Database : MEDLINE
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[PMID]: 29438743
[Au] Autor:Biscaro V; Piccinelli G; Gargiulo F; Ianiro G; Caruso A; Caccuri F; De Francesco MA
[Ad] Address:Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy.
[Ti] Title:Detection and molecular characterization of enteric viruses in children with acute gastroenteritis in Northern Italy.
[So] Source:Infect Genet Evol;60:35-41, 2018 Feb 10.
[Is] ISSN:1567-7257
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Enteric viral infections are a major concern for public health, and viral acute gastroenteritis is the principal cause of pediatric morbidity and mortality worldwide, mostly in developing countries. The purpose of this study was to determine the prevalence of different enteric viruses detected in a pediatric population with acute gastroenteritis symptoms, and to characterize the strains detected. Stools were collected from children, aged from 2 months to 15 years old, admitted to one of the main hospitals of Northern Italy, between November 2015 and October 2016. Stools were tested for nine enteric viruses (adenovirus, rotavirus A, norovirus, astrovirus, sapovirus, enterovirus, parechovirus, bocavirus and aichivirus) by molecular methods. Furthermore, rotavirus, norovirus and adenovirus were deeply characterized by nucleotide sequencing and phylogenetic analysis. A total of 151 out of 510 (29.6%) stools analyzed resulted positive for at least one of the enteric virus investigated. The most common virus detected was rotavirus A (53/151, 35.1%), followed by norovirus (39/151, 25.8%), adenovirus (35/151, 23.1%), sapovirus (9/151, 6%), enterovirus (5/151, 3.3%), astrovirus (5/151, 3.3%), parechovirus (4/151, 2.6%) and bocavirus (1/151, 0.6%). Aichi virus was not detected in any sample. Co-infections were detected in 12 out of 510 faecal samples (2.3%). These data improved the knowledge of the enteric viruses circulating in children in Northern Italy. In fact, besides rotavirus, adenovirus and norovirus, several viruses circulated across the whole year in the pediatric population object of this study. The introduction of specific viral diagnosis in our clinical setting will improve patient care by reducing unnecessary use of antibiotics addressing the right etiologic diagnosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29377961
[Au] Autor:DeBerg HA; Zaidi MB; Altman MC; Khaenam P; Gersuk VH; Campos FD; Perez-Martinez I; Meza-Segura M; Chaussabel D; Banchereau J; Estrada-Garcia T; Linsley PS
[Ad] Address:Benaroya Research Institute at Virginia Mason, Seattle, Washington, United States of America.
[Ti] Title:Shared and organism-specific host responses to childhood diarrheal diseases revealed by whole blood transcript profiling.
[So] Source:PLoS One;13(1):e0192082, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Globally, diarrheal diseases are a leading cause of death in children under five and disproportionately affect children in developing countries. Children who contract diarrheal diseases are rarely screened to identify the etiologic agent due to time and cost considerations associated with pathogen-specific screening and hence pathogen-directed therapy is uncommon. The development of biomarkers to rapidly identify underlying pathogens could improve treatment options and clinical outcomes in childhood diarrheal diseases. Here, we perform RNA sequencing on blood samples collected from children evaluated in an emergency room setting with diarrheal disease where the pathogen(s) present are known. We determine host response gene signatures specific to Salmonella, Shigella and rotavirus, but not E. coli, infections that distinguish them from each other and from healthy controls. Specifically, we observed differential expression of genes related to chemokine receptors or inflammasome signaling in Shigella cases, such as CCR3, CXCR8, and NLRC4, and interferon response genes, such as IFI44 and OASL, in rotavirus cases. Our findings add insight into the host peripheral immune response to these pathogens, and suggest strategies and limitations for the use host response transcript signatures for diagnosing the etiologic agent of childhood diarrheal diseases.
[Mh] MeSH terms primary: Diarrhea/immunology
Gene Expression Profiling
RNA, Messenger/blood
[Mh] MeSH terms secundary: Child
Diarrhea/blood
Diarrhea/genetics
Gastrointestinal Diseases/genetics
Gastrointestinal Diseases/microbiology
Humans
Rotavirus/isolation & purification
Shigella/isolation & purification
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (RNA, Messenger)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0192082

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[PMID]: 29519592
[Au] Autor:Giri S; Priya Hemavathy R; Arumugam R; Sherchand JB; Thu HM; Galagoda G; Myat TW; Abeysinghe N; Gunasekara M; Janakan N; Pradhan R; Bura V; Wijesinghe P; Kang G
[Ad] Address:Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India. Electronic address: sidharthgiri@cmcvellore.ac.in.
