Key result
The introduction of the rotavirus vaccine reduced Rotavirus A infection frequency in children under five with diarrhea from 34.9% in the pre-vaccine period to 21.8% in the post-vaccine period.
Why the study?
Following the introduction of the monovalent rotavirus vaccine, Nampula province continued reporting high frequencies of Rotavirus A infection and emerging genotypes, requiring assessment across pre- and post-vaccine periods.
Does the introduction of the rotavirus vaccine reduce the frequency of Rotavirus A infection in children under five with diarrhea?
Cross-Sectional (n=614)
No
Does the introduction of the rotavirus vaccine reduce the frequency of Rotavirus A infection in children under five with diarrhea?
Absolute Event Rate: 21.8% vs 34.9%
p-value: p=0.001
The introduction of the monovalent rotavirus vaccine in Mozambique significantly reduced RVA infection frequency among children with diarrhea, though infection and genotype diversity remain high in vaccinated infants.
Vaccine introduction was associated with lower RVA rates in Mozambican children; leaves open effectiveness questions amid residual infections.
Mozambique introduced the monovalent rotavirus vaccine (Rotarix®, GSK Biologicals, Rixensart, Belgium) in September 2015. Previous analysis, showed that Nampula province continues reporting a high frequency of Rotavirus A (RVA) infection and the emergence of G9P[6], G9P[4] and G3P[4] genotypes. This analysis aimed to determine the RVA frequency; risk factors; genotype distribution by vaccination status and age between pre- and post-vaccine periods in children under-five years old with diarrhea in Nampula. A cross-sectional, hospital-based surveillance study was conducted in the Hospital Central de Nampula in Mozambique. Socio-demographic and clinical data were collected to assess factors related to RVA infection in both periods. Stool specimens were screened to detect RVA by ELISA, and positive samples were genotyped. Between 2015 (pre-vaccine period) and 2016-2019 (post-vaccine period), 614 stool specimens were collected and tested for RVA in which 34.9% (67/192) were positive in pre-vaccine period and 21.8% (92/422) in post-vaccine (p = 0.001). In the post-vaccine period, age, year, and contact with different animal species (chicken, duck, or multiple animals) were associated with RVA infection. RVA infection was higher in children partially vaccinated (40.7%, 11/27) followed by the fully vaccinated (29.3%, 56/191) and the unvaccinated (15.3%, 21/137) (p = 0.002). G1P[8] and G9P[4] were common in vaccinated children less than 12 months. The present analysis showed that RVA infection reduced slightly in the post-vaccine period, with a high proportion of infection and genotype diversity in children, under 12 months of age, vaccinated. Further research on factors associated with RVA infection on vaccinated compared to unvaccinated children and vaccination optimization should be done.
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Chissaque et al. (2021) conducted a cross-sectional in Rotavirus A infection in children with diarrhea (n=614). Post-vaccine period (Rotarix introduction) vs. Pre-vaccine period was evaluated on Rotavirus A infection frequency (p=0.001). The introduction of the rotavirus vaccine reduced Rotavirus A infection frequency in children under five with diarrhea from 34.9% in the pre-vaccine period to 21.8% in the post-vaccine period.
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