title: Reduction of diarrhea-associated hospitalizations among children aged < 5 Years in Panama following the introduction of rotavirus vaccine.
abstract: BACKGROUND
  In March 2006, rotavirus vaccine (Rotarix, RV1) was introduced into the Panamanian national immunization program. We assessed the effect of vaccine on diarrhea-associated hospitalizations among young Panamanian children.
  
  
  METHODS
  We obtained monthly numbers of diarrhea-associated hospitalizations among children aged ≤ 5 years during 2003 and 2008 from 5 health regions in Panama, representing 53% of the birth cohort. We compared the number of diarrhea-associated hospitalizations during the postvaccine years of 2007 and 2008 with the prevaccine mean numbers 2003-2005 among children < 1 year and those 1 to 4 years of age. Administrative data were used to estimate national rotavirus vaccine coverage.
  
  
  RESULTS
  During prevaccine years, diarrhea-associated hospitalizations among children < 5 years in the 5 regions averaged 4057 annually. After the vaccine introduction, a decrease in diarrhea-associated hospitalizations of 22% (898 fewer) occurred in 2007 and 37% (1502 fewer) in 2008. Greater reductions were observed during January through June, the months presumed to have high rotavirus activity in prevaccine years (33% reduction in 2007 and 58% in 2008, compared with prevaccine mean). Reduction estimates were similar among infants and those aged 1-4 years of age, even though only 25% of the latter group was likely to have received vaccine by early 2008. Estimated coverage with ≥ 1 dose of rotavirus vaccine among infants increased from 63% at the end of 2006 to 94% at the end of 2008.
  
  
  CONCLUSIONS
  RV1 appears to have had a substantial impact on diarrhea-associated hospitalizations among young children in Panama.
authors.affiliation: Ministry of Health, Panama City, Panama, Panama City, Panama.
authors.forename: Yadira
authors.initials: Y
authors.lastname: Molto
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Cortes
authors.forename: Lucia Helena
authors.initials: LH
authors.lastname: De Oliveira
authors.forename: Adrianna
authors.initials: A
authors.lastname: Mike
authors.forename: Itzel
authors.initials: I
authors.lastname: Solis
authors.forename: Onix
authors.initials: O
authors.lastname: Suman
authors.forename: Luis
authors.initials: L
authors.lastname: Coronado
authors.forename: Manish M
authors.initials: MM
authors.lastname: Patel
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Cortese
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000517:prevention & control*; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D010176:Panama / Q000453:epidemiology; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022243:Rotavirus Vaccines