing RV related literatures, RV disease data in China, World Health Organization(WHO) position paper on RV vaccines and expert discussion. This consensus aims to provide professional staff with scientific information on rotavirus vaccine use, and evidences for developing the immunization strategy of childhood RVGE in China.
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Child , Child, Preschool , Humans , Infant , China , Consensus , Gastroenteritis/prevention & control , Hospitalization , Rotavirus , Rotavirus Infections/prevention & control , VaccinationABSTRACT
Background and Aims:There is a high burden of vaccine-preventable diseases in the children under five years of age, particularly pneumonia diarrhea and which is greatly affected by low immunization coverage despite the existing efforts and policies. This study was carried out in Butaleja district and was aimed at establishing the socio-demographic determinants of vaccine coverage for pneumococcus and rotavirus among under five children (U5C) in the district. Study Design:This was a mixed methods cross-sectional study.Place and Duration of Study:Busolwe Town Council, Butaleja District, Eastern Uganda.Methodology:Structured researcher administered questionnaires were administered to 434 caregivers of U5C in different parts of Butaleja district. In-depth interviews with key informants and focused group discussions with Village Health Teams and community members were conducted. Review of Health Management Information Systems records was done. STATA 15 was used to analyze the data.Results:The study found that there is a declining trend in completion of the doses of Pneumococcal vaccine (PCV) and Rotavirus vaccine. For example, in quarter 1 of 2019, out of the 312 children who started immunization, only 2 completed Rota virus immunization and only 117 completed PCV vaccinations a trend that has been observed since 2016. The factors that showed a significant association with the the fact that they gave their child at least one dose of the vaccinewere having been sensitized on the current immunisation schedule(P-value = <0.001), misunderstanding that vaccine is harmful for child(P-value = 0.007), willingness to take children to vaccination(P-value = <0.001), and social factors such as family (P-value = <0.030). Gender also played a key determinant role where the children’s fathers lacked knowledge on significance of immunization and thus discouraged the mothers from taking the children for immunization. Inadequate funding was also highlighted from the Focus Group Discussions.Conclusion:Vaccine coverage for pneumococcus and rotavirus is still low in Butaleja district mainly due to the attitudes and perceptions of caregivers as well as the knowledge gap. There is need forextensive sensitization of all community members to enable them understand the significance of immunization. It would further be important to increase the funding of the immunization programme to intensify and ensure effectual outreaches as well as the establishment and enforcement of a policy for immunization compliance.
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Objective@#To analyze vaccination situation of oral live attenuated rotavirus vaccine (LLR strain) among children from six provinces in China.@*Methods@#In 2014, we selected 12 counties in Guangdong, Jiangsu, Chongqing, Jiangxi, Heilongjiang and Gansu provinces by using stratified cluster random sampling method and extract information of children born from January 1, 2008 to December 31, 2012 from Children's Immunization Information System. We investigated ten children of each birth cohort in each county by checking the vaccination certification, and a total of 606 children were investigated. A survey was conducted to check the information of the children's vaccination certification with the data of Children's Immunization Information System by questionnaire including the basic information (province, county, name, gender, birth date, etc) and the rotavirus vaccination (vaccination date, dose, etc) to analyze the rotavirus vaccination situation.@*Results@#340 of 606 children were male. There were 121, 124, 122, 119 and 120 children born in 2008-2012, respectively. The proportions of the first and the second dose of rotavirus vaccination were 32.8% (199) and 9.7% (59). The proportion of the third dose of rotavirus vaccination among children born between 2008 and 2010 was 3.5% (13) since children born in 2011 and 2012 did not reach the age of third dose vaccination. The proportion of the first dose of rotavirus vaccination in high, middle and low per capita disposable income areas was 45.0% (91), 37.7% (77) and 15.5% (31) respectively (χ2= 43.15, P<0.001). Among 199 children vaccinated with the first dose of vaccine, the vaccination age mainly concentrated in 2 to 21 months, of which the peak was 5 to 13 months (66.8%, 133). The intervals between 2 doses of vaccination were mainly from 12 to 13 months (42.4%, 25) among the 59 children who received at least 2 doses of vaccine. In the 13 children vaccinated with 3 doses, the intervals between the second and the third dose were 12 months (5). Of the 271 doses of rotavirus vaccine vaccinated during 2008-2014, 34.7% (94 doses) were vaccinated in June-August, 88 were vaccinated simultaneously with 18 other vaccines, accounting for 32.5% of the total. Of the 18 other vaccines, inactivated vaccines such as diphtheria vaccine (30 doses), Hib vaccine (14 doses), group A meningitis vaccine (10 doses) were predominant.@*Conclusion@#The proportion of rotavirus vaccination was low and the vaccination age was relatively late. The vaccination mode was different from the recommendation of WHO. It is recommended that routine immunization of rotavirus vaccines should be carried out in early-months of children.
