Effectiveness and Impact of Monovalent Rotavirus Vaccination in Afghanistan, a test-negative case-control analysis
Abstract
Background- Afghanistan introduced monovalent rotavirus vaccine (Rotarix®) into its national immunization schedule in January 2018. While post-licensure studies have demonstrated substantial declines in rotavirus gastroenteritis (RVGE) cases and deaths globally, there is limited evidence of rotavirus vaccine effectiveness (VE) and impact from low-income countries in Asia. We aimed at evaluating the VE for Rotarix® and the impact of Rotarix® on RVGE hospitalizations among children aged <5 years in Afghanistan. Method – We used a test-negative case-control design embedded in an active sentinel surveillance platform to evaluate VE. Children born on or after January 01, 2018, with documentation of their rotavirus vaccination status and admitted for acute gastroenteritis (AGE) at one of four sentinel hospitals from May 2018 through December 2021 were eligible to be included. We used an unconditional logistic regression model to estimate VE and 95% confidence interval (CI) for a full series compared to no rotavirus vaccine doses among admitted AGE patients. VE against hospitalization was calculated as (1-(odds of being vaccinated in cases) / (odds of being vaccinated in controls)) x 100%. We compared pre- (2013–2015) and post-vaccine (2019–2021) surveillance data from two sites to calculate vaccine impact. Findings – The VE analysis included 1172 cases and 2173 controls. Approximately 63% of cases and controls were male, and 65% were 6–11 months of age. Two doses of Rotarix® were…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
Read the paper
Related studies
- Patient-Centered Pharmaceutical Design to Improve Acceptability of Medicines: Similarities and Differences in Paediatric and Geriatric Populations
- Evidence-based clinical practice guidelines for irritable bowel syndrome 2020
- Phase 2b Study of Pimodivir (JNJ-63623872) as Monotherapy or in Combination With Oseltamivir for Treatment of Acute Uncomplicated Seasonal Influenza A: TOPAZ Trial
- Gastrointestinal manifestations in COVID-19
- COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist
- Persistent gut barrier damage and commensal bacterial influx following eradication of Giardia infection in mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.