TY - JOUR
T1 - Impact of a twelve-year rotavirus vaccine program on acute diarrhea mortality and hospitalization in Brazil
AU - De Jesus, Myrela Conceição Santos
AU - Santos, Victor Santana
AU - Storti-Melo, Luciane Moreno
AU - De Souza, Carlos Dornels Freire
AU - Barreto, Íkaro Daniel De Carvalho
AU - Paes, Marcelo Vitor Costa
AU - Lima, Pablo Amércio Silva
AU - Bohland, Anna Klara
AU - Berezin, Eitan N.
AU - Machado, Ricardo Luiz Dantas
AU - Cuevas, Luis
AU - Gurgel, Ricardo Queiroz
PY - 2020/6/30
Y1 - 2020/6/30
N2 - BackgroundMonitoring the impact of vaccine programs is necessary to identify changes in vaccine efficacy. We report the impact of the 12-year rotavirus vaccine program on diarrhea mortality and hospitalizations and their correlation to socioeconomic indicators.Methodsthis ecological study describes diarrhea hospitalizations and deaths from 2006 to 2018 in Brazil and correlates rotavirus vaccine coverage, hospitalizations and deaths to socioeconomic indicators and social vulnerability index (SVI) by state and region. Hospitalizations, deaths, and vaccine coverage trends were analyzed using Joinpoint regression models. Associations between hospitalizations, mortality and rotavirus vaccination coverage and socioeconomic and SVI indicators were established using Ordinary Least Square regressions.ResultsRotavirus vaccine coverage remained stable between 2006 and 2018 (annual percentage changes (APC) [95%CI]: 4.4% [−0.3%, 9.2%]). Diarrhea hospitalization rates decreased 52.5% (−5.7% [−7.5%, −3.8%]), from 68.4 to 32.5 hospitalizations per 10,000 children <5 years-old between 2006 and 2018, with significant decreases in diarrhea mortality (−9.8% [−11.2%, −8.5%]). The Northeast region experienced the largest reductions (−13.9% [−15.7%, −12.2%]). Vaccination coverage and diarrhea-mortality were inversely correlated with the SVI.ConclusionThe burden of childhood diarrhea has decreased over an extended period. States with high SVI, but high vaccination coverage had the largest reductions in hospitalizations and deaths.
AB - BackgroundMonitoring the impact of vaccine programs is necessary to identify changes in vaccine efficacy. We report the impact of the 12-year rotavirus vaccine program on diarrhea mortality and hospitalizations and their correlation to socioeconomic indicators.Methodsthis ecological study describes diarrhea hospitalizations and deaths from 2006 to 2018 in Brazil and correlates rotavirus vaccine coverage, hospitalizations and deaths to socioeconomic indicators and social vulnerability index (SVI) by state and region. Hospitalizations, deaths, and vaccine coverage trends were analyzed using Joinpoint regression models. Associations between hospitalizations, mortality and rotavirus vaccination coverage and socioeconomic and SVI indicators were established using Ordinary Least Square regressions.ResultsRotavirus vaccine coverage remained stable between 2006 and 2018 (annual percentage changes (APC) [95%CI]: 4.4% [−0.3%, 9.2%]). Diarrhea hospitalization rates decreased 52.5% (−5.7% [−7.5%, −3.8%]), from 68.4 to 32.5 hospitalizations per 10,000 children <5 years-old between 2006 and 2018, with significant decreases in diarrhea mortality (−9.8% [−11.2%, −8.5%]). The Northeast region experienced the largest reductions (−13.9% [−15.7%, −12.2%]). Vaccination coverage and diarrhea-mortality were inversely correlated with the SVI.ConclusionThe burden of childhood diarrhea has decreased over an extended period. States with high SVI, but high vaccination coverage had the largest reductions in hospitalizations and deaths.
KW - Acute diarrhea
KW - Brazil
KW - hospitalization
KW - mortality
KW - rotavirus
KW - rotavirus vaccine
U2 - 10.1080/14760584.2020.1775081
DO - 10.1080/14760584.2020.1775081
M3 - Article
SN - 1476-0584
VL - 19
SP - 585
EP - 593
JO - Expert Review of Vaccines
JF - Expert Review of Vaccines
IS - 6
ER -