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Objective To investigate the immunization coverage of oral live attenuated rotavirus vaccines and its influencing factors among children under 5 years old in Jinshan District of Shanghai in order to provide references for optimizing vaccination management in this area. Methods A cross-sectional study was conducted in 6 community vaccination clinics randomly selected from 12 vaccination clinics in Jinshan District. In each selected clinic,145 children under 5 years old were continuously recruited. Information on immunization status,demographics of children,family socioeconomic status and parents′knowledge of vacci-nation were collected through questionnaire interview. Logistic regression was used to analyze factors influen-cing immunization status by using SPSS22.0. Results Among the 863 participating children, the immuni-zation coverage rate of oral live attenuated rotavirus vaccines was 61.07%. Multivariate analysis revealed that children having an urban registration status (OR=2.21),better family income (OR=1.47) and par-ents with high recognition of rotavirus diarrhea (OR=8.56) and stronger intention to following "doctor′s suggestions" (OR=1.96) were more likely to accept oral live attenuated rotavirus vaccines, while those from families with a medical professional were less likely to be vaccinated (OR=0.57). Conclusion The immunization coverage rate of oral live attenuated rotavirus vaccines among children in Jinshan District were influenced by various factors such as children′s household registration status, household income, parents′knowledge regarding vaccination and doctors′suggestions. Health education on immunization should be strengthened and tailor-made to improve the coverage of oral rotavirus vaccination.
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OBJECTIVE: This study aimed to analyze Rotavirus (ROTA) and Measles, Mumps and Rubella (MMR) vaccine wastage in vaccination rooms of Juiz de Fora city, MG, Brazil, to identify factors related to this wastage. METHODS: The study had a cross-sectional design, based on spreadsheets reporting monthly vaccine use in a year; and based on questionnaires applied to 45 urban vaccination rooms. A linear regression model was developed, endeavoring to predict vaccine loss rates using variables related to vaccination room infrastructure/operational conditions. RESULTS: Statistical significance was detected for ROTA loss variables: vaccine knowledge, health unit type and number of personnel in the vaccination room (R2=0.33; p = 0.001). It was also found that 1,254 ROTA and 33,762 MMR doses were wasted during the period. Concerning ROTA, 331 (26.4%) were technical losses, and 923 (73.6%) miscellaneous losses; for the MMR vaccine, these numbers were 23,281 (68.96%) for technical losses and 10,481 (31.04%) for miscellaneous losses. CONCLUSION: The percentage losses in the period were significant, which should induce the production of health protocols to facilitate the correction of weaknesses in the studied vaccine cold chain.
RESUMO: Este estudo analisou as perdas vacinais das vacinas contra o Rotavírus (ROTA) e contra o Sarampo, Caxumba e Rubéola (VTV) em salas de vacinação de Juiz de Fora, MG, a fim de identificar os fatores relacionados a essas perdas. MÉTODO: Tratou-se de um estudo transversal, baseado na análise dos movimentos mensais das vacinas estudadas durante um ano, por meio de planilhas e de questionários aplicados em 45 salas de vacinação urbanas. Um modelo de regressão linear foi desenvolvido, tentando prever perdas vacinais por meio de variáveis de infra-estrutura e funcionamento das salas. RESULTADOS: Foi detectada significância estatística para o modelo ROTA, variáveis: conhecimento sobre vacinas, tipo de unidade e número de funcionários que atuam na sala de vacina (R2=0,33; p = 0,001). Constatou-se 1254 doses perdidas de ROTA e 33762 de VTV durante o período pesquisado. Das 1254 doses perdidas de ROTA, 331 (26,4%) foram devidas a Perdas Técnicas, e 923 (73,6%) a Perdas Diversas. Para a vacina VTV, das 33762 doses perdidas, 23281 (68,96%) foram por Perdas Técnicas, e 10481 (31,04%) por Perdas Diversas. CONCLUSÃO: Conclui-se que as perdas percentuais, no período, foram significantes, podendo instigar a produção de protocolos de saúde para auxiliar a eliminação dos pontos frágeis na cadeia de aplicação das vacinas.