[Ti] Title:Molecular epidemiology of rotaviruses in the south-east Asian region from 2009 to 2015.
[So] Source:Vaccine;, 2018 Mar 05.
[Is] ISSN:1873-2518
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: In Asia, rotavirus accounts for approximately 45% of admissions due to acute gastroenteritis in children <5 years, and causes about 145,000 deaths every year. We studied the distribution of rotavirus strains from Myanmar, Sri Lanka, and Nepal during 2009-2015. METHODS: Stool samples collected from children <5 years of age hospitalized with acute diarrhea in the three sites and positive for rotavirus antigen by enzyme immunoassay (EIA) were sent to the Christian Medical College, Vellore from 2009 to 2015. G and P typing of rotavirus strains were performed using reverse-transcription polymerase chain reaction (RT-PCR). RESULT: Of the 2354 EIA positive samples tested, G12P[8] (36.8%), G1P[8] (30.1%), and G12P[6] (41.3%) were the most common strains isolated from Myanmar, Sri Lanka, and Nepal respectively. CONCLUSION: There was substantial diversity of rotavirus genotypes, and continued surveillance in developing countries of Asia will help in understanding the epidemiology of rotavirus before and after introduction of vaccines.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 13986 MEDLINE  
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[PMID]: 29518828
[Au] Autor:Yu G; Wang WJ; Liu DR; Tao ZF; Hui XY; Hou J; Sun JQ; Wang XC
[Ad] Address:Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China.
[Ti] Title:[Clinical characteristics of human recombination activating gene 1 mutations in 8 immunodeficiency patients with diverse phenotypes].
[So] Source:Zhonghua Er Ke Za Zhi;56(3):186-191, 2018 Mar 02.
[Is] ISSN:0578-1310
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:To investigate the clinical characteristics of 8 immunodeficiency cases caused by human recombination activating gene 1 (RAG1) mutations, and to explore the relationship among genotypes, clinical manifestations and immunophenotypes. Clinical data were collected and analyzed from patients with RAG1 mutations who visited the Department of Clinical Immunology, Children's Hospital of Fudan University between October 2013 and June 2017. The data included clinical manifestations, immunophenotypes and genotypes. A total of 8 patients were diagnosed with RAG1 deficiency (6 boys and 2 girls). The minimum age of onset was 2 months, and the maximum age was 4 months. The minimum age of diagnosis was 2 months, and the maximum age was 13 years. Four patients had a family history of infant death due to severe infections. Two cases were born to the same consanguineous parents. All cases had recurrent infections, including involvement of respiratory tract (8 cases), digestive tract (6 cases), urinary tract (1 case), and central nervous system (1 case). The pathogens of infection included bacteria, viruses and fungi. Rotavirus was found in 3 cases, cytomegalovirus (CMV) in 5 cases, bacillus Calmette-Gurin adverse reaction in 2 cases (1 of whom had a positive acid-fast smear from lymph node puncture fluid), fungal infection in 3 cases. One case had multiple nodular space-occupying lesions in lungs and abdominal cavity complicated with multiple bone destruction. The peripheral blood lymphocyte counts of all patients ranged between 0.1 10(9)/L and 3.310(9)/L (median, 0.6510(9)/L). Eosinophilia was found in 3 cases (range, (0.48-1.69) 10(9)/L). The patients were classified according to immunophenotype as severe combined immunodeficiency phenotype (4 cases), leaky severe combined immunodeficiency (2 cases), Omenn syndrome (1 case) and combined immunodeficiency (1 case) . Decreased serum IgG levels were found in 3 cases, increased serum IgM levels in 3 cases, increased serum IgE levels in 5 cases. RAG1 homozygous mutations were detected in 5 cases and RAG1 compound heterozygous mutations in 3 cases. Two novel mutations and six previously reported mutations were identified. Three cases were successfully treated with hematopoietic stem cell transplantation. Four cases died due to infections, and the 13 year-old patient was still under follow-up in the outpatient clinic. Different RAG1 gene mutations can lead to diverse clinical presentations and immune phenotypes. Clinicians should pay attention to the family history of infant death with severe infection. In that situation, immunological evaluation and gene detection should be performed as early as possible.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.3760/cma.j.issn.0578-1310.2018.03.007

  5 / 13986 MEDLINE  
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[PMID]: 29309581
[Au] Autor:Dawkins BR; Mirelman AJ; Asaria M; Johansson KA; Cookson RA
[Ad] Address:Academic Unit of Health Economics, Leeds Institute of Health Sciences, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK.
