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Published on: January 28, 2019
Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination
Mohammed Amood Al-Kamarany1, Lina Al-Areqi2, Abulatif Mujally2
1Department of Pharmacy Practice, Faculty of Clinical Pharmacy and Tropical Medicine Center, Hodeidah University, P.O. Box 3114, Hodeidah, Yemen; Program of Health and Drug, Tihama Foundation for Drug Studies and Research, Hodeidah, Yemen.
Insights
The introduction of the rotavirus vaccine in Yemen significantly reduced childhood diarrheal disease hospitalizations by 75.93%. Rotavirus vaccination is crucial for public health in Yemen.
Area of Science:
- Pediatrics
- Vaccinology
- Infectious Diseases
Background:
- Rotavirus is a leading cause of severe diarrheal disease in young children globally.
- Yemen introduced the Rotarix™ rotavirus vaccine in 2012, with a two-dose schedule for infants.
- Understanding the vaccine's impact on hospitalization and circulating strains is vital for public health strategies.
Purpose of the Study:
- To evaluate the effect of rotavirus vaccine introduction on diarrheal disease hospitalization rates in children under five.
- To identify changes in prevalent rotavirus genotypes before and after vaccine implementation in Yemen.
Main Methods:
- A longitudinal observational study was conducted at the Yemeni-Swedish Hospital in Taiz, Yemen.
- Fecal samples were collected and analyzed using Enzyme Linkage Immunosorbent Assay (ELISA) for rotavirus detection.
- Data from the prevaccination period (Jan 2009-Jul 2012) and postvaccination period (Jan 2013-Dec 2014) were compared.
Main Results:
- Rotavirus hospitalization incidence decreased from 43.79% in 2009 to 10.54% in 2014, a reduction of 75.93%.
- Vaccine coverage rose from 23% in 2012 to 72% in 2014.
- Predominant genotypes shifted from G2P[4] (55.0%) pre-vaccination to G1P[8] (31%) post-vaccination.
Conclusions:
- Rotavirus vaccination in Yemen has led to a substantial decrease in diarrheal hospitalizations among young children.
- Sustained vaccine efficacy against evolving rotavirus strains and efficient delivery systems are key for future success.
- The findings underscore the importance of rotavirus vaccination programs in reducing childhood morbidity and mortality.
Abstract:
The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™ ® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH) in Taiz, Yemen. Prevaccination covered January 2009-July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013-December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA). The incidence of rotavirus hospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%), followed by G1P[8] (15.0%), while in postvaccination period G1P[8] (31%) was the predominant genotype, followed by G9P[8] (27.5%). In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.
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