[Show abstract][Hide abstract] ABSTRACT: To evaluate the effectiveness of rotavirus vaccination among young children in Belgium.
Prospective case-control study.
Random sample of 39 Belgian hospitals, February 2008 to June 2010.
215 children admitted to hospital with rotavirus gastroenteritis confirmed by polymerase chain reaction and 276 age and hospital matched controls. All children were of an eligible age to have received rotavirus vaccination (that is, born after 1 October 2006 and aged ≥ 14 weeks).
Vaccination status of children admitted to hospital with rotavirus gastroenteritis and matched controls.
99 children (48%) admitted with rotavirus gastroenteritis and 244 (91%) controls had received at least one dose of any rotavirus vaccine (P<0.001). The monovalent rotavirus vaccine accounted for 92% (n=594) of all rotavirus vaccine doses. With hospital admission as the outcome, the unadjusted effectiveness of two doses of the monovalent rotavirus vaccine was 90% (95% confidence interval 81% to 95%) overall, 91% (75% to 97%) in children aged 3-11 months, and 90% (76% to 96%) in those aged ≥ 12 months. The G2P genotype accounted for 52% of cases confirmed by polymerase chain reaction with eligible matched controls. Vaccine effectiveness was 85% (64% to 94%) against G2P and 95% (78% to 99%) against G1P. In 25% of cases confirmed by polymerase chain reaction with eligible matched controls, there was reported co-infection with adenovirus, astrovirus and/or norovirus. Vaccine effectiveness against co-infected cases was 86% (52% to 96%). Effectiveness of at least one dose of any rotavirus vaccine (intention to vaccinate analysis) was 91% (82% to 95%).
Rotavirus vaccination is effective for the prevention of admission to hospital for rotavirus gastroenteritis among young children in Belgium, despite the high prevalence of G2P and viral co-infection.
[Show abstract][Hide abstract] ABSTRACT: Rotavirus (RV) is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK) to investigate the impact of paediatric rotavirus gastroenteritis (RVGE) on affected children and their parents.
A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged <5 years presenting to a general practitioner or paediatrician for RVGE at centres in Spain, Italy or Poland. RV infection was confirmed by polymerase chain reaction (PCR) testing (n = 264). The questionnaire was validated and used to assess the emotional impact of paediatric RVGE on the parents.
Questionnaire responses showed that acute RVGE in a child adversely affects the parents' daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale) was associated with higher parental worries due to symptoms and greater changes in the child's behaviour, and a trend to higher impact on parents' daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire.
Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child's illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children.
[Show abstract][Hide abstract] ABSTRACT: This observational, prospective study was undertaken to estimate the burden of rotavirus (RV) gastroenteritis (GE) leading to general practitioner (GP)/family paediatrician (FP) visits among children aged <5 years in Czech Republic, Germany, Italy, Poland, Spain and the UK. Children aged <5 years presenting with acute GE provided stool samples for rapid RV testing. RV+ samples were confirmed and typed by RT-PCR. Demographic and clinical data were collected for all RVGE episodes. Transmission patterns among other household children aged <5 years were also assessed. From November 2005 to May 2007, excluding data from the UK, 497/3,813 (13.0%) children aged <5 years presenting with acute GE to GP/FP and tested were RV+ by PCR. Most RVGE cases (69.1%) occurred in children aged <2 years, occurred between December and May (93.1%) and were moderate or severe by Vesikari score (92.9%). RV strain distribution varied between countries: G9P was the most common type in Poland (54/76) and Spain (172/196), G1P was predominant in the Czech Republic (56/64) and Italy (46/107), and G4P and G1P both prevailed in Germany (17/54 and 13/54, respectively). A total of 24/122 (19.7%) children aged <5 years resident in the same household as a PCR+ study participant also developed RVGE. Conclusion. This multinational epidemiological study in Europe shows that RV is easily transmitted among household children, with RVGE burden highest among children aged <2 years accessing primary healthcare for acute GE.
European Journal of Pediatrics 02/2011; 170(2):213-22. DOI:10.1007/s00431-010-1289-1 · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Between December 2006-May 2007, 371 children aged <3 years attending 15 day care centers (DCCs) in Paris, France were actively followed for acute gastroenteritis [GE; diarrhea (≥3 loose stools/24 hours with or without vomiting) for <14 days] and outbreaks of acute GE (≥3 cases in a DCC with onset within 11 days). Demographic, clinical and cost-related information was collected for all acute GE episodes. All children with acute GE and all participating attendees at affected DCC s during an outbreak (irrespective of symptoms) provided stool samples for rotavirus (RV) testing (RotaStrip™). RV-positive samples were typed by polymerase chain reaction (PCR). Overall incidence of RVGE among DCC attendees <3 years was 46.7 cases/100,000 person-days (95% CI: 26.7, 75.8) and was highest among children aged 5-11 months [139.2 cases/100,000 person-days (95% CI: 60.1, 274.2)]. 16/69 (23.2%) GE episodes were RV-positive by PCR, with 50% of RV-positive episodes occurring in children aged <1 year. G1P was the most common RV type (12/16). Over half of the RVGE episodes that could be evaluated scored severe on the Vesikari scale and most RVGE episodes resulted in parents/guardians accessing health care services. We found 10 children with RVGE to be the likely origin of outbreaks in 3 DCCs, in which 5/10 (50.0%), 6/21 (28.6%) and 7/23 (30.4%) children tested RV-positive. One in 25 DCC attendees exposed to RVGE developed RVGE and 1 in 9 contracted asymptomatic RV infection. RV-positive episodes had higher mean total costs than RV-negative episodes (€484.00 versus €182.80, respectively). Results highlight the ease with which RV can spread in a day care setting and the resulting burden on DCC attendees and their families. The introduction of new RV vaccines into national immunization programs should help prevent similar outbreaks and protect DCC attendees.
Human vaccines 05/2010; 6(5):399-406. DOI:10.4161/hv.6.5.11021 · 3.64 Impact Factor