Timing and Predictors of Severe Rotavirus Gastroenteritis among Unvaccinated Infants in Low- and Middle-Income Countries

Citation

Gruber, Joann F.; Becker-Dreps, Sylvia I.; Hudgens, Michael G.; Brookhart, M. Alan; Thomas, James C.; & Jonsson Funk, Michele L. (2018). Timing and Predictors of Severe Rotavirus Gastroenteritis among Unvaccinated Infants in Low- and Middle-Income Countries. Epidemiology & Infection, 146(6), 698-704. PMCID: PMC5895523

Abstract

Delays in rotavirus vaccine schedule could improve performance in low- and middle-income countries (LMICs). However, delaying the first dose could be detrimental if infants experience severe rotavirus gastroenteritis (RVGE) early in life. Our objective was to describe the timing and predictors of severe RVGE in unvaccinated children in LMICs. We analysed the placebo arms from two clinical trials (cohort 1: NCT00241644; cohort 2: NCT00362648). We estimated the rate, cumulative incidence (per 1000 infants) and age distribution of severe RVGE episodes. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CI) for the association between baseline factors and severe RVGE. Cumulative incidence at 6 months of age was 23/1000 (95% CI 15-30) in cohort 1 and 6/1000 (95% CI 3-8) in cohort 2. Early antibiotic use (compared with no use) was associated with 2.03 (95% CI 1.18-3.48) and 1.41 (95% CI 0.80-2.51) times the rate of severe RVGE in cohorts 1 and 2, respectively. The cumulative incidence of severe RVGE was low at 6 months of age, suggesting that a 4-week delay in the vaccination schedule may not result in a large number of severe RVGE episodes prior to vaccine receipt.

URL

http://dx.doi.org/10.1017/S0950268818000626

Reference Type

Journal Article

Year Published

2018

Journal Title

Epidemiology & Infection

Author(s)

Gruber, Joann F.
Becker-Dreps, Sylvia I.
Hudgens, Michael G.
Brookhart, M. Alan
Thomas, James C.
Jonsson Funk, Michele L.

PMCID

PMC5895523

ORCiD

Thomas, JC - 0000-0002-2225-2052