Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource-limited rural population in Mbita, Western Kenya

Ernest Apondi Wandera, Shah Mohammad, Martin Bundi, James Nyangao, Amina Galata, Cyrus Kathiiko, Erick Odoyo, Sora Guyo, Gabriel Miring'u, Satoshi Komoto, Yoshio Ichinose

Research output: Contribution to journalArticle

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Abstract

Objectives: A two-dose oral monovalent rotavirus vaccine (RV1) was introduced into the Kenyan National Immunization Program in July 2014. We assessed trends in hospitalisation for rotavirus-specific acute gastroenteritis (AGE) and strain distribution among children <5 years in a rural, resource-limited setting in Kenya before and after the nationwide implementation of the vaccine. Methods: Data on rotavirus AGE and strain distribution were derived from a 5-year hospital-based surveillance. We compared rotavirus-related hospitalisations and strain distribution in the 2-year post-vaccine period with the 3-year pre-vaccine baseline. Vaccine administrative data from the Unit of Vaccines and Immunization Services (UVIS) for Mbita sub-county were used to estimate rotavirus immunisation coverage in the study area. Results: We observed a 48% (95% CI: 27–64%) overall decline in rotavirus-related hospitalisations among children aged <5 years in the post-vaccine period. Coverage with the last dose of rotavirus vaccine increased from 51% in year 1% to 72% in year 2 of the vaccine implementation. Concurrently, reductions in rotavirus hospitalisations increased from 40% in the first year to 53% in the second year of vaccine use. The reductions were most pronounced among the vaccine-eligible group, with the proportion of cases in this age group dropping to 14% in post-vaccine years from a high of 51% in the pre-vaccine period. A diversity of rotavirus strains circulated before the introduction of the vaccine with G1P[8] being the most dominant strain. G2P[4] replaced G1P[8] as the dominant strain after the vaccine was introduced. Conclusions: Rotavirus vaccination has resulted in a notable decline in hospital admissions for rotavirus infections in a rural resource-limited population in Kenya. This provides early evidence for continued use of rotavirus vaccines in routine childhood immunisations in Kenya. Our data also underscore the need for expanding coverage on second dose so as to maximise the impact of the vaccine.

Original languageEnglish
Pages (from-to)425-432
Number of pages8
JournalTropical Medicine and International Health
Volume23
Issue number4
DOIs
Publication statusPublished - 01-04-2018

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Rotavirus
Kenya
Rural Population
Vaccination
Hospitalization
Vaccines
Rotavirus Vaccines
Immunization
Gastroenteritis
Rotavirus Infections
Immunization Programs

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Wandera, Ernest Apondi ; Mohammad, Shah ; Bundi, Martin ; Nyangao, James ; Galata, Amina ; Kathiiko, Cyrus ; Odoyo, Erick ; Guyo, Sora ; Miring'u, Gabriel ; Komoto, Satoshi ; Ichinose, Yoshio. / Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource-limited rural population in Mbita, Western Kenya. In: Tropical Medicine and International Health. 2018 ; Vol. 23, No. 4. pp. 425-432.
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title = "Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource-limited rural population in Mbita, Western Kenya",
abstract = "Objectives: A two-dose oral monovalent rotavirus vaccine (RV1) was introduced into the Kenyan National Immunization Program in July 2014. We assessed trends in hospitalisation for rotavirus-specific acute gastroenteritis (AGE) and strain distribution among children <5 years in a rural, resource-limited setting in Kenya before and after the nationwide implementation of the vaccine. Methods: Data on rotavirus AGE and strain distribution were derived from a 5-year hospital-based surveillance. We compared rotavirus-related hospitalisations and strain distribution in the 2-year post-vaccine period with the 3-year pre-vaccine baseline. Vaccine administrative data from the Unit of Vaccines and Immunization Services (UVIS) for Mbita sub-county were used to estimate rotavirus immunisation coverage in the study area. Results: We observed a 48{\%} (95{\%} CI: 27–64{\%}) overall decline in rotavirus-related hospitalisations among children aged <5 years in the post-vaccine period. Coverage with the last dose of rotavirus vaccine increased from 51{\%} in year 1{\%} to 72{\%} in year 2 of the vaccine implementation. Concurrently, reductions in rotavirus hospitalisations increased from 40{\%} in the first year to 53{\%} in the second year of vaccine use. The reductions were most pronounced among the vaccine-eligible group, with the proportion of cases in this age group dropping to 14{\%} in post-vaccine years from a high of 51{\%} in the pre-vaccine period. A diversity of rotavirus strains circulated before the introduction of the vaccine with G1P[8] being the most dominant strain. G2P[4] replaced G1P[8] as the dominant strain after the vaccine was introduced. Conclusions: Rotavirus vaccination has resulted in a notable decline in hospital admissions for rotavirus infections in a rural resource-limited population in Kenya. This provides early evidence for continued use of rotavirus vaccines in routine childhood immunisations in Kenya. Our data also underscore the need for expanding coverage on second dose so as to maximise the impact of the vaccine.",
author = "Wandera, {Ernest Apondi} and Shah Mohammad and Martin Bundi and James Nyangao and Amina Galata and Cyrus Kathiiko and Erick Odoyo and Sora Guyo and Gabriel Miring'u and Satoshi Komoto and Yoshio Ichinose",
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Wandera, EA, Mohammad, S, Bundi, M, Nyangao, J, Galata, A, Kathiiko, C, Odoyo, E, Guyo, S, Miring'u, G, Komoto, S & Ichinose, Y 2018, 'Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource-limited rural population in Mbita, Western Kenya', Tropical Medicine and International Health, vol. 23, no. 4, pp. 425-432. https://doi.org/10.1111/tmi.13040

Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource-limited rural population in Mbita, Western Kenya. / Wandera, Ernest Apondi; Mohammad, Shah; Bundi, Martin; Nyangao, James; Galata, Amina; Kathiiko, Cyrus; Odoyo, Erick; Guyo, Sora; Miring'u, Gabriel; Komoto, Satoshi; Ichinose, Yoshio.

In: Tropical Medicine and International Health, Vol. 23, No. 4, 01.04.2018, p. 425-432.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource-limited rural population in Mbita, Western Kenya

AU - Wandera, Ernest Apondi

AU - Mohammad, Shah

AU - Bundi, Martin

AU - Nyangao, James

AU - Galata, Amina

AU - Kathiiko, Cyrus

AU - Odoyo, Erick

AU - Guyo, Sora

AU - Miring'u, Gabriel

AU - Komoto, Satoshi

AU - Ichinose, Yoshio

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Objectives: A two-dose oral monovalent rotavirus vaccine (RV1) was introduced into the Kenyan National Immunization Program in July 2014. We assessed trends in hospitalisation for rotavirus-specific acute gastroenteritis (AGE) and strain distribution among children <5 years in a rural, resource-limited setting in Kenya before and after the nationwide implementation of the vaccine. Methods: Data on rotavirus AGE and strain distribution were derived from a 5-year hospital-based surveillance. We compared rotavirus-related hospitalisations and strain distribution in the 2-year post-vaccine period with the 3-year pre-vaccine baseline. Vaccine administrative data from the Unit of Vaccines and Immunization Services (UVIS) for Mbita sub-county were used to estimate rotavirus immunisation coverage in the study area. Results: We observed a 48% (95% CI: 27–64%) overall decline in rotavirus-related hospitalisations among children aged <5 years in the post-vaccine period. Coverage with the last dose of rotavirus vaccine increased from 51% in year 1% to 72% in year 2 of the vaccine implementation. Concurrently, reductions in rotavirus hospitalisations increased from 40% in the first year to 53% in the second year of vaccine use. The reductions were most pronounced among the vaccine-eligible group, with the proportion of cases in this age group dropping to 14% in post-vaccine years from a high of 51% in the pre-vaccine period. A diversity of rotavirus strains circulated before the introduction of the vaccine with G1P[8] being the most dominant strain. G2P[4] replaced G1P[8] as the dominant strain after the vaccine was introduced. Conclusions: Rotavirus vaccination has resulted in a notable decline in hospital admissions for rotavirus infections in a rural resource-limited population in Kenya. This provides early evidence for continued use of rotavirus vaccines in routine childhood immunisations in Kenya. Our data also underscore the need for expanding coverage on second dose so as to maximise the impact of the vaccine.

AB - Objectives: A two-dose oral monovalent rotavirus vaccine (RV1) was introduced into the Kenyan National Immunization Program in July 2014. We assessed trends in hospitalisation for rotavirus-specific acute gastroenteritis (AGE) and strain distribution among children <5 years in a rural, resource-limited setting in Kenya before and after the nationwide implementation of the vaccine. Methods: Data on rotavirus AGE and strain distribution were derived from a 5-year hospital-based surveillance. We compared rotavirus-related hospitalisations and strain distribution in the 2-year post-vaccine period with the 3-year pre-vaccine baseline. Vaccine administrative data from the Unit of Vaccines and Immunization Services (UVIS) for Mbita sub-county were used to estimate rotavirus immunisation coverage in the study area. Results: We observed a 48% (95% CI: 27–64%) overall decline in rotavirus-related hospitalisations among children aged <5 years in the post-vaccine period. Coverage with the last dose of rotavirus vaccine increased from 51% in year 1% to 72% in year 2 of the vaccine implementation. Concurrently, reductions in rotavirus hospitalisations increased from 40% in the first year to 53% in the second year of vaccine use. The reductions were most pronounced among the vaccine-eligible group, with the proportion of cases in this age group dropping to 14% in post-vaccine years from a high of 51% in the pre-vaccine period. A diversity of rotavirus strains circulated before the introduction of the vaccine with G1P[8] being the most dominant strain. G2P[4] replaced G1P[8] as the dominant strain after the vaccine was introduced. Conclusions: Rotavirus vaccination has resulted in a notable decline in hospital admissions for rotavirus infections in a rural resource-limited population in Kenya. This provides early evidence for continued use of rotavirus vaccines in routine childhood immunisations in Kenya. Our data also underscore the need for expanding coverage on second dose so as to maximise the impact of the vaccine.

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