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Publications

Journal Article Ppublish 1 citation

PubMed: 42586106 DOI: 10.1016/S2352-4642(26)00158-6

Rotavirus vaccine effectiveness against rotavirus and acute gastroenteritis mortality: an analysis of pooled case-control studies from the MNSSTER-V dataset.

Lancet Child Adolesc Health 10(10):699-709

Authors: Mary C Moran, Eleanor Burnett, Michelle J Groome, Fausta Michael, Robert F Breiman, Annick Lalaina Robinson, Volga Iniguez, Hilda A Mujuru, David M Goldfarb, Christophe Luhata Lungayo, Inácio Mandomando, Isidore Juste O Bonkoungou, Palwasha Anwari, Ingrid Contreras-Roldán, Christabel Enweronu-Laryea, Kofi N'Zue, Cissy Nalunkuma, Nguyen Van Trang, Stela Gheorghita, Gayane Sahakyan, Anvar Nazurdinov, Renat Latipov, Jeannine Uwimana, Gloria Rey-Benito, Goitom Weldegebriel, Jason M Mwenda, Umesh D Parashar, Jacqueline E Tate

Affiliations

  • Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Ministry of Health, Dodoma, Tanzania.
  • Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Johannesburg, South Africa.
  • CHU Mère Enfant Tsaralalàna, Antananarivo, Madagascar.
  • Instituto de Biologia Molecular y Biotecnologia, Universidad Mayor de San Andres, La Paz, Bolivia.
  • Department of Paediatrics and Child Health, University of Zimbabwe and Harare Central Hospital, Harare, Zimbabwe.
  • University of British Columbia, Vancouver, BC, Canada.
  • Programme Élargi de Vaccination, Kinshasa, DR Congo.
  • Centro de Investigação em Saúde de Manhiça, Manhica, Mozambique; Global Health and Tropical Medicine, Associate Laboratory in Translation and Innovation Towards Global Health, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal; Instituto Nacional de Saúde, Maputo, Mozambique; ISGlobal, Barcelona, Spain.
  • Central Reference Laboratory/National Public Health Institute, Ouagadougou, Burkina Faso.
  • Ottawa, ON, Canada.
  • Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
  • University of Ghana Medical School, Accra, Ghana.
  • WHO Country Office, Abidjan, Côte d'Ivoire.
  • Paediatrics and Child Health, Lubaga Hospital, Kampala, Uganda.
  • National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
  • National Agency for Public Health, Ministry of Health of the Republic of Moldova, Chisinau, Moldova.
  • National Institute of Health, Ministry of Health of the Republic of Armenia, Yerevan, Armenia.
  • SEI Avicenna Tajik State Medical University, Dushanbe, Tajikistan.
  • Institute of Virology, Tashkent, Uzbekistan.
  • Department of Pathology, Kigali University Teaching Hospital, Kigali, Rwanda.
  • Pan American Health Organization, Washington, DC, USA.
  • WHO/AFRO Inter Country Support Team, Harare, Zimbabwe.
  • Diarrhoeal Pathogen Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa.

Abstract

BACKGROUND

Rotavirus accounts for an estimated 25% of diarrhoea deaths in children under 5 years globally, and more than 140 countries have included rotavirus vaccines in their routine national infant vaccination programmes. We aimed to calculate rotavirus vaccine effectiveness against rotavirus-positive and all-cause acute gastroenteritis deaths.

METHODS

The Multi-National Subpopulations Study to Evaluate Rotavirus Vaccines (MNSSTER-V) dataset combines child-level data from test-negative case-control studies of rotavirus vaccine effectiveness that enrolled children under 5 years of age seeking care for acute gastroenteritis at hospitals or emergency departments in 24 countries between July 1, 2007, and Aug 24, 2023. Children were included in this study if they were: younger than 5 years, met the acute gastroenteritis case definition (had at least three episodes of diarrhoea in a 24-h period, had non-bloody and non-chronic diarrhoea, and were enrolled within 7 days of diarrhoea onset), met vaccine card quality metrics, had vaccine delivery dates if the child was reported to have received a rotavirus vaccine, and had a reported outcome of death or discharge. In-hospital acute gastroenteritis deaths were characterised, and rotavirus vaccine effectiveness against all-cause and rotavirus-positive acute gastroenteritis mortality was calculated using an unconditional logistic regression model with adjustment for national under-5 mortality strata and child's age. Vaccine effectiveness analyses against all-cause and rotavirus-positive acute gastroenteritis mortality were restricted to children aged at least 3 months who received any routine vaccines from countries reporting at least one acute gastroenteritis death.

FINDINGS

From the MNSSTER-V dataset, we included 27 252 children younger than 5 years enrolled from 22 countries; outcomes of patients were not available for two countries. At least one in-hospital acute gastroenteritis death was reported from 16 countries including 21 522 children; in total, 183 all-cause acute gastroenteritis deaths and 25 rotavirus-positive deaths were reported. Among children aged at least 3 months who had received any routine vaccines, receiving at least one dose of a rotavirus vaccine had an adjusted vaccine effectiveness of 75·8% (95% CI 28·4 to 91·8; n=13 630) against rotavirus-positive acute gastroenteritis mortality and 20·8% (-47·0 to 57·3; n=20 005) against all-cause acute gastroenteritis mortality.

INTERPRETATION

Rotavirus vaccines are effective in preventing rotavirus-positive acute gastroenteritis mortality. Continued efforts to improve vaccine delivery could help to reduce acute gastroenteritis mortality due to rotavirus worldwide.

FUNDING

None.

MeSH

Mortality, Rotavirus Vaccines, Vaccines, Rotavirus, Gastroenteritis, Case-Control Studies, Aged, Pediatrics, Child