Impact of the introduction of rotavirus vaccine on hospital admissions for diarrhoea among children in Kenya : a controlled interrupted time series analysis

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Abstract

Introduction
Monovalent rotavirus vaccine, RotarixTM, was introduced in Kenya in July 2014, is recommended to infants as oral doses at ages 6 and 10 weeks. A multi-site study was established in two population based surveillance sites to evaluate vaccine impact on the incidence of rotavirus-associated hospitalisations (RVH).

Methods
Hospital-based surveillance was conducted from January 2010 to June 2017 for acute diarrhoea hospitalisations among children aged <5 years in two health facilities in Kenya. A controlled interrupted time series analysis was undertaken to compare RVH pre and post vaccine introduction using rotavirus negative cases as a control series. The change in incidence post vaccine introduction was estimated from a negative binomial model that adjusted for secular trend, seasonality and multiple health worker industrial actions (strikes).

Results
Between January 2010 and June 2017 there were 1513 and 1652 diarrhoea hospitalisations in Kilifi and Siaya; among those tested for rotavirus, 28% (315/1142) and 23% (197/877) were positive, respectively. There was a 57% (95% CI: 8 to 80) reduction in RVH observed in the first year post vaccine introduction in Kilifi and a 59% (95% CI: 20 to 79) reduction in Siaya. In the second year, RVH decreased further at both sites, 80% (95% CI: 46 to 93) reduction in Kilifi and 82% reduction in Siaya (95% CI: 61 to 92), and this reduction was sustained at both sites into the third year.

Conclusions
A substantial reduction of RVH and all-cause diarrhoea has been observed in two demographic surveillance sites in Kenya within 3 years of vaccine introduction.

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