title: Diarrhoea-related hospitalizations in children before and after implementation of monovalent rotavirus vaccination in Mexico.
abstract: OBJECTIVE
  To assess, by socioeconomic setting, the effect of nationwide vaccination against species A rotavirus (RVA) on childhood diarrhoea-related hospitalizations in Mexico.
  
  
  METHODS
  Data on children younger than 5 years who were hospitalized for diarrhoea in health ministry hospitals between 1 January 2003 and 31 December 2011 were collected from monthly discharge reports. Human development indexes were used to categorize the states where hospitals were located as having generally high, intermediate or low socioeconomic status. Annual rates of hospitalization for diarrhoea--per 10,000 hospitalizations for any cause--were calculated. Administrative data were used to estimate vaccine coverage.
  
  
  RESULTS
  In the states with high, intermediate and low socioeconomic status, coverage with a two-dose monovalent RVA vaccine--among children younger than 5 years--had reached 93%, 86% and 71%, respectively, by 2010. The corresponding median annual rates of hospitalization for diarrhoea--per 10,000 admissions--fell from 1001, 834 and 1033 in the "prevaccine" period of 2003-2006, to 597, 497 and 705 in the "postvaccine" period from 2008 to 2011, respectively. These decreases correspond to rate reductions of 40% (95% confidence interval, CI: 38-43), 41% (95% CI: 38-43) and 32% (95% CI: 29-34), respectively. Nationwide, RVA vaccination appeared to have averted approximately 16,500 hospitalizations for childhood diarrhoea in each year of the postvaccine period.
  
  
  CONCLUSIONS
  Monovalent RVA vaccination has substantially reduced childhood diarrhoea-related hospitalizations for four continuous years in discretely different socioeconomic populations across Mexico.
authors.affiliation: National Center for Child and Adolescent Health, Ministry of Health, Mexico City, Mexico .
authors.forename: Marcelino
authors.initials: M
authors.lastname: Esparza-Aguilar
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, NE - Mailstop A-47, Atlanta, GA 30333, United States of America (USA).
authors.forename: Paul A
authors.initials: PA
authors.lastname: Gastañaduy
authors.affiliation: National Center for Child and Adolescent Health, Ministry of Health, Mexico City, Mexico .
authors.forename: Edgar
authors.initials: E
authors.lastname: Sánchez-Uribe
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, NE - Mailstop A-47, Atlanta, GA 30333, United States of America (USA).
authors.forename: Rishi
authors.initials: R
authors.lastname: Desai
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA .
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.affiliation: National Center for Child and Adolescent Health, Ministry of Health, Mexico City, Mexico .
authors.forename: Vesta
authors.initials: V
authors.lastname: Richardson
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA .
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D022243:Rotavirus Vaccines / Q000008:administration & dosage*
chemical_list: D022243:Rotavirus Vaccines