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Humans , Measles-Mumps-Rubella Vaccine , Rotavirus Vaccines , Cross-Sectional Studies , Immunization Schedule , Vaccination CoverageABSTRACT
PURPOSE: Despite withdrawal of RotaShield® and the development of second generation live attenuated rotavirus vaccines, concerns remain regarding the relationship between rotavirus vaccine and intussusception. Nevertheless, since there is no study in Korea, we reviewed data from cases at Severance Children's Hospital to determine the association between rotavirus vaccine and intussusception. MATERIALS AND METHODS: Patients coded as intussusception and following a prescription of RotaTeq® from 2007 to 2013 were reviewed. We calculated comparative incidence figures (CIFs) and 95% confidence intervals (CIs) to compare the risk of intussusception in Korea with the risk in the United States. Expected cases within the four-week post-vaccination window were calculated by applying rates of intussusception from data compiled by the Health Insurance Review and Assessment Service (for a five-year period) to numbers of vaccinations. RESULTS: In total, 10530 doses of pentavalent rotavirus vaccine were administered. A total of 65 intussusception cases were diagnosed, although only two cases occurred within four weeks after vaccination. This was compared to six cases within 999123 doses in United States from April 2008 to March 2013 (CIF, 31.63; CI, 31.33–31.93). When we adjusted incidence rate differences for both countries, the CIF decreased to 7.05 (CI, 6.72–7.40). When we compared our identified cases with the expected cases from our hospital, there was no increased intussusception occurring within four weeks of vaccination. CONCLUSION: We found no association between pentavalent rotavirus vaccine and intussusception. Therefore, rotavirus vaccination should be considered due to its benefits of preventing rotavirus-associated diseases.
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Humans , Incidence , Insurance, Health , Intussusception , Korea , Prescriptions , Retrospective Studies , Rotavirus Vaccines , Rotavirus , United States , VaccinationABSTRACT
Objective: To assess feasibility of monitoring intussusception by hospitals participating in the National Rotavirus Surveillance Network. Methods: Questionnaire-based survey in 28 hospitals. One hospital with electronic records selected for detailed data analysis. Results: There was 75% response to the questionnaire. Few network hospitals were suitable for monitoring intussusception in addition to ongoing activities, but there was at least one potential sentinel hospital in each region. The hospital selected for detailed data analysis of cases of intussusception reported an incidence rate of 112 per 100,000 child years in infants. Over 90% of intussusceptions were managed without surgery. Conclusions: Selection of sentinel hospitals for intussusception surveillance is feasible and necessary, but will require training, increased awareness and referral.
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Objective: To assess feasibility of monitoring intussusception by hospitals participating in the National Rotavirus Surveillance Network. Methods: Questionnaire-based survey in 28 hospitals. One hospital with electronic records selected for detailed data analysis. Results: There was 75% response to the questionnaire. Few network hospitals were suitable for monitoring intussusception in addition to ongoing activities, but there was at least one potential sentinel hospital in each region. The hospital selected for detailed data analysis of cases of intussusception reported an incidence rate of 112 per 100,000 child years in infants. Over 90% of intussusceptions were managed without surgery. Conclusions: Selection of sentinel hospitals for intussusception surveillance is feasible and necessary, but will require training, increased awareness and referral.