[Ti] Title:Distributional cost-effectiveness analysis in low- and middle-income countries: illustrative example of rotavirus vaccination in Ethiopia.
[So] Source:Health Policy Plan;33(3):456-463, 2018 Apr 01.
[Is] ISSN:1460-2237
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Reducing health inequality is a major policy concern for low- and middle-income countries (LMICs) on the path to universal health coverage. However, health inequality impacts are rarely quantified in cost-effectiveness analyses of health programmes. Distributional cost-effectiveness analysis (DCEA) is a method developed to analyse the expected social distributions of costs and health benefits, and the potential trade-offs that may exist between maximising total health and reducing health inequality. This is the first paper to show how DCEA can be applied in LMICs. Using the introduction of rotavirus vaccination in Ethiopia as an illustrative example, we analyse a hypothetical re-designed vaccination programme, which invests additional resources into vaccine delivery in rural areas, and compare this with the standard programme currently implemented in Ethiopia. We show that the re-designed programme has an incremental cost-effectiveness ratio of US$69 per health-adjusted life year (HALY) compared with the standard programme. This is potentially cost-ineffective when compared with current estimates of health opportunity cost in Ethiopia. However, rural populations are typically less wealthy than urban populations and experience poorer lifetime health. Prioritising such populations can thus be seen as being equitable. We analyse the trade-off between cost-effectiveness and equity using the Atkinson inequality aversion parameter, ε, representing the decision maker's strength of concern for reducing health inequality. We find that the more equitable programme would be considered worthwhile by a decision maker whose inequality concern is greater than ε = 5.66, which at current levels of health inequality in Ethiopia implies that health gains are weighted at least 3.86 times more highly in the poorest compared with the richest wealth quintile group. We explore the sensitivity of this conclusion to a range of assumptions and cost-per-HALY threshold values, to illustrate how DCEA can inform the thinking of decision makers and stakeholders about health equity trade-offs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1093/heapol/czx175

  6 / 13986 MEDLINE  
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[PMID]: 28465097
[Au] Autor:Cohet C; Rosillon D; Willame C; Haguinet F; Marenne MN; Fontaine S; Buyse H; Bauchau V; Baril L
[Ad] Address:GSK Vaccines, Wavre, Belgium. Electronic address: catherine.x.cohet@gsk.com.
[Ti] Title:Challenges in conducting post-authorisation safety studies (PASS): A vaccine manufacturer's view.
[So] Source:Vaccine;35(23):3041-3049, 2017 05 25.
[Is] ISSN:1873-2518
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Post-authorisation safety studies (PASS) of vaccines assess or quantify the risk of adverse events following immunisation that were not identified or could not be estimated pre-licensure. The aim of this perspective paper is to describe the authors' experience in the design and conduct of twelve PASS that contributed to the evaluation of the benefit-risk of vaccines in real-world settings. We describe challenges and learnings from selected PASS of rotavirus, malaria, influenza, human papillomavirus and measles-mumps-rubella-varicella vaccines that assessed or identified potential or theoretical risks, which may lead to changes to risk management plans and/or to label updates. Study settings include the use of large healthcare databases and de novo data collection. PASS methodology is influenced by the background incidence of the outcome of interest, vaccine uptake, availability and quality of data sources, identification of the at-risk population and of suitable comparators, availability of validated case definitions, and the frequent need for case ascertainment in large databases. Challenges include the requirement for valid exposure and outcome data, identification of, and access to, adequate data sources, and mitigating limitations including bias and confounding. Assessing feasibility is becoming a key step to confirm that study objectives can be met in a timely manner. PASS provide critical information for regulators, public health agencies, vaccine manufacturers and ultimately, individuals. Collaborative approaches and synergistic efforts between vaccine manufacturers and key stakeholders, such as regulatory and public health agencies, are needed to facilitate access to data, and to drive optimal study design and implementation, with the aim of generating robust evidence.
