Jenney, Adam WJ; Reyburn, Rita; Ratu, Felisita T; Tuivaga, Evelyn; Nguyen, Cattram; Covea, Sokoveti; Thomas, Sarah; Rafai, Eric; Devi, Rachel; Bright, Kathryn; +12 more... Jenkins, Kylie; Temple, Beth; Tikoduadua, Lisi; Kado, Joe; Mulholland, E Kim; Kirkwood, Carl D; Fox, Kimberley K; Bines, Julie E; Grabovac, Varja; Khan, Aalisha Sahu; Kama, Mike; Russell, Fiona M; (2020) The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji. The Lancet regional health. Western Pacific, 6. 100053-. ISSN 2666-6065 DOI: https://doi.org/10.1016/j.lanwpc.2020.100053
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Abstract
BACKGROUND: In 2012, Fiji became the first independent Pacific island country to introduce rotavirus vaccine. We describe the impact of rotavirus vaccine on all-cause diarrhoea admissions in all ages, and rotavirus diarrhoea in children <5 years of age. METHODS: An observational study was conducted retrospectively on all admissions to the public tertiary hospitals in Fiji (2007-2018) and prospectively on all rotavirus-positive diarrhoea admissions in children <5 years at two hospital sites (2006-2018, and 2010-2015), along with rotavirus diarrhoea outpatient presentations at one secondary public hospital (2010-2015). The impact of rotavirus vaccine was determined using incidence rate ratios (IRR) of all-cause diarrhoea admissions and rotavirus diarrhoea, comparing the pre-vaccine and post-vaccine periods. All-cause admissions were used as a control. Multiple imputation was used to impute missing stool samples. FINDINGS: All-cause diarrhoea admissions declined among all age groups except among infants ≤2 months old and adults ≥55 years. For children <5 years, all-cause diarrhoea admissions declined by 39% (IRR)=0•61, 95%CI; 0•57-0•65, p-value<0•001). There was an 81% (95%CI; 51-94%) reduction in mortality among all-cause diarrhoea admissions in children under <5 years. Rotavirus diarrhoea admissions at the largest hospital among children <5 years declined by 87% (IRR=0•13, 95%CI; 0•10-0•17, p-value<0•001). Among rotavirus diarrhoea outpatient presentations, the IRR was 0•39 (95%CI; 0•11, 1.21, p-value=0.077). INTERPRETATIONS: Morbidity and mortality due to rotavirus and all-cause diarrhoea in Fiji has declined in people aged 2 months to 54 years after the introduction of the RV vaccine. FUNDING: Supported by WHO and the Australian Government.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Research Centre |
Vaccine Centre Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 34327400 |
Elements ID | 159089 |
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Filename: The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji.pdf
Licence: Creative Commons: Attribution 3.0
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