title: Effectiveness of rotavirus vaccine against hospitalized rotavirus diarrhea: A case-control study.
abstract: Rotavirus is one of the leading cause of hospitalization and outpatients visits among children under five years. This study evaluated overall and genotype-specific vaccine effectiveness of oral monovalent rotavirus vaccine (G1P[8] strain) in preventing hospital admission of Brazilian children with rotavirus acute diarrhea. A hospital based case-control study was conducted in five Regions of Brazil using the National Rotavirus Acute Diarrhea Surveillance System from July 2008 to August 2011. A total of 215 cases (aged 4-24 months) admitted with confirmed rotavirus diarrhea were recruited and 1961 controls hospitalized without diarrhea were frequency matched by sex and age group to cases. Two-dose adjusted vaccine effectiveness (adjusted by year of birth and the frequency matching variables) was 76% (95%CI: 58-86) lasting for two years. Effectiveness controlled by the available potential confounders was 72% (95%CI: 44-85), suggesting no appreciable confounding by those factors for which adjustment was made. In a half of the cases the rotavirus genotype was G2P[4] and in 15% G1P[8]. Genotype-specific VE (two doses) was 89% (95%CI: 78-95), for G1P[8] and 76% (95%CI: 64-84) for G2P[4]. For all G1, it was 74% (95%CI: 35-90), for all G2, 76% (95%CI: 63-84), and for all non G1/G2 genotypes, 63% (95%CI: -27-99). Effectiveness for one dose was 62% (95%CI: 39-97). Effectiveness of two-dose monovalent rotavirus vaccine in preventing hospital admission with rotavirus diarrhea was high, lasted for two years and it was similar against both G1P[8] and G2P[4]. Based on the findings of the study we recommend the continued use of rotavirus in the Brazilian National Immunization Program and the monitoring of the early emergence of unusual and novel rotavirus genotypes.
authors: Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, Campus Universitário do Canela, CEP 40110-040, Salvador, Bahia, Brazil. Electronic address: my.ichihara@gmail.com.
authors: Maria Y T
authors: MY
authors: Ichihara
authors: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1H 7HT London, United Kingdom. Electronic address: laura.rodrigues@lshtm.ac.uk.
authors: Laura C
authors: LC
authors: Rodrigues
authors: Department of Exact Sciences, University of the State of Feira de Santana, Avenida Transnordestina, Novo Horizonte, CEP 44036-900, Feira de Santana, Bahia, Brazil. Electronic address: carlosateles@yahoo.com.br.
authors: Carlos A S
authors: CA
authors: Teles Santos
authors: Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, Campus Universitário do Canela, CEP 40110-040, Salvador, Bahia, Brazil. Electronic address: magloria@ufba.br.
authors: Maria da Gloria L C
authors: Mda G
authors: Teixeira
authors: Institute Multidisciplinar of Health, Campus Anísio Teixeira, Federal University of Bahia, Vitoria da Conquista, Bahia, Brazil. Electronic address: sandrego@hotmail.com.
authors: Sandra R
authors: SR
authors: De Jesus
authors: Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, Campus Universitário do Canela, CEP 40110-040, Salvador, Bahia, Brazil. Electronic address: sheilaalvim@hotmail.com.
authors: Sheila M
authors: SM
authors: Alvim De Matos
authors: Avenida Brasil, 4365-Pav. Hélio & Peggy Pereira, CEP 21040-360, Rio de Janeiro, Manguinhos, Brazil. Electronic address: jpgleite@gmail.com.
authors: Jose P
authors: JP
authors: Gagliardi Leite
authors: Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, Campus Universitário do Canela, CEP 40110-040, Salvador, Bahia, Brazil. Electronic address: mauricio@ufba.br.
authors: Mauricio L
authors: ML
authors: Barreto
mesh_terms: D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D062665:Epidemiological Monitoring; D005260:Female; D006760:Hospitalization; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D012401:Rotavirus / Q000145:classification / Q000235:genetics; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D022243:Rotavirus Vaccines
keywords: Acute diarrhea hospitalization; Child diarrhea; Hospitalization; Rotavirus diarrhea; Vaccine; Vaccine effectiveness