Background: Rotavirus infection is the most common cause of severe gastroenteritis in children worldwide. New rotavirus vaccines are not currently used in the five countries that make up the Central Asian region. Three of these countries, Kazakhstan, Uzbekistan, and Kyrgyzstan, have a combined total population of 48 million and an estimated 1 million annual births.
Methods: We conducted prospective hospital-based surveillance for rotavirus diarrhea in three Central Asian countries (Kazakhstan, Uzbekistan, and Kyrgyzstan) during 2005-2009 to estimate the burden of rotavirus. We calculated the proportion of rotavirus among children aged <5 years hospitalized with acute diarrhea and estimated numbers of rotavirus-associated deaths, hospitalizations, outpatient visits, and home care episodes.
Results: Of 20 780 children hospitalized with diarrhea and enrolled in the study, 26% (95% confidence interval (CI) 25-27) were positive for rotavirus antigen by ELISA. On an annual basis, 4007 (2.6 per 1000 child-years) rotavirus hospitalizations occur in Kazakhstan, 5491 (2.1 per 1000 child-years) in Uzbekistan, and 3883 (6.8 per 1000 child-years) in Kyrgyzstan. Rotavirus is also estimated to cause 68 (0.04 per 1000 child-years) deaths in children aged <5 years in Kazakhstan, 662 (0.25 per 1000 child-years) in Uzbekistan, and 156 (0.27 per 1000 child-years) in Kyrgyzstan.
Conclusion: This study presents an epidemiological picture of rotavirus disease in Central Asia and illustrates a substantial rotavirus burden, which is preventable with rotavirus vaccination.
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http://dx.doi.org/10.1016/j.ijid.2011.03.014 | DOI Listing |
Sci Total Environ
January 2025
Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Poor water, sanitation, and hygiene (WASH) are the primary risks of exposure to enteric viral infection. Our study aimed to describe the role of WASH conditions and practices as risk factors for enteric viral infections in children under 5. Literature on the risk factors associated with all-cause diarrhea masks the taxa-specific drivers of diarrhea from specific pathogens, limiting the application of relevant control strategies.
View Article and Find Full Text PDFClin Exp Immunol
January 2025
Bill & Melinda Gates Foundation, Seattle, WA, USA.
Oral vaccines have several advantages compared with parenteral administration: they can be relatively cheap to produce in high quantities, easier to administer, and induce intestinal mucosal immunity that can protect against infection. These characteristics have led to successful use of oral vaccines against rotavirus, polio, and cholera. Unfortunately, oral vaccines for all three diseases have demonstrated lower performance in the highest-burden settings where they are most needed.
View Article and Find Full Text PDFJ Multidiscip Healthc
December 2024
Department of Epidemiology and Biostatistics, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
Background: Malnourished children in low- and middle-income countries (LMICs) often exhibit reduced vaccine efficacy, particularly for oral vaccines like polio and rotavirus, due to impaired immune responses. Nutritional deficiencies, such as in vitamin A and zinc, along with environmental factors like poor sanitation, exacerbate this issue. Existing research has explored the individual impacts of malnutrition on vaccine outcomes, but a comprehensive framework that integrates nutritional, immune, and environmental factors has been lacking.
View Article and Find Full Text PDFAm J Epidemiol
December 2024
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Rotavirus vaccine appears to perform sub-optimally in countries with higher rotavirus burden. We hypothesized that differences in the magnitude of rotavirus exposures may bias vaccine efficacy (VE) estimates, so true differences in country-specific rotavirus VE would be exaggerated without accommodating differences in exposure. We estimated VE against any-severity and severe rotavirus gastroenteritis (RVGE) using Poisson regression models fit to pooled individual-level data from Phase II and III monovalent rotavirus vaccine trials conducted between 2000 and 2012.
View Article and Find Full Text PDFVaccine
December 2024
ICMR- National Institute for Research in Bacterial Infections (formerly ICMR-NICED), Kolkata, India. Electronic address:
Background: Despite global rotavirus vaccination efforts, rotavirus remains a leading cause of childhood deaths from acute gastroenteritis. Post-vaccination studies in India, particularly in eastern India, have been limited, despite high prevalence of rotavirus in this region prior to vaccine introduction. This study was conducted to assess the impact of rotavirus vaccine on the epidemiology of rotavirus and other enteric viruses, as well as the changes in the diversity of rotavirus strains among children (≤5 years) with acute gastroenteritis.
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