[Mh] MeSH terms primary: Adverse Drug Reaction Reporting Systems
Drug Industry/legislation & jurisprudence
Technology, Pharmaceutical/legislation & jurisprudence
Vaccines/adverse effects
[Mh] MeSH terms secundary: Chickenpox Vaccine/adverse effects
Humans
Influenza Vaccines/adverse effects
Malaria Vaccines/adverse effects
Measles-Mumps-Rubella Vaccine/adverse effects
Papillomavirus Vaccines/adverse effects
Risk Assessment
Rotavirus Vaccines/adverse effects
Technology, Pharmaceutical/methods
Technology, Pharmaceutical/organization & administration
Vaccination
Vaccines/administration & dosage
Vaccines, Attenuated
Vaccines, Combined/adverse effects
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Chickenpox Vaccine); 0 (Influenza Vaccines); 0 (Malaria Vaccines); 0 (Measles-Mumps-Rubella Vaccine); 0 (Papillomavirus Vaccines); 0 (Rotavirus Vaccines); 0 (Vaccines); 0 (Vaccines, Attenuated); 0 (Vaccines, Combined); 0 (measles, mumps, rubella, varicella vaccine)
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:170504
[St] Status:MEDLINE

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[PMID]: 28455169
[Au] Autor:Lee BY; Wedlock PT; Haidari LA; Elder K; Potet J; Manring R; Connor DL; Spiker ML; Bonner K; Rangarajan A; Hunyh D; Brown ST
[Ad] Address:HERMES Logistics Modeling Team, Baltimore, MD and Pittsburgh, PA, United States; Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. Electronic address: brucelee@jhu.edu.
[Ti] Title:Economic impact of thermostable vaccines.
[So] Source:Vaccine;35(23):3135-3142, 2017 05 25.
[Is] ISSN:1873-2518
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: While our previous work has shown that replacing existing vaccines with thermostable vaccines can relieve bottlenecks in vaccine supply chains and thus increase vaccine availability, the question remains whether this benefit would outweigh the additional cost of thermostable formulations. METHODS: Using HERMES simulation models of the vaccine supply chains for the Republic of Benin, the state of Bihar (India), and Niger, we simulated replacing different existing vaccines with thermostable formulations and determined the resulting clinical and economic impact. Costs measured included the costs of vaccines, logistics, and disease outcomes averted. RESULTS: Replacing a particular vaccine with a thermostable version yielded cost savings in many cases even when charging a price premium (two or three times the current vaccine price). For example, replacing the current pentavalent vaccine with a thermostable version without increasing the vaccine price saved from $366 to $10,945 per 100 members of the vaccine's target population. Doubling the vaccine price still resulted in cost savings that ranged from $300 to $10,706, and tripling the vaccine price resulted in cost savings from $234 to $10,468. As another example, a thermostable rotavirus vaccine (RV) at its current (year) price saved between $131 and $1065. Doubling and tripling the thermostable rotavirus price resulted in cost savings ranging from $102 to $936 and $73 to $808, respectively. Switching to thermostable formulations was highly cost-effective or cost-effective in most scenarios explored. CONCLUSION: Medical cost and productivity savings could outweigh even significant price premiums charged for thermostable formulations of vaccines, providing support for their use.
[Mh] MeSH terms primary: Rotavirus Vaccines/economics
Rotavirus Vaccines/supply & distribution
Vaccine Potency
[Mh] MeSH terms secundary: Benin/epidemiology
Computer Simulation
Cost-Benefit Analysis
Humans
India/epidemiology
Infant
Niger/epidemiology
Rotavirus Infections/epidemiology
Rotavirus Infections/prevention & control
Temperature
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Nm] Name of substance:0 (Rotavirus Vaccines)
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:170430
[St] Status:MEDLINE

  8 / 13986 MEDLINE  
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[PMID]: 29517476
[Au] Autor:Chen F; Knutson TP; Ciarlet M; Sturos M; Marthaler DG
[Ad] Address:2​State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China.
[Ti] Title:Complete genome characterization of a rotavirus B (RVB) strain identified in Alpine goat kids with enteritis reveals inter-species transmission with RVB bovine strains.
[So] Source:J Gen Virol;, 2018 Mar 08.