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Objective: To characterize rotavirus infections detected in rotavirus vaccinated children hospitalized for acute gastroenteritis. Design: Observational, hospital-based study. Setting: Three hospitals in Pune, Western India. Participants: Children aged <5 years hospitalized for acute gastroenteritis during 2013-14. Methods: Rotavirus capture ELISA was performed on all stool samples that were collected from patients following informed consent from parents. VP7 and VP4 genes of rotavirus strains were genotyped by multiplex RT-PCR. Stool samples from vaccinated children were tested for other enteric viruses. Results: Among the 529 children, 53 were vaccinated with at least one dose of the rotavirus vaccine. There was no difference in the mean (SD) (months) age of vaccinated [14.8 (10.6)] and unvaccinated [14.4 (10.5)] children. Rotavirus positivity was significantly higher (47%) in unvaccinated than in vaccinated (28.3%) children (P=0.01). Mean Vesikari score and severe cases were significantly more in rotavirus positive than in negative children within unvaccinated group (P<0.001), while these did not differ within the vaccinated group. Rotavirus strain G1P[8] was identified as the most prevalent strain in both, vaccinated (60%) and unvaccinated (72.8%) groups. No association was found between mean Vesikari score and viral coinfections. Conclusions: This study suggests decline in rotavirus positivity in rotavirus-vaccinated children hospitalized for acute gastroenteritis and high prevalence of G1P[8] and non-rotaviral co-infections in Pune, Western India.
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Objective To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy,in China.Methods Through constructing decision tree-Markov model,we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as:group with no vaccination,Rotavirus vaccination group and Rotateq vaccination group,respectively.We determined the optimal program,based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP).Results Compared with non-vaccination group,the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss,respectively.Results from sensitivity analysis indicated that both results were robust.Compared with Rotavirus vaccination program,the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss.Data from the sensitivity analysis indicated that the result was not robust.Conclusion From the perspective of health economics,both two-dose Rotarix vaccine and three-dose's Rotateq vaccine programs were highly cost-effective,when compared to the non-vaccination program.It was appropriate to integrate rotavirus vaccine into the routine immunization program.Considering the large amount of extra cost that had to spend on Rotateq vaccination program,results from the sensitivity analysis showed that it was not robust.Rotateq vaccine required one more dose than the Rotarix vaccine,to be effective.However,it appeared more difficult to practice,suggesting that it was better to choose the Rotarix vaccine,at current stage.
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Objective To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy,in China.Methods Through constructing decision tree-Markov model,we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as:group with no vaccination,Rotavirus vaccination group and Rotateq vaccination group,respectively.We determined the optimal program,based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP).Results Compared with non-vaccination group,the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss,respectively.Results from sensitivity analysis indicated that both results were robust.Compared with Rotavirus vaccination program,the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss.Data from the sensitivity analysis indicated that the result was not robust.Conclusion From the perspective of health economics,both two-dose Rotarix vaccine and three-dose's Rotateq vaccine programs were highly cost-effective,when compared to the non-vaccination program.It was appropriate to integrate rotavirus vaccine into the routine immunization program.Considering the large amount of extra cost that had to spend on Rotateq vaccination program,results from the sensitivity analysis showed that it was not robust.Rotateq vaccine required one more dose than the Rotarix vaccine,to be effective.However,it appeared more difficult to practice,suggesting that it was better to choose the Rotarix vaccine,at current stage.
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Background: Rotavirus vaccines were introduced in Japan in November 2011. We evaluated the subsequent reduction of the health-care burden of rotavirus gastroenteritis. Methods: We conducted active surveillance for rotavirus gastroenteritis among children under 5 years old before and after the vaccine introduction. We surveyed hospitalization rates for rotavirus gastroenteritis in children in Tsu City, Mie Prefecture, Japan, from 2007 to 2015 and surveyed the number of outpatient visits at a Tsu City clinic from 2010 to 2015. Stool samples were obtained for rotavirus testing and genotype investigation. We assessed rotavirus vaccine coverage for infants living in Tsu City. Results: In the pre-vaccine years (2007-2011), hospitalization rates for rotavirus gastroenteritis in children under 5 years old were 5.5, 4.3, 3.1 and 3.9 cases per 1000 person-years, respectively. In the post-vaccine years (2011-2015), the rates were 3.0, 3.5, 0.8 and 0.6 cases per 1000 person-years, respectively. The hospitalization rate decreased significantly in the 2013-2014 and 2014-2015 seasons compared to the average of the seasons before vaccine introduction (p < 0.0001). In one pre-vaccine year (2010-2011), the number of outpatient visits due to the rotavirus infection was 66. In the post-vaccine years (2011-2015), the numbers for each season was 23, 23, 7 and 5, respectively. The most dominant rotavirus genotype shifted from G3P[8] to G1P[8] and to G2P[4]. The coverage of one dose of rotavirus vaccine in Tsu City was 56.5% in 2014. Conclusion: After the vaccine introduction, the hospitalization rates and outpatient visits for rotavirus gastroenteritis greatly decreased.
