Rotavirus vaccine A cost effective control measure for India
ABSTRACT Globally, rotavirus diarrhea results in 453,000 deaths in children younger than 5 y—37% of deaths attributable to diarrhea and 5% of all deaths in children younger than 5 y. India alone accounts for 22% (~100,000 deaths) of all deaths attributable to rotavirus infection. Two oral rotavirus vaccines are available: Rotarix, a monovalent P1A G1 vaccine (GlaxoSmithKline), and RotaTeq, a pentavalent bovine-human reassortant vaccine (Merck). Rotarix is administered in a 2-dose schedule with the first and second doses of DTP (DTP1, DTP2). RotaTeq requires a 3-dose schedule with DTP1, DTP2 and DTP3 with an interval of 4–10 weeks between doses. The first dose of either vaccine should be administered to infants aged 6–15 weeks irrespective of the history of previous rotavirus infection, and the maximum age for administering the last dose of either vaccine should be 32 weeks. Although India would require funding from international health organizations/GAVI until new indigenous rotavirus vaccine candidates are developed at a cheaper price, introduction of vaccination into the national immunization program would be a cost-effective step toward control of the rotavirus diarrhea-related morbidity and mortality in India.
- SourceAvailable from: Mohammod Jobayer ChistiPublic health nutrition: principles and practice in community and global health, Edited by Favilene C, Brown M, 01/2014: chapter Childhood diarrhea and severe malnutrition: pages 235-55; Jones & Bartlett Learning.
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ABSTRACT: Background More than half of the over 18 million incompletely vaccinated children worldwide in 2011 lived in India (32%), Nigeria (14%) and Indonesia (7%). Overall immunization coverage in India was 61% in 2009. Few studies have explored the role of parental attitudes in children's vaccination. Objectives To explore the correlates of completion of routine vaccination among children in Mysore City, India. Methods A two-stage probability sample of 800 girls aged 11–15 years was selected from 12 schools in Mysore to take home questionnaires to be completed by their parents. The questionnaire elicited information on socio-demographic characteristics, attitudes and practices relevant to vaccination. Bivariate and multivariable logistic regression analyses were performed to identify factors independently associated with completion of routine vaccination. Results Of the 797 (99.6%) parents who completed questionnaires, 29.9% reported completing all routine vaccinations for their children. Parents who had obtained optional vaccinations for their children (adjusted odds ratio [AOR]: 4.56; 95% confidence interval [CI]: 3.09–6.74), who believed in vaccines’ effectiveness (2.50; 1.19–5.28) and who asked doctors or nurses about vaccination (2.07; 1.10–3.90) were significantly more likely to report complete vaccination, after controlling for all other factors. Belief that the disease was more protective than vaccination was independently associated with lower likelihood of vaccination series completion (0.71; 0.52–0.96). No other attitudinal or socio-demographic factors were associated with vaccine completion. Conclusion Interest and belief in vaccine effectiveness are important facilitators motivating parents to obtain full vaccination for their children in India.Journal of Infection and Public Health 07/2014; 8(1). DOI:10.1016/j.jiph.2014.05.003
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ABSTRACT: Background: To monitor the prevalence of rotaviral diarrhoea in under-5 children (U5C) as a retrospective study in a tertiary care hospital during one year. Methods: Suspected stool samples were diagnosed for rotavirus by an enzyme immunoassay kit. The same stool samples were diagnosed for the detection of any secondary bacterial infection through routine microbiological diagnosis. Results and Conclusions: Of the total 265 stool samples, 123 were diagnosed positive with rotaviral infection, of which, 59 (50. 86%) samples were from children in the age group of 0 to 12 month; further, 28 (41.79%), 17 (58.52%), 14 (35.71%) and 5 (46.41%) were from age groups, 13-24, 25-36, 37-48 and 49-60 month age groups, respectively. Cases of secondary bacteremia were with Klebsiella sp., Enterobacter sp., Escherichia coli and Shigella sp. in the stool samples in age groups as given: 14 (0-12 month), 3 (13-24 month), 2 (37-48 month) and 1 (25-36 month). Of the total 123 rotaviral positive infants, 62 patients had fever and 100 patients had vomiting; while, 57, 47 and 10 patients had ‘mild’, ‘some’ and ‘severe’ dehydration, respectively. Further, 34 and 89 rotaviral positive children were with malnutrition and normal nutrition, respectively; while, 19, 89 and 15 patients were hospitalized for ≤ 2, 3 – 6, and ≥7 days, respectively. Data sets for ‘severity of dehydration’ and ‘days of hospitalization’ were statistically significant, with Kruskal-Wallis H-test, independently. Of 142 rotaviral negative patients, 27 with bacterial diarrhoea, 6 with parasitic infections, 20 with antibiotic intolerance and 31 with lactose intolerance were recorded.The Gazette of the Egyptian Paediatric Association 06/2015; 63(1):41-51. DOI:10.1016/j.epag.2015.04.003