[Is] ISSN:1465-2099
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Rotavirus B (RVB) has been associated with enteric disease in many animal species. An RVB strain was identified in pooled intestinal samples from Alpine caprine kids (between 2 and 3 days of age) experiencing high (>90 %) morbidity, and the complete caprine RVB genome was characterized. Histology revealed villus atrophy, the samples tested positive for RVB by real-time RT-PCR and metagenomic next-generation sequencing identified only RVB and orf virus. In the VP4 gene segment, the caprine RVB strain had a higher percentage nucleotide identity to the Indian bovine RVB strains than to the Japanese bovine RVB strains, but the VP7, VP6, VP2, NSP1, NSP2 and NSP5 gene segments of the American caprine RVB strain were genetically related to the Japanese bovine RVB strains. The results indicate a lack of RVB sequences to understand reassortment or the evolutionary relationship of RVB strains from cattle and goats.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1099/jgv.0.001022

  9 / 13986 MEDLINE  
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[PMID]: 29514935
[Au] Autor:Keske S; Zabun B; Aksoy K; Can F; Palaoglu E; Ergnl
[Ad] Address:American Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
[Ti] Title:The Rapid Molecular Detection of Gastrointestinal Pathogens and its Role in Antimicrobial Stewardship.
[So] Source:J Clin Microbiol;, 2018 Mar 07.
[Is] ISSN:1098-660X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:We aimed to detect the etiological agents of acute diarrhea by molecular gastrointestinal pathogen test (MGPT) and to assess its impact on antimicrobial stewardship program (ASP). This is a prospective, observational study and was conducted between 1 January 2015 and 30 June 2017. We included consequent patients, who had acute diarrhea. At the end of 2015, we implemented ASP in acute diarrhea and we compared the outcomes in pre-ASP and post-ASP. An FDA-cleared multiplexed gastrointestinal PCR panel system, BioFire filmArray (Idaho Technology, Salt Lake City, UT) which detects twenty pathogens in stool was used. In 499 out of 699 patients (71%) at least one pathogen was detected. Among 314 adults with positive MGPT, 101 (32%) Enteropathogenic E. coli (EC), 71 (23%) Enteroaggregative EC, 68 (22%) Enterotoxigenic EC, 55 (18%) Shiga-like toxin producing EC, 53 (17%) Noro virus, 48 (15%) spp., 21 (7%) spp., and 20 (6%) were detected. Among 185 children, 55 (30%) EPEC, 37 (20%) , 32 (17%) Noro virus, 29 (16%) EAEC, 22 (12%) STEC, 21 (11%) ETEC, 21 (11%) spp., 20 (11%) spp., and 16 (5%) Rotavirus were detected. Inappropriate antibiotic use decreased in Post-ASP when compared with Pre-ASP among inpatients (42.9% and 25.8%, p=0.023). Using MGPT in clinical practice significantly decreased unnecessary use of antibiotics. Detection of high rates of in children, spp, and relatively high rates of spp. which was hard to isolate by routine stool culture were remarkable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher

  10 / 13986 MEDLINE  
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Clinical Trials Registry
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[PMID]: 29514306
[Au] Autor:Rogawski ET; Platts-Mills JA; Colgate ER; Haque R; Zaman K; Petri WA; Kirkpatrick BD
[Ad] Address:Department of Public Health Sciences, University of Virginia, Charlottesville.
[Ti] Title:Quantifying the Impact of Natural Immunity on Rotavirus Vaccine Efficacy Estimates: A Clinical Trial in Dhaka, Bangladesh (PROVIDE) and a Simulation Study.
[So] Source:J Infect Dis;217(6):861-868, 2018 Mar 05.
[Is] ISSN:1537-6613
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background: The low efficacy of rotavirus vaccines in clinical trials performed in low-resource settings may be partially explained by acquired immunity from natural exposure, especially in settings with high disease incidence. Methods: In a clinical trial of monovalent rotavirus vaccine in Bangladesh, we compared the original per-protocol efficacy estimate to efficacy derived from a recurrent events survival model in which children were considered naturally exposed and potentially immune after their first rotavirus diarrhea (RVD) episode. We then simulated trial cohorts to estimate the expected impact of prior exposure on efficacy estimates for varying rotavirus incidence rates and vaccine efficacies. Results: Accounting for natural immunity increased the per-protocol vaccine efficacy estimate against severe RVD from 63.1% (95% confidence interval [CI], 33.0%-79.7%) to 70.2% (95% CI, 44.5%-84.0%) in the postvaccination period, and original year 2 efficacy was underestimated by 14%. The simulations demonstrated that this expected impact increases linearly with RVD incidence, will be greatest for vaccine efficacies near 50%, and can reach 20% in settings with high incidence and low efficacy. Conclusions: High rotavirus incidence leads to predictably lower vaccine efficacy estimates due to the acquisition of natural immunity in unvaccinated children, and this phenomenon should be considered when comparing efficacy estimates across settings. Clinical Trials Registration: NCT01375647.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Data-Review
[do] DOI:10.1093/infdis/jix668


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