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Se ha establecido en los países tropicales que la infección por rotavirus muestra actividad durante todo el año. Sin embargo, estudios realizados en Venezuela y Brasil sugieren un comportamiento estacional de la infección. Por otro lado, algunos trabajos relacionan la estacionalidad de la infección con variables climáticas como la precipitación. El presente estudio tiene como objetivos analizar el patrón de comportamiento de la infección por rotavirus en el estado Carabobo-Venezuela (2001-2005), asociar la estacionalidad de la infección con la precipitación y según el patrón estacional, estimar la edad de mayor riesgo para sufrir la enfermedad. El análisis de las series temporales rotavirus y precipitación acumulada se realizó con el paquete SPSS. La infección mostró dos períodos: uno de alta incidencia (noviembre-abril) y otro de baja incidencia (mayo-octubre). La serie de precipitación acumulada presentó un comportamiento opuesto. La mayor frecuencia (73,8% 573/779) de eventos para los nacidos en la estación de baja incidencia del virus se registró a más temprana edad (media edad 6,5 ± 2,0 meses) al compararla con los nacidos en la estación de alta incidencia (63,5% 568/870, media edad 11,7 ± 2,2 meses). Se demostró la estacionalidad de la infección y la relación inversa entre la precipitación y la incidencia del virus. Además, se comprobó cómo el período de nacimiento determina la edad y riesgo de sufrir la infección. Esta información generada durante el período prevacuna será de mucha ayuda para medir el impacto de la inmunización contra el rotavirus.
In general, it has been reported that rotavirus infection was detected year round in tropical countries. However, studies in Venezuela and Brazil suggest a seasonal behavior of the infection. On the other hand, some studies link infection with climatic variables such as rainfall. This study analyzes the pattern of behavior of the rotavirus infection in Carabobo-Venezuela (2001-2005), associates the seasonality of the infection with rainfall, and according to the seasonal pattern, estimates the age of greatest risk for infection. The analysis of the rotavirus temporal series and accumulated precipitation was performed with the software SPSS. The infection showed two periods: high incidence (November-April) and low incidence (MayOctober). Accumulated precipitation presents an opposite behavior. The highest frequency of events (73.8 % 573/779) for those born in the period with a low incidence of the virus was recorded at an earlier age (mean age 6.5 ± 2.0 months) when compared with those born in the station of high incidence (63.5% 568/870, mean age 11.7 ± 2.2 months). Seasonality of the infection and the inverse relationship between virus incidence and rainfall was demonstrated. In addition, it was found that the period of birth determines the age and risk of infection. This information generated during the pre-vaccine period will be helpful to measure the impact of the vaccine against the rotavirus.
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Child, Preschool , Female , Humans , Infant , Male , Rain , Rotavirus Infections/epidemiology , Seasons , Venezuela/epidemiology , Incidence , Risk FactorsABSTRACT
BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis in children <5 years of age. The first vaccine, RotaShield was developed, but withdrawn because of its association with increased risk of intussusception. Then, RotaTeq and Rotarix were developed. Although in pre-licensure studies, they were not associated with an increased risk of intussusceptions, in recent studies, it has been controversial. Regarding increased risk of intussusception, we studied the difference in the age of intussusception after rotavirus vaccination. METHODS: A retrospective analysis was conducted on 136 patients diagnosed with intussusception at Yeungnam University Medical Center for 4 years in the pre-vaccination period (group A) and in the post vaccination period (group B). Sex, mean age and age distribution of intussusceptions were compared according to the type of rotavirus vaccine (group B-1, RotaTeq; group B-2, Rotarix). RESULTS: The median ages of group A and group B were 18.8+/-19.6 months and 15.5+/-10.2 months, with no significant differences (p=0.23). The median ages of group B-1 and group B-2 were 15.3+/-9.3 months and 15.6+/-10.8 months, with no significant differences (p=0.91). And No significant difference in the distribution of onset age was observed between groups, and only 6 patients were diagnosed with intussusceptions within 1 month after vaccination. CONCLUSION: No difference was observed in the distribution of onset age of intussusception after rotavirus vaccination and according to the type of rotavirus vaccine. Our study has a limitation in that it was conducted in part of the Daegu area. Additional study is needed.
