The impact of rotavirus vaccination on emergency department visits and hospital admissions for acute diarrhea in children under 5 years

Rev Assoc Med Bras (1992). 2016 Sep;62(6):506-512. doi: 10.1590/1806-9282.62.06.506.

Abstract

Introduction:: Acute diarrheal disease is the second cause of death in children under 5 years. In Brazil, from 2003 to 2009, acute diarrhea was responsible for nearly 100,000 hospital admissions per year and 4% of the deaths in children under 5 years. Rotavirus is the leading cause of severe acute diarrhea worldwide. In 2006, the rotavirus monovalent vaccine (RV1) was added to the Brazilian National Immunization Program.

Objectives:: To analyze the impact of the RV1 on emergency department (ED) visits and hospital admissions for acute diarrhea.

Method:: A retrospective ecologic study at the University Hospital, University of São Paulo. The study analyzed the pre-vaccine (2003-2005) and the post-vaccine (2007-2009) periods. We screened the main diagnosis of all ED attendances and hospital admissions of children under 5 years in an electronic registry system database and calculated the rates of ED visits and hospital admissions. The reduction rate was analyzed according to the following formula: reduction (%) = (1 - odds ratio) x 100.

Results:: The rates of ED visits for acute diarrhea was 85.8 and 80.9 per 1,000 total ED visits in the pre and post vaccination periods, respectively, resulting in 6% reduction (95CI 4 to 9%, p<0.001). The rates of hospital admissions for acute diarrhea was 40.8 per 1,000 in the pre-vaccine period and dropped to 24.9 per 1,000 hospitalizations, resulting in 40% reduction (95CI 22 to 54%, p<0.001).

Conclusion:: The introduction of the RV1 vaccine resulted in 6% reduction in the ED visits and 40% reduction in hospital admissions for acute diarrhea.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Brazil / epidemiology
  • Child, Preschool
  • Diarrhea / epidemiology
  • Diarrhea / prevention & control
  • Diarrhea / virology*
  • Emergency Service, Hospital
  • Hospitalization / statistics & numerical data
  • Humans
  • Immunization Programs
  • Infant
  • Retrospective Studies
  • Rotavirus Infections / epidemiology
  • Rotavirus Infections / prevention & control*
  • Rotavirus Vaccines / administration & dosage*
  • Seasons

Substances

  • Rotavirus Vaccines