Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size

Background Diarrhea mortality remains a leading cause of child death and rotavirus vaccine an effective tool for preventing severe rotavirus diarrhea. New data suggest vaccine efficacy may vary by region. Methods We reviewed published vaccine efficacy trials to estimate a regional-specific effect of...

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Bibliographic Details
Published in:BMC public health Vol. 11; no. Suppl 3; p. S16
Main Authors: Fischer Walker, Christa L, Black, Robert E
Format: Journal Article
Language:English
Published: London BioMed Central 13.04.2011
Springer Nature B.V
BMC
Subjects:
Africa South of the Sahara - epidemiology
Africa, Northern - epidemiology
Asia - epidemiology
Biostatistics
Child
Children & youth
Developed Countries
Developing countries
Diarrhea
Diarrhea - mortality
Diarrhea - prevention & control
Diarrhea - virology
Environmental Health
Epidemiology
Humans
Latin America - epidemiology
LDCs
Medicine
Medicine & Public Health
Mortality
Public Health
Review
Rotavirus - immunology
Rotavirus Infections - prevention & control
Rotavirus Vaccines - administration & dosage
Severity of Illness Index
Vaccine
Vaccines
Viruses
Africa, Northern
Africa South of the Sahara
Asia
Latin America
Child Health Epidemiology Reference Group
Diarrhea Incidence
Latin America Region
Diarrhea Mortality
Vaccine Efficacy
ISSN:1471-2458, 1471-2458
Online Access:Get full text
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Summary:Background Diarrhea mortality remains a leading cause of child death and rotavirus vaccine an effective tool for preventing severe rotavirus diarrhea. New data suggest vaccine efficacy may vary by region. Methods We reviewed published vaccine efficacy trials to estimate a regional-specific effect of vaccine efficacy on severe rotavirus diarrhea and hospitalizations. We assessed the quality of evidence using a standard protocol and conducted meta-analyses where more than 1 data point was available. Results Rotavirus vaccine prevented severe rotavirus episodes in all regions; 81% of episodes in Latin America, 42.7% of episodes in high-mortality Asia, 50% of episodes in sub-Saharan Africa, 88% of episodes low-mortality Asia and North Africa, and 91% of episodes in developed countries. The effect sizes observed for preventing severe rotavirus diarrhea will be used in LiST as the effect size for rotavirus vaccine on rotavirus-specific diarrhea mortality. Conclusions Vaccine trials have not measured the effect of vaccine on diarrhea mortality. The overall quality of the evidence and consistency observed across studies suggests that estimating mortality based on a severe morbidity reduction is highly plausible.
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ISSN:1471-2458
1471-2458
DOI:10.1186/1471-2458-11-S3-S16