Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.

<h4>Background</h4>Rotavirus vaccines have been adopted in African countries since 2009, including Mozambique (2015). Disease burden data are needed to evaluate the impact of rotavirus vaccine. We report the burden of rotavirus-associated diarrhea in Mozambique from the Global Enteric Mu...

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Main Authors: Sozinho Acácio, Tacilta Nhampossa, Llorenç Quintò, Delfino Vubil, Marcelino Garrine, Quique Bassat, Tamer Farag, Sandra Panchalingam, James P Nataro, Karen L Kotloff, Myron M Levine, Sharon M Tennant, Pedro L Alonso, Inácio Mandomando
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249714&type=printable
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author Sozinho Acácio
Tacilta Nhampossa
Llorenç Quintò
Delfino Vubil
Marcelino Garrine
Quique Bassat
Tamer Farag
Sandra Panchalingam
James P Nataro
Karen L Kotloff
Myron M Levine
Sharon M Tennant
Pedro L Alonso
Inácio Mandomando
author_facet Sozinho Acácio
Tacilta Nhampossa
Llorenç Quintò
Delfino Vubil
Marcelino Garrine
Quique Bassat
Tamer Farag
Sandra Panchalingam
James P Nataro
Karen L Kotloff
Myron M Levine
Sharon M Tennant
Pedro L Alonso
Inácio Mandomando
author_sort Sozinho Acácio
collection DOAJ
description <h4>Background</h4>Rotavirus vaccines have been adopted in African countries since 2009, including Mozambique (2015). Disease burden data are needed to evaluate the impact of rotavirus vaccine. We report the burden of rotavirus-associated diarrhea in Mozambique from the Global Enteric Multicenter Study (GEMS) before vaccine introduction.<h4>Methods</h4>A case-control study (GEMS), was conducted in Manhiça district, recruiting children aged 0-59 months with moderate-to-severe diarrhea (MSD) and less-severe-diarrhea (LSD) between December 2007 and November 2012; including 1-3 matched (age, sex and neighborhood) healthy community controls. Clinical and epidemiological data and stool samples (for laboratory investigation) were collected. Association of rotavirus with MSD or LSD was determined by conditional logistic regression and adjusted attributable fractions (AF) calculated, and risk factors for rotavirus diarrhea assessed.<h4>Results</h4>Overall 915 cases and 1,977 controls for MSD, and 431 cases and 430 controls for LSD were enrolled. Rotavirus positivity was 44% (217/495) for cases and 15% (160/1046) of controls, with AF = 34.9% (95% CI: 32.85-37.06) and adjusted Odds Ratio (aOR) of 6.4 p< 0.0001 in infants with MSD compared to 30% (46/155) in cases and 14% (22/154) in controls yielding AF = 18.7%, (95% CI: 12.02-25.39) and aOR = 2.8, p = 0.0011 in infants with LSD. The proportion of children with rotavirus was 32% (21/66) among HIV-positive children and 23% (128/566) among HIV-negative ones for MSD. Presence of animals in the compound (OR = 1.9; p = 0.0151) and giving stored water to the child (OR = 2.0, p = 0.0483) were risk factors for MSD; while animals in the compound (OR = 2.37, p = 0.007); not having routine access to water on a daily basis (OR = 1.53, p = 0.015) and washing hands before cooking (OR = 1.76, p = 0.0197) were risk factors for LSD.<h4>Conclusion</h4>The implementation of vaccination against rotavirus may likely result in a significant reduction of rotavirus-associated diarrhea, suggesting the need for monitoring of vaccine impact.
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institution Kabale University
issn 1932-6203
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publishDate 2021-01-01
publisher Public Library of Science (PLoS)
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series PLoS ONE
spelling doaj-art-1801b1d8e8e848ffaba6cd177fb5d1db2025-08-20T03:25:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01164e024971410.1371/journal.pone.0249714Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.Sozinho AcácioTacilta NhampossaLlorenç QuintòDelfino VubilMarcelino GarrineQuique BassatTamer FaragSandra PanchalingamJames P NataroKaren L KotloffMyron M LevineSharon M TennantPedro L AlonsoInácio Mandomando<h4>Background</h4>Rotavirus vaccines have been adopted in African countries since 2009, including Mozambique (2015). Disease burden data are needed to evaluate the impact of rotavirus vaccine. We report the burden of rotavirus-associated diarrhea in Mozambique from the Global Enteric Multicenter Study (GEMS) before vaccine introduction.<h4>Methods</h4>A case-control study (GEMS), was conducted in Manhiça district, recruiting children aged 0-59 months with moderate-to-severe diarrhea (MSD) and less-severe-diarrhea (LSD) between December 2007 and November 2012; including 1-3 matched (age, sex and neighborhood) healthy community controls. Clinical and epidemiological data and stool samples (for laboratory investigation) were collected. Association of rotavirus with MSD or LSD was determined by conditional logistic regression and adjusted attributable fractions (AF) calculated, and risk factors for rotavirus diarrhea assessed.<h4>Results</h4>Overall 915 cases and 1,977 controls for MSD, and 431 cases and 430 controls for LSD were enrolled. Rotavirus positivity was 44% (217/495) for cases and 15% (160/1046) of controls, with AF = 34.9% (95% CI: 32.85-37.06) and adjusted Odds Ratio (aOR) of 6.4 p< 0.0001 in infants with MSD compared to 30% (46/155) in cases and 14% (22/154) in controls yielding AF = 18.7%, (95% CI: 12.02-25.39) and aOR = 2.8, p = 0.0011 in infants with LSD. The proportion of children with rotavirus was 32% (21/66) among HIV-positive children and 23% (128/566) among HIV-negative ones for MSD. Presence of animals in the compound (OR = 1.9; p = 0.0151) and giving stored water to the child (OR = 2.0, p = 0.0483) were risk factors for MSD; while animals in the compound (OR = 2.37, p = 0.007); not having routine access to water on a daily basis (OR = 1.53, p = 0.015) and washing hands before cooking (OR = 1.76, p = 0.0197) were risk factors for LSD.<h4>Conclusion</h4>The implementation of vaccination against rotavirus may likely result in a significant reduction of rotavirus-associated diarrