title: Effectiveness of rotavirus vaccination against childhood diarrhoea in El Salvador: case-control study.
abstract: OBJECTIVE
  To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America.
  
  
  METHODS
  Matched case-control study.
  
  
  METHODS
  Seven hospitals in cities across El Salvador, January 2007 to June 2009.
  
  
  METHODS
  323 children aged less than 2 years admitted with laboratory confirmed rotavirus diarrhoea and 969 healthy controls matched for age and neighbourhood.
  
  
  METHODS
  Effectiveness of rotavirus vaccination ((1-adjusted odds ratio of vaccination)x100) against rotavirus diarrhoea requiring hospital admission.
  
  
  RESULTS
  Cases and controls were similar for breast feeding, premature birth, maternal education, and socioeconomic variables. G1P[8] strains were identified in 92% of rotavirus cases. Effectiveness of two doses of vaccination against diarrhoea requiring hospital admission was 76% (95% confidence interval 64% to 84%). Protection was significantly lower (P=0.046) among children aged 12 months or more (59%, 27% to 77%) compared with children aged 6-11 months (83%, 68% to 91%). One dose of vaccine was 51% (26% to 67%) effective. At the sentinel hospitals, all admissions for diarrhoea among children under 5 declined by 40% in 2008 and by 51% in 2009 from the prevaccine year 2006.
  
  
  CONCLUSIONS
  A monovalent rotavirus vaccine was highly effective against admissions for rotavirus diarrhoea in children aged less than 2 years in El Salvador and substantially reduced the number of such admissions in this low-middle income setting. The impact on disease epidemiology after vaccination, particularly among older children, warrants future attention.
authors.affiliation: Ministerio de Salud, San Salvador, El Salvador.
authors.forename: Orbelina
authors.initials: O
authors.lastname: de Palma
authors.forename: Lilian
authors.initials: L
authors.lastname: Cruz
authors.forename: Hector
authors.initials: H
authors.lastname: Ramos
authors.forename: Amada
authors.initials: A
authors.lastname: de Baires
authors.forename: Nora
authors.initials: N
authors.lastname: Villatoro
authors.forename: Desiree
authors.initials: D
authors.lastname: Pastor
authors.forename: Lucia Helena
authors.initials: LH
authors.lastname: de Oliveira
authors.forename: Tara
authors.initials: T
authors.lastname: Kerin
authors.forename: Michael
authors.initials: M
authors.lastname: Bowen
authors.forename: Jon
authors.initials: J
authors.lastname: Gentsch
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Esposito
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Tate
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
mesh_terms: D016022:Case-Control Studies; D003967:Diarrhea / Q000517:prevention & control* / Q000821:virology; D004544:El Salvador; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012400:Rotavirus Infections / Q000517:prevention & control*; D022243:Rotavirus Vaccines; D016896:Treatment Outcome
chemical_list: D022243:Rotavirus Vaccines