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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Population effectiveness of the pentavalent and monovalent rotavirus vaccines: A systematic review and meta-analysis of observational studies
BMC Infectious Diseases, Volume 17, No. 1, Article 569, Year 2017
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Description
Background: Rotavirus was the leading cause of acute gastroenteritis (AGE) in infants and young children prior to the introduction of routine vaccination. Since 2006 there have been two licensed vaccines available with successful clinical trials leading the World Health Organization to recommend rotavirus vaccination for all children worldwide. In order to inform immunisation policy we have conducted a systematic review and meta-analysis of observation studies to assess population effectiveness against acute gastroenteritis. Methods: We systematically searched PubMed, Medline, Web of Science, Cinhal and Academic Search Premier and grey literature sources for studies published between January 2006 and April 2014. Studies were eligible for inclusion if they were observational measuring population effectiveness of rotavirus vaccination against health care attendances for rotavirus gastroenteritis or AGE. To evaluate study quality we use used the Newcastle-Ottawa Scale for non-randomised studies, categorising studies by risk of bias. Publication bias was assessed using funnel plots. If two or more studies reported a measure of vaccine effectiveness (VE), we conducted a random effects meta-analysis. We stratified analyses by World Bank country income level and used study quality in sensitivity analyses. Results: We identified 30 studies, 19 were from high-income countries and 11 from middle-income countries. Vaccine effectiveness against hospitalization for laboratory confirmed rotavirus gastroenteritis was highest in high-income countries (89% VE; 95% CI 84-92%) compared to middle-income countries (74% VE; 95% CI 67-80%). Vaccine effectiveness was higher for those receiving the complete vaccine schedule (81% VE; 95% CI 75-86%) compared to partial schedule (62% VE; 95% CI 55-69%). Two studies from high-income countries measured VE against community consultations for AGE with a pooled estimate of 40% (95% CI 13-58%; 2 studies). Conclusions: We found strong evidence to further support the continued use of rotavirus vaccines. Vaccine effectiveness was similar to that reported in clinical trials for both high and middle-income countries. There is limited data from Low income settings at present. There was lower effectiveness against milder disease. Further studies, should continue to report effectiveness against AGE and less-severe rotavirus disease because as evidenced by pre-vaccine introduction studies this is likely to contribute the greatest burden on healthcare resources, particularly in high-income countries. © 2017 The Author(s).
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC5556361/bin/12879_2017_2613_MOESM1_ESM.docx
Authors & Co-Authors
Hungerford, Daniel
United Kingdom, Liverpool
University of Liverpool
United Kingdom, London
Public Health England
Tucker, Angela
United Kingdom, Manchester
Health Education England North West
Iturriza-Gómara, Miren
United Kingdom, Liverpool
University of Liverpool
United Kingdom, Liverpool
Nihr Health Protection Research Unit in Emerging and Zoonotic Infections
Vivancos, R.
United Kingdom, London
Public Health England
United Kingdom, Liverpool
Nihr Health Protection Research Unit in Emerging and Zoonotic Infections
Cunliffe, Nigel A.
United Kingdom, Liverpool
University of Liverpool
United Kingdom, Liverpool
Alder Hey Children's Nhs Foundation Trust
French, N.
United Kingdom, Liverpool
University of Liverpool
United Kingdom, Liverpool
Liverpool University Hospitals Nhs Foundation Trust
Statistics
Citations: 35
Authors: 6
Affiliations: 6
Identifiers
Doi:
10.1186/s12879-017-2613-4
ISSN:
14712334
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Systematic review