BACKGROUND Following the conclusion of a human rotavirus vaccine (HRV) cluster-randomized, controlled trial (CRT) in Matlab, Bangladesh, HRV was included in Matlab's routine immunization program. We describe the population-level impact of programmatic rotavirus vaccination in Bangladesh in children <2 years of age. METHODS Interrupted time series were used to estimate the impact of HRV introduction. We used diarrheal surveillance collected between 2000 and 2014 within the 2 service delivery areas (International Centre for Diarrhoeal Disease Research, Bangladesh [icddr,b] service area [ISA] and government service area [GSA]) of the Matlab Health and Demographic Surveillance System, administered by icddr,b. Age group-specific incidence rates were calculated for both rotavirus-positive (RV+) and rotavirus-negative (RV-) diarrhea diagnoses of any severity presenting to the hospital. We used 2 models to assess the impact within each service area: Model 1 used the pre-vaccine time period in all villages (HRV- and control-only) and Model 2 combined the pre-vaccine time period and the CRT time period, using outcomes from control-only villages. RESULTS Both models demonstrated a downward trend in RV+ diarrheal incidences in the ISA villages during 3.5 years of routine HRV use, though only Model 2 was statistically significant. Significant impacts of HRV on RV+ diarrhea incidences in GSA villages were not observed in either model. Differences in population-level impacts between the 2 delivery areas may be due to the varied rotavirus vaccine coverage and presentation rates to the hospital. CONCLUSIONS This study provides initial evidence of the population-level impact of rotavirus vaccines in children <2 years of age in Matlab, Bangladesh. Further studies are needed of the rotavirus vaccine impact after the nationwide introduction in Bangladesh.

中文翻译：

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孟加拉国农村Matlab的轮状病毒疫苗引入对2岁以下儿童的腹泻医疗的影响。

背景技术在孟加拉国Matlab的人类轮状病毒疫苗（HRV）集群随机对照试验（CRT）得出结论之后，HRV已包括在Matlab的常规免疫计划中。我们描述了孟加拉国程序性轮状病毒疫苗接种对2岁以下儿童的人口水平影响。方法采用中断时间序列来估计HRV引入的影响。我们使用了2000年至2014年间在Matlab健康与人口统计学监测系统的两个服务提供区域（国际腹泻病研究中心，孟加拉国[icddr，b]服务区域[ISA]和政府服务区域[GSA]）中收集的腹泻监测，由icddr，b。管理。计算出轮状病毒阳性（RV +）和轮状病毒阴性（RV-）腹泻诊断出的任何严重程度的特定年龄组发病率。我们使用了2个模型来评估每个服务区域内的影响：模型1使用了所有村庄的疫苗接种前时间段（仅适用于HRV和对照），模型2使用以下方法结合了疫苗接种前时间段和CRT时间段：仅控制村庄的结果。结果两种模型均显示，在常规HRV使用3.5年期间，ISA村的RV +腹泻发生率呈下降趋势，尽管只有模型2具有统计学意义。两种模型均未观察到HRV对GSA村RV +腹泻发生率的显着影响。两个分娩地区在人群水平上的影响差异可能是由于轮状病毒疫苗覆盖率和到医院就诊率的差异所致。结论这项研究提供了轮状病毒疫苗对孟加拉国Matlab的2岁以下儿童的人群水平影响的初步证据。在孟加拉国全国推广后，需要进一步研究轮状病毒疫苗的影响。