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Child , Humans , Academic Medical Centers , Age Distribution , Age of Onset , Gastroenteritis , Intussusception , Retrospective Studies , Rotavirus , VaccinationABSTRACT
The aim of this study is to investigate the impact of rotavirus vaccine on hospitalization rates for acute diarrhea in children younger than 5 years old after the introduction of the vaccine in 2006. A descriptive analytical observational study was carried out of the hospitalization rates occurred between 2000 and 2011 in 22 Regional Health Centers of Paraná State, Brazil. The effect of the vaccine was assessed by applying the SARIMA/Box-Jenkins time series methodology of intervention analysis, which allows verifying the slopes of the series are different after the introduction of the vaccine and estimating the magnitude of these effects for children younger than five years of age, by age group, for each region center. It was verified a statistically significant reduction by center/month on hospitalization rates for children 1 year old and younger, with averages of 47% and 58%, respectively, in December 2011.
O objetivo desse estudo é investigar o impacto da vacina do rotavírus nas taxas de internação por diarreia aguda em crianças menores de cinco anos após a introdução da vacina em 2006. Foi realizado um estudo analítico observacional descritivo das taxas de hospitalização ocorridas entre 2000 e 2011, em 22 Centros Regionais de Saúde do Estado do Paraná, Brasil. O efeito da vacina foi avaliado por séries temporais aplicando a metodologia SARIMA/Box-Jenkins com análise da intervenção, a qual permite verificar que os declives das séries são diferentes após a introdução da vacina, bem como estimar a magnitude desses efeitos para crianças menores de cinco anos de idade, por faixa etária, para cada região. Verificou-se redução estatisticamente significativa por centro/mês nas taxas de internação por diarreia aguda para as crianças menores de 1 ano de idade e de 1 ano de idade, com médias de 47% e 58%, respectivamente, em dezembro de 2011.
El objetivo de este estudio es investigar el impacto de la vacuna contra el rotavirus en las tasas de hospitalización, relacionadas con diarrea aguda en niños menores de 5 años, después de que se introdujese la vacuna en 2006. Se trata de un estudio observacional, analítico descriptivo de las tasas de hospitalización acaecidas entre 2000 y 2011 en 22 centros regionales de salud del estado de Paraná, Brasil. El efecto de la vacuna se evaluó mediante la aplicación de la serie de tiempo SARIMA/metodología de Box-Jenkins de análisis de intervención, lo que demuestra que los declives de las series son diferentes después de la introducción de la vacuna, con el fin de estimar la magnitud de estos efectos en los niños menores 5 años de edad, por grupos de edad para cada región. Se ha encontrado una reducción estadísticamente significativa de centro/mes en las tasas de hospitalización para niños menores de 1 año de edad y de 1 año de edad, con un promedio de 47% y 58%, respectivamente, en diciembre de 2011.
Subject(s)
Child, Preschool , Humans , Infant , Diarrhea/prevention & control , Gastroenteritis/prevention & control , Rotavirus Infections/prevention & control , Rotavirus Vaccines/administration & dosage , Acute Disease , Brazil , Diarrhea/epidemiology , Diarrhea/virology , Gastroenteritis/epidemiology , Gastroenteritis/virology , Hospitalization/statistics & numerical data , Rotavirus Infections/epidemiologyABSTRACT
Introducción. La gastroenteritis aguda es una enfermedad frecuente en pediatría. Rotavirus es el principal agente etiológico. Objetivos. Describir las características epidemiológicas y clínicas de las gastroenteritis agudas según su etiología por rotavirus u otra en niños menores de 5 años en una institución privada de Buenos Aires. Objetivo secundario: evaluar los costos. Material y métodos. Estudio transversal, descriptivo, observacional, de un año de duración, en niños menores de 5 años con gastroenteritis. El rotavirus fue diagnosticado mediante la prueba VIKIA® Rota-Adeno. Se recolectaron datos demográficos, clínicos y de vacunación. Se realizó el análisis univariado de los datos. Resultados. Se incluyeron 275 pacientes; 18,5% fueron R+. Rotavirus fue más frecuente en los menores de 2 años y entre marzo y junio. Las gastroenteritis por rotavirus fueron más graves, requirieron más internaciones (OR 2,07; IC 95% 1,17 a 7,13) y provocaron más costos. En la muestra estudiada la variable vacunación redujo el riesgo de infección por rotavirus. Conclusiones. Las gastroenteritis agudas por rotavirus se diferenciaron de otras etiologías por tener un pico estacional, y por la mediana de edad, la gravedad, la asociación con internación y el aumento de los costos.
