Rotavirus vaccine effectiveness in Hong Kong young children
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摘要Background
Rotavirus is a common infectious cause of childhood hospitalisation in Hong Kong. The incidence of rotavirus admissions in children below five years was 542 per 100,000 person-years from 1997 to 2011. Rotavirus vaccines have been licensed and used in the private sector in Hong Kong since 2006 but have not been included in the government’s Childhood Immunisation Programme (CIP). This study aimed to evaluate rotavirus vaccine effectiveness against hospitalisation in Hong Kong children aged below five years.

Methods
During the 2014/2015 rotavirus season, a test-negative designed case-control study was conducted in six public hospitals in Hong Kong. Hospitalised acute gastroenteritis (AGE) patients meeting the inclusion criteria were invited to participate. AGE was defined as the occurrence of two or more episodes of vomiting and/ or three or more episodes of diarrhoea within a 24-hour period. Demographic information, birth and medical histories, disease severity, rotavirus laboratory results and verbal records of immunisation history were collected. Copies of immunisation records were obtained if possible. Case-patients were defined as enrolled subjects with stool specimens obtained in the first 48 hours of hospitalisation that tested positive for rotavirus and control-patients were those with stool specimens testing negative for rotavirus. Vaccine effectiveness was calculated as 1 minus the odds ratio for rotavirus vaccinated case-patients versus non-vaccinated control-patients. All analyses were performed using statistical software R version 3.2.2 and SAS version 9.3 (SAS Institute, Cary, NC).

Results
From 31 October 2014 to 23 April 2015, there were 525 evaluable enrolled subjects of which 404 had immunisation records seen and were included in the vaccine effectiveness analysis. 126 (31%) subjects tested positive for rotavirus and 278 (69%) tested negative. 3 (2.4%) and 67 (24%) subjects received at least 1 dose of rotavirus vaccine in case- and control-patients respectively. The unmatched vaccine effectiveness was 92% (95% confidence interval [CI]: 75%, 98%). For the matched analyses by age only and both age and admission date, 96% (95% CI: 72%, 100%) and 89% (95% CI: 51%, 97%) protection against rotavirus hospitalisation were found respectively. Vaccine effectiveness for full series rotavirus vaccination only was similar to the combined full and partial series results (88% to 96% in matched and unmatched analyses). 17% of all subjects and 24% of the rotavirus-negative subjects had received rotavirus vaccine through the private sector.

Conclusions
Rotavirus vaccine is highly effective in preventing hospitalisation from rotavirus disease. Incorporation of the vaccine into the CIP could significantly reduce hospitalisations of Hong Kong children aged below five years.

Acknowledgements
This work was supported by the Research Grants Council General Research Fund [CUHK 14111514].
出版社接受日期07.09.2016
著者Yeung KHT, Tate JE, Chan CC, Chan MCW, Chan PKS, Poon KH, Siu SLY, Fung GPG, Ng KL, Chan IMC, Yu PT, Ng CH, Lau YL, Nelson EAS
會議名稱Twelfth International Rotavirus Symposium 2016
會議開始日07.09.2016
會議完結日09.09.2016
會議地點Melbourne
會議國家/地區澳大利亞
出版年份2016
語言英式英語

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