Impact of a twelve-year rotavirus vaccine program on acute diarrhea mortality and hospitalization in Brazil: 2006-2018.,Expert Review of Vaccines

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Impact of a twelve-year rotavirus vaccine program on acute diarrhea mortality and hospitalization in Brazil: 2006-2018.
Expert Review of Vaccines ( IF 6.2 ) Pub Date : 2020-06-16 , DOI: 10.1080/14760584.2020.1775081
Myrela Conceição Santos De Jesus ₁ , Victor Santana Santos ₂ , Luciane Moreno Storti-Melo ₃ , Carlos Dornels Freire De Souza ₄ , Íkaro Daniel De Carvalho Barreto ₅ , Marcelo Vitor Costa Paes ₆ , Pablo Amércio Silva Lima ₆ , Anna Klara Bohland ₆ , Eitan N Berezin ₇ , Ricardo Luiz Dantas Machado _{1,

8} , Luis Eduardo Cuevas ₉ , Ricardo Queiroz Gurgel ₆

Affiliation

Background

Monitoring 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.

Methods

this 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.

Results

Rotavirus 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.

Conclusion

The 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.

中文翻译：

一项为期12年的轮状病毒疫苗计划对巴西急性腹泻死亡率和住院治疗的影响：2006-2018年。

背景

监测疫苗计划的影响对于确定疫苗功效的变化是必要的。我们报告了12年轮状病毒疫苗计划对腹泻死亡率和住院率的影响及其与社会经济指标的相关性。

方法

这项生态研究描述了2006年至2018年巴西腹泻住院和死亡人数，并将轮状病毒疫苗的覆盖率，住院和死亡人数与州和地区的社会经济指标和社会脆弱性指数（SVI）相关联。使用Joinpoint回归模型分析了住院，死亡和疫苗覆盖率趋势。住院率，死亡率和轮状病毒疫苗接种率与社会经济指标和SVI指标之间的关联使用普通最小二乘回归法建立。

结果

轮状病毒疫苗覆盖率在2006年至2018年期间保持稳定（年度百分比变化（APC）[95％CI]：4.4％[-0.3％，9.2％]）。腹泻住院率下降了52.5％（-5.7％[-7.5％，-3.8％]），在2006年至2018年期间，每10,000名<5岁儿童的住院治疗从68.4例减少到32.5例，腹泻死亡率显着降低（-9.8％[ -11.2％，-8.5％]。东北地区的降幅最大（-13.9％[−15.7％，-12.2％]）。疫苗接种率和腹泻死亡率与SVI成反比。