Introduction. Acute gastroenteritis is a common disease in children. Rotavirus is the major etiologic agent. Objectives. To describe the epidemiological and clinical characteristics of acute gastroenteritis according to their etiology (rotavirus or other) in children younger than 5 years old in a private institution in the City of Buenos Aires. Secondary objective: to analyze related costs. Material and Methods. Cross sectional, descriptive, observational study conducted during one year in children younger than 5 years old with gastroenteritis. The presence of rotavirus was diagnosed with the VIKIA® Rota-Adeno test. Demographic, clinical and immunization data were collected. A univariate data analysis was performed. Results. A total of 275 patients were included; 18.5% of them were R+. Rotavirus was more common in children younger than 2 years old and in the period between March and June. The cases of rotavirus gastroenteritis were more severe, required more hospitalizations (OR 2.07; 95% CI 1.17-7.13), and resulted in higher costs. In the sample studied, the immunization outcome measure reduced the risk of rotavirus infection. Conclusions. Acute gastroenteritis caused by rotavirus were different from other etiologies in that they had a seasonal peak and in relation to the median age of patients, the severity of the condition, the association with hospitalization and the increase in costs.
Subject(s)
Child, Preschool , Humans , Infant , Gastroenteritis/diagnosis , Gastroenteritis/epidemiology , Rotavirus Infections , Acute Disease , Argentina , Cross-Sectional Studies , Gastroenteritis/virology , Hospitalization , Hospitals, Private , Urban HealthABSTRACT
Objetivo: Avaliar a cobertura da vacina oral do Rotavírus humano em lactentes entre janeiro de 2006 a dezembro de 2009. Método: Estudo documental e descritivo com abordagem quantitativa. Os dados foram coletados através das fichas espelhos da caderneta de vacinação infantil. O Comitê de Ética em Pesquisa da SMS-RJ aprovou a pesquisa sobre CAAE nº 0015.0.314.000-10. Resultados: O maior índice de cobertura vacinal foi em 2006 (83,2%) em relação aos outros anos. Em 2007 constata-se que 125 (10,6%) espelhos da caderneta de vacinação não constavam anotações sobre a vacina oral do Rotavírus humano; somente 120 (9,9%) crianças realizaram a primeira dose em 2008; as que realizaram as duas doses entre os anos de 2006 a 2009 somaram 3.833 (80,6%). Conclusão: O desafio de garantir cobertura vacinal de 100% para a população infantil requer de todos os envolvidos nesse processo um empenho intersetorial.
Objective: To evaluate the coverage of oral Rotavirus vaccine in human infants between January 2006 and December 2009. Method: Documentary and descriptive study with quantitative approach. Data were collected through the records of the book mirrors the childhood immunization. The Ethics Committee in Research of SMS-RJ approved research on CAAE Nº 0015.0.314.000-10. Results: The highest rate of coverage was in 2006 (83,2%) compared to other years. In 2007 it was found that 125 (10,6%) of the book mirrors vaccination not included notes on the human rotavirus oral vaccine, only 120 (9,9%) children were the first dose in 2008, those who underwent the two doses between the years 2006 to 2009 totaled 3833 (80,6%). Conclusion: The challenge of ensuring 100% immunization coverage for the pediatric population requires everyone involved in this process an intersectoral commitment.
