(2019) Effectiveness of monovalent rotavirus vaccine against hospitalization with acute rotavirus gastroenteritis in Kenyan children. Clinical Infectious Diseases . ciz664. doi:10.1093/cid/ciz664 (In Press)

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Abstract

Rotavirus remains a leading cause of diarrheal illness and death among children worldwide. Data on rotavirus vaccine effectiveness in sub-Saharan Africa are limited. Kenya introduced monovalent rotavirus vaccine (RV1) in July 2014. We assessed RV1 effectiveness against rotavirus-associated hospitalization in Kenyan children. Between July-2014 and December-2017, we conducted surveillance for acute gastroenteritis (AGE) in three hospitals across Kenya. We analysed data from children age-eligible for ≥1 RV1 dose, with stool tested for rotavirus and confirmed vaccination history. We compared RV1 coverage among those who tested rotavirus-positive (cases) versus rotavirus-negative (controls) using multivariable logistic regression; effectiveness was 1-adjusted odds ratio for vaccination x100%. Among 677 eligible children, 110 (16%) were rotavirus-positive. Vaccination data were available for 91 (83%) cases; 51 (56%) had received 2 RV1 doses and 33 (36%) 0 doses. Among 567 controls, 418 (74%) had vaccination data; 308 (74%) had 2 doses and 69 (16%) 0 doses. Overall 2-dose effectiveness was 64% (95% confidence interval [CI]: 35-80%); for children aged <12 months 67% (95%CI: 30-84%) and children aged ≥12 months 72% (95%CI: 10-91%). Significant effectiveness was seen in children with normal weight-for-age (84% [95%CI: 62-93%]), length/height-for-age (75% [95%CI: 48-88%]) and weight-for-length/height (84% [95%CI: 64-93%]); however, no protection was found among underweight, stunted nor wasted children. RV1 in the routine Kenyan immunization program provides significant protection against rotavirus AGE hospitalization. Protection was sustained beyond infancy. Malnutrition appears to diminish vaccine effectiveness. Efforts to improve rotavirus vaccine uptake and nutritional status are important to maximize vaccine benefit. [Abstract copyright: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.]

Item Type:	Journal Article
Divisions:	Faculty of Science > Life Sciences (2010- )
SWORD Depositor:	Library Publications Router
Journal or Publication Title:	Clinical Infectious Diseases
Publisher:	Oxford University Press
ISSN:	1537-6591
Official Date:	20 July 2019
Dates:	Date Event 20 July 2019 Published
Date of first compliant deposit:	12 September 2019
Article Number:	ciz664
DOI:	10.1093/cid/ciz664
Status:	Peer Reviewed
Publication Status:	In Press
Publisher Statement:	This is a pre-copyedited, author-produced version of an article accepted for publication in Clinical Infectious Diseases following peer review. The version of record Sammy Khagayi, Richard Omore, Grieven P Otieno, Billy Ogwel, John B Ochieng, Jane Juma, Evans Apondi, Godfrey Bigogo, Clayton Onyango, Mwanajuma Ngama, Regina Njeru, Betty E Owor, Mike J Mwanga, Yaw Addo, Collins Tabu, Anyangu Amwayi, Jason M Mwenda, Jacqueline E Tate, Umesh D Parashar, Robert F Breiman, D James Nokes, Jennifer R Verani, Effectiveness of monovalent rotavirus vaccine against hospitalization with acute rotavirus gastroenteritis in Kenyan children, Clinical Infectious Diseases, , ciz664 is available online at: https://doi.org/10.1093/cid/ciz664
Access rights to Published version:	Restricted or Subscription Access

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