Detection of rotavirus before and after monovalent rotavirus vaccine introduction and vaccine effectiveness among children in mainland Tanzania. Jani, B., Hokororo, A., Mchomvu, J., Cortese, M. M., Kamugisha, C., Mujuni, D., Kallovya, D., Parashar, U. D., Mwenda, J. M., Lyimo, D., Tanzania Rotavirus Surveillance Teams, Materu, A., Omari, K. F., Waziri, M., Laswai, T., Juma, H., Mlay, J., Dogani, J., Stephen, E., Seugendo, M., Nkumbi, U., Lyakurwa, A., Matojo, A., Bendera, E., Senyota, J., Msingwa, V., Fungo, Y., Michael, F., Mpamba, A., Chambo, A., Cholobi, H., Lyamuya, F., Chami, I., Mchome, E., Mshana, A. M., Mushi, E., Mariki, U., Chard, R., Tuju, D., Ambokile, N., Lukwale, F., Kyessi, F., Khamis, A., Michael, I., Macha, D., & Saguti, A. Vaccine, April, 2018.
doi  abstract   bibtex   
BACKGROUND: Monovalent rotavirus vaccine (RV1) was introduced in Tanzania in January 2013 under the Reach Every Child initiative, to be given at ages 6 and 10 weeks. We used the sentinel hospital rotavirus surveillance system to examine the rotavirus detection rate before and after vaccine introduction and estimate vaccine effectiveness. METHODS: Before vaccine introduction, rotavirus surveillance was established at two mainland hospitals; children admitted for acute diarrhea were eligible for enrollment and stools were tested for rotavirus antigen. We compared the rotavirus positivity rate in the pre-vaccine period (Tanga Hospital, 2009 and 2011; Bugando Medical Centre, 2012) to that from post-introduction years, 2014-2015. In 2013, surveillance was established at 9 additional hospitals. We examined rotavirus positivity among infants at these sites for 2014-2015. We obtained vaccine records and calculated vaccine effectiveness at 3 sites using case-test-negative control design. RESULTS: At Tanga Hospital, the rotavirus positivity rate among infants was 41% (102/251) pre-vaccine and 14% (28/197) in post-vaccine years (rate ratio: 0.35 [95% CI 0.22-0.54]). At Bugando, the positivity rate was 58% (83/143) pre-vaccine, and 18% (49/277) post-introduction (rate ratio 0.30 [95% CI 0.210.44]). Results were similar among children \textless5 years. At the new sites, the median site rotavirus positivity rate among infants was 26% in 2014 (range 19-44%) and 18% in 2015 (range 16-33%). The effectiveness of ≥1 RV1 dose against rotavirus hospitalization among children 5-23 months was 53% (95% CI: -14, 81), and 66% (95% CI: 9-87) against hospitalization with intravenous rehydration. Following introduction, peak rotavirus activity occurred later in the year and appeared more concentrated in time. CONCLUSION: Rotavirus surveillance data from Tanzania indicate that the rotavirus positivity rate among children hospitalized with diarrhea that were enrolled was substantially reduced after vaccine introduction. Low positivity rates among infants were detected at hospitals across the country. Overall, the data support that rotavirus vaccine has been successfully introduced and is effective in Tanzanian children.
@article{jani_detection_2018,
	title = {Detection of rotavirus before and after monovalent rotavirus vaccine introduction and vaccine effectiveness among children in mainland {Tanzania}},
	issn = {1873-2518},
	doi = {10/gdcffr},
	abstract = {BACKGROUND: Monovalent rotavirus vaccine (RV1) was introduced in Tanzania in January 2013 under the Reach Every Child initiative, to be given at ages 6 and 10 weeks. We used the sentinel hospital rotavirus surveillance system to examine the rotavirus detection rate before and after vaccine introduction and estimate vaccine effectiveness.
METHODS: Before vaccine introduction, rotavirus surveillance was established at two mainland hospitals; children admitted for acute diarrhea were eligible for enrollment and stools were tested for rotavirus antigen. We compared the rotavirus positivity rate in the pre-vaccine period (Tanga Hospital, 2009 and 2011; Bugando Medical Centre, 2012) to that from post-introduction years, 2014-2015. In 2013, surveillance was established at 9 additional hospitals. We examined rotavirus positivity among infants at these sites for 2014-2015. We obtained vaccine records and calculated vaccine effectiveness at 3 sites using case-test-negative control design.
RESULTS: At Tanga Hospital, the rotavirus positivity rate among infants was 41\% (102/251) pre-vaccine and 14\% (28/197) in post-vaccine years (rate ratio: 0.35 [95\% CI 0.22-0.54]). At Bugando, the positivity rate was 58\% (83/143) pre-vaccine, and 18\% (49/277) post-introduction (rate ratio 0.30 [95\% CI 0.210.44]). Results were similar among children {\textless}5 years. At the new sites, the median site rotavirus positivity rate among infants was 26\% in 2014 (range 19-44\%) and 18\% in 2015 (range 16-33\%). The effectiveness of ≥1 RV1 dose against rotavirus hospitalization among children 5-23 months was 53\% (95\% CI: -14, 81), and 66\% (95\% CI: 9-87) against hospitalization with intravenous rehydration. Following introduction, peak rotavirus activity occurred later in the year and appeared more concentrated in time.
CONCLUSION: Rotavirus surveillance data from Tanzania indicate that the rotavirus positivity rate among children hospitalized with diarrhea that were enrolled was substantially reduced after vaccine introduction. Low positivity rates among infants were detected at hospitals across the country. Overall, the data support that rotavirus vaccine has been successfully introduced and is effective in Tanzanian children.},
	language = {eng},
	journal = {Vaccine},
	author = {Jani, Bhavin and Hokororo, Adolfine and Mchomvu, Jackson and Cortese, Margaret M. and Kamugisha, Christopher and Mujuni, Delphinius and Kallovya, Dotto and Parashar, Umesh D. and Mwenda, Jason M. and Lyimo, DaFrossa and {Tanzania Rotavirus Surveillance Teams} and Materu, Antonia and Omari, Kakuri Frank and Waziri, Mark and Laswai, Theresia and Juma, Hamisi and Mlay, Josephine and Dogani, Juliana and Stephen, Eugenia and Seugendo, Mwanisha and Nkumbi, Uyanjo and Lyakurwa, Anna and Matojo, Anivera and Bendera, Elice and Senyota, Jonathan and Msingwa, Veronica and Fungo, Yohana and Michael, Fausta and Mpamba, Amina and Chambo, Alfred and Cholobi, Happy and Lyamuya, Faraja and Chami, Inviollatha and Mchome, Esther and Mshana, Amina Mohamed and Mushi, Edward and Mariki, Uforo and Chard, Ronica and Tuju, Deborah and Ambokile, Nuswe and Lukwale, Fatuma and Kyessi, Furaha and Khamis, Asha and Michael, Innocent and Macha, Doreen and Saguti, Angelina},
	month = apr,
	year = {2018},
	pmid = {29655631},
}
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