Incidence of rotavirus gastroenteritis by age in African, Asian and European children: Relevance for timing of rotavirus vaccination.
Variability in rotavirus gastroenteritis (RVGE) epidemiology can influence the optimal vaccination schedule. We evaluated regional trends in the age of RVGE episodes in low- to middle- versus high-income countries in three continents. We undertook a post-hoc analysis based on efficacy trials of a human rotavirus vaccine (HRV; Rotarix™, GSK Vaccines), in which 1348, 1641, and 5250 healthy infants received a placebo in Europe (NCT00140686), Africa (NCT00241644), and Asia (NCT00197210, NCT00329745). Incidence of any/severe RVGE by age at onset was evaluated by active surveillance over the first two years of life. Severity of RVGE episodes was assessed using the Vesikari-scale. The incidence of any RVGE in Africa was higher than in Europe during the first year of life (≤2.78% vs. ≤2.03% per month), but much lower during the second one (≤0.86% versus ≤2.00% per month). The incidence of severe RVGE in Africa was slightly lower than in Europe during the first year of life. Nevertheless, temporal profiles for the incidence of severe RVGE in Africa and Europe during the first (≤1.00% and ≤1.23% per month) and second (≤0.53% and ≤1.13% per month) years of life were similar to those of any RVGE. Any/severe RVGE incidences peaked at younger ages in Africa vs. Europe. In high-income Asian regions, severe RVGE incidence (≤0.31% per month) remained low during the study. The burden of any RVGE was higher earlier in life in children from low- to middle- compared with high-income countries. Differing rotavirus vaccine schedules are likely warranted to maximize protection in different settings.
a Initiative for Vaccine Research, World Health Organization , Geneva , Switzerland.|b Diarrhoeal Pathogens Research Unit, Medical Research Council , MEDUNSA , South Africa.
A Duncan
AD
Steele
c Medical Research Council , Respiratory and Meningeal Pathogens Research Unit & Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences , Johannesburg , South Africa.
Shabir A
SA
Madhi
d Institute of Infection and Global Health, University of Liverpool , Ronald Ross Building, Liverpool , UK.
Nigel A
NA
Cunliffe
e Vaccine Research Center, Medical School, University of Tampere , Tampere , Finland.
Timo
T
Vesikari
f Department of Pediatrics , KK, Women's & Children's Hospital , Singapore , Singapore.
Kong Boo
KB
Phua
g Division of Family Medicine , Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore , Singapore.
Fong Seng
FS
Lim
h Department of Pediatrics , Faculty of Medicine, The Chinese University of Hong Kong , China.
E Anthony S
EA
Nelson
i Department of Pediatrics and Adolescent Medicine , Queen Mary Hospital, LKS Faculty of Medicine, University of Hong Kong , China.
Yu-Lung
YL
Lau
j Division of Infectious Diseases, Children's Hospital, National Taiwan University College of Medicine.
Li-Min
LM
Huang
k GSK Pharmaceuticals Ltd. , Bangalore , India.
Naveen
N
Karkada
l GSK Vaccines , Wavre , Belgium.
Serge
S
Debrus
m GSK Vaccines , Philadelphia , PA , USA.
Htay Htay
HH
Han
l GSK Vaccines , Wavre , Belgium.
Bernd
B
Benninghoff
D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D001208:Asia / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D010919:Placebos / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000276:immunology
D010919:Placebos; C492457:RIX4414 vaccine; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
children; human rotavirus vaccine; incidence; infants; rotavirus gastroenteritis