Objetivo: Evaluar la cobertura de la vacuna oral contra el rotavirus en los bebés humanos entre enero de 2006 y diciembre de 2009. Método: Estudio descriptivo y documental con enfoque cuantitativo. Los datos fueron recolectados a través de los registros del libro refleja la inmunización en la infancia. El Comité de Ética en Investigación de la investigación de SMS-RJ aprobado el CAAE Nº 0015.0.314.000-10. Resultados: La mayor tasa de cobertura fue en 2006 (83,2%) en comparación con otros años. En 2007 se encontró que 125 (10,6%) del libro refleja la vacunación no notas incluidas en la vacuna oral contra el rotavirus humano, sólo 120 (9,9%) eran niños de la primera dosis en el año 2008, quienes se sometieron a los dos dosis entre los años 2006 a 2009 ascendieron a 3.833 (80,6%). Conclusión: El reto de garantizar 100% la cobertura de vacunación para la población pediátrica requiere de todos los involucrados en este proceso un compromiso intersectorial.
Subject(s)
Humans , Male , Female , Infant , Vaccination Coverage , Child Health , Rotavirus Vaccines , Brazil , Infant CareABSTRACT
El impacto socioeconómico y la mortalidad que producen la enfermedad diarreica aguda (EDA) ha sido preocupación delas organizaciones internacionales. La prevención en EDA agrupa estrategias básicas de saneamiento ambiental y atención primaria. Unasolución es promover la educación en la población de riesgo. Estimar el conocimiento materno sobre estrategias primarias deprevención de diarrea. Se realizó un estudio observacional de corte transversal, tipo encuesta a madres que acuden a losservicios de pediatría del Instituto Autónomo Hospital Universitario de Los Andes durante el lapso noviembre marzo 2012. Se utilizóChi cuadrado de Pearson (p <0,05) para el análisis estadístico. Resultados Se incluyeron 111 madres: 50,4% tenían entre 20 y 35 añosde edad, 40,6% provenientes del distrito sanitario Mérida, de estratos sociales Graffar IV-V; 33.3% tenían enseñanza secundaria. Sinembargo, solo 14,4% tuvo conocimiento adecuado sobre estrategias primarias de prevención en diarrea, 85% con desconocimiento de laexistencia de la vacuna antirotavirus. Solo 28% utiliza suero oral. Se estableció asociación significativa entre bajo nivel de instrucciónmaterna y nivel socioeconómico, con pobre conocimiento en prevención en EDA (p=0,002). El desconocimiento maternode estrategias de prevención en EDA tuvo relación directa con bajos niveles de instrucción materna y nivel socioeconómico; por ello lascampañas de educación deben dirigirse a estos grupos. Alimentación, rehidratación oral y vacunas son tópicos a reforzar. El saneamientoy la promoción de la higiene con participación de la comunidad pueden llevar a una reducción significativa de la incidencia de diarreaen niños
Socioeconomic impact and mortality caused by acute diarrheal disease (ADD) has been a concern of international organizations. One solution is to promote education in the population at risk. ADD prevention basic strategies include measures such as hand washing, food hygiene, proper disposal of excreta and vaccination. To determine maternal knowledge in primary strategies for preventing diarrhea. This is a cross-sectional observational survey study that included mothers attending pediatric services at the Instituto Autónomo Hospital Universitario de Los Andes, November - March 2012. Pearson Chi-square was utilized (p < 0,05) for statistical analysis. 111 mothers were included, 50.4% were between 20 - 35 years of age; 40.6% were from the sanitary district of Merida and were classified as social strata Graffar IV-V; 33.3% had high school education. However, only 14.4% had adequate knowledge in regard to strategies in primary prevention in diarrhea, with lack of knowledge in 85% of the availability of the vaccine anti-rotavirus. Only 28% had employed oral hydration solutions. A significant association between low maternal education level and socioeconomic level with poor knowledge in prevention in ADD was found (p = 0.002). Lackof maternal knowledge of prevention in ADD strategies is in direct relation with low level of maternal education and socio-economic level, which emphasizes the importance of educational campaigns directed to these groups. Food, oral rehydration and vaccines are topics to reinforce. Sanitation and promoting hygiene with community participation may lead to a significant reduction of the incidence of diarrhea in children