title: Impact of Rotavirus Vaccination on Hospitalizations and Deaths From Childhood Gastroenteritis in Botswana.
abstract: BACKGROUND
  A monovalent human rotavirus vaccine (RV1) was introduced in Botswana in July 2012. We assessed the impact of RV1 vaccination on childhood gastroenteritis-related hospitalizations and deaths in 2013 and 2014.
  
  
  METHODS
  We obtained data from registers of 4 hospitals in Botswana on hospitalizations and deaths from gastroenteritis, regardless of cause, among children <5 years of age. Gastroenteritis hospitalizations and deaths during the prevaccine period (January 2009-December 2012) were compared to the postvaccine period (January 2013-December 2014). Vaccine coverage was estimated from data collected through a concurrent vaccine effectiveness study at the same hospitals.
  
  
  RESULTS
  By December 2014, coverage with ≥1 dose of RV1 was an estimated 90% among infants <1 year of age and 76% among children 12-23 months of age. In the prevaccine period, the annual median number of gastroenteritis-related hospitalizations in children <5 years of age was 1212, and of gastroenteritis-related deaths in children <2 years of age was 77. In the postvaccine period, gastroenteritis-related hospitalizations decreased by 23% (95% confidence interval [CI], 16%-29%) to 937, and gastroenteritis-related deaths decreased by 22% (95% CI, -9% to 44%) to 60. Declines were most prominent during the rotavirus season (May-October) and among infants <1 year of age, with reductions of 43% (95% CI, 34%-51%) in gastroenteritis hospitalizations and 48% (95% CI, 11%-69%) in gastroenteritis deaths.
  
  
  CONCLUSIONS
  Following introduction of RV1 into the national immunization program, significant declines in hospitalizations and deaths from gastroenteritis were observed among children in Botswana, suggestive of the beneficial public health impact of rotavirus vaccination.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia, Pennsylvania Botswana-UPenn Partnership, Gaborone, Botswana.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Enane
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Gastañaduy
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana Division of Microbiology, Department of Pathology, University of British Columbia, Vancouver, Canada Department of Pediatrics, University of Botswana, Gaborone Division of Infectious Disease, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Goldfarb
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana Division of Infectious Disease, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Pernica
authors.affiliation: National Health Laboratory, Gaborone, Botswana.
authors.forename: Margaret
authors.initials: M
authors.lastname: Mokomane
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana.
authors.forename: Banno
authors.initials: B
authors.lastname: Moorad
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana.
authors.forename: Lingani
authors.initials: L
authors.lastname: Masole
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Tate
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana Department of Pediatrics, University of Botswana, Gaborone Division of Infectious Diseases and Section of Global Health, Department of Pediatrics, Children's Hospital of Philadelphia and the University of Pennsylvania, Philadelphia.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Steenhoff
mesh_terms: D001902:Botswana / Q000453:epidemiology; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005759:Gastroenteritis / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011634:Public Health; D012189:Retrospective Studies; D012401:Rotavirus / Q000276:immunology; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination / Q000706:statistics & numerical data; D064166:Vaccine Potency; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000276:immunology
chemical_list: C492457:RIX4414 vaccine; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: morbidity; mortality; rotavirus vaccine