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Wednesday 15 June 2016
A Systematic Review of the Effect of Rotavirus Vaccination on Diarrhea Outcomes Among Children Younger Than 5 Years

This week WAidid suggests the Systematic Review published on Pediatric Infectious Diseases Journal on May 31st, 2016 on Rotavirus effects.

Diarrheal disease is a leading cause of childhood morbidity and mortality globally. Rotavirus is the leading cause of vaccine-preventable diarrhea among children under-five and is associated with approximately 28% of diarrheal deaths. WHO recommends the inclusion of rotavirus vaccination in all national immunization programs. There are two licensed oral live-attenuated rotavirus vaccines currently available globally: a monovalent human rotavirus vaccine (Rotarix (RV1) ) and a pentavalent bovine–human reassortant rotavirus vaccine (RotaTeq (RV5)). In 2011, a systematic review of published vaccine efficacy trials and effectiveness studies estimated that rotavirus vaccines reduced severe rotavirus diarrhea by 91% in developed countries, 88% in low-mortality countries in Asia and North Africa, 81% in Latin America, and 50% in sub Saharan Africa. In this systematic review, the authours aimed to expand upon the existing evidence base for the efficacy and effectiveness of rotavirus vaccination against morbidity and mortality among children <5 years of age. The results of our systematic review confirm the protective efficacy and effectiveness of rotavirus vaccination against rotavirus and all diarrheal outcomes among children under-five globally. efficacy was highest in the developed region followed by East/Southeastern Asia, Latin America and the Caribbean, South Asia and Sub Saharan Africa (Figure 2), and effectiveness estimates followed a similar regional pattern. Possible explanations for varying levels of protection include regional differences in gut microbiome, environmental enteropathy, inhibitory maternal antibodies and/or interactions with other viruses in the gut. Though the protective effects conferred by rotavirus vaccines are greater in higher income settings, rotavirus vaccination has the potential to avert more severe childhood diarrhea cases and deaths in low-income regions where the incidence of severe rotavirus is highest and adequate diarrhea management is less accessible.

Lamberti LM, Ashraf S, Walker CL, Black RE