What is the clinical evidence from this study?

Study design: Observational. Population: Childhood diarrhea (rotavirus). Intervention: Rotavirus vaccination vs. No vaccination (baseline estimates). Primary outcome: Prevented rotavirus hospitalizations in 2016 (29 African countries) (95% CI 112321-154654).

August 23, 2017Expert Review of Vaccines

Estimated reductions in hospitalizations and deaths from childhood diarrhea following implementation of rotavirus vaccination in Africa

Q: What are the key findings of this study?

Rotavirus vaccination in 29 African countries prevented an estimated 134,714 hospitalizations and 20,986 deaths among children under 5 years of age in 2016.

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Key result

Rotavirus vaccination is linked to ~135,000 fewer hospitalizations among African children under five.

95% CI 112321-154654

Why the study?

Does rotavirus vaccination reduce hospitalizations and deaths from childhood diarrhea in Africa?

Study Design

Type

Observational

Structured PICO

Does rotavirus vaccination reduce hospitalizations and deaths from childhood diarrhea in Africa?

Population

Children <5 years of age in African countries

Intervention

Rotavirus vaccination (live attenuated, oral rotavirus vaccines: Rotarix and RotaTeq) implemented in national immunization programs

Comparator

No rotavirus vaccination (baseline estimates)

Outcome

Estimated reductions in rotavirus hospitalizations and deathshard clinical

Rotavirus vaccination in national immunization programs across 29 African countries prevented an estimated 134,714 hospitalizations and 20,986 deaths in 2016, with potential for greater impact upon wider implementation.

Limitations

Available data for African region-specific rotavirus hospitalizations are sparse
Local practice and hospital admission patterns for diarrhea change over time, affecting hospitalization rates
Small number of available vaccine effectiveness evaluations may be influenced by outlier results
Estimates were based only on full-series coverage, potentially underestimating the full impact of partial immunization or indirect protection
Assumed that rotavirus vaccine coverage would achieve levels similar to other routine childhood vaccines, which may not reflect actual lag in some countries
Sparse available data for African region-specific rotavirus hospitalizations
Age-based hospitalization rates based on data from only five African countries
Small number of available vaccine effectiveness evaluations
Only estimated reductions based on full-series coverage
Assumed coverage of rotavirus vaccine would achieve levels similar to other routine childhood vaccines
Country-level estimates mask within-country disparities in coverage

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports rotavirus vaccination programs in Africa; leaves open questions on coverage optimization and equity.

Cite This Study

Shah et al. (2017) conducted an observational in Childhood diarrhea (rotavirus). Rotavirus vaccination vs. No vaccination (baseline estimates) was evaluated on Prevented rotavirus hospitalizations in 2016 (29 African countries) (95% CI 112321-154654). Rotavirus vaccination in 29 African countries prevented an estimated 134,714 hospitalizations and 20,986 deaths among children under 5 years of age in 2016.

synapsesocial.com/papers/6a08a1881e8b9db648de1fcb https://doi.org/10.1080/14760584.2017.1371595

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Estimated reductions in hospitalizations and deaths from childhood diarrhea following implementation of rotavirus vaccination in Africa

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Estimated reductions in hospitalizations and deaths from childhood diarrhea following implementation of rotavirus vaccination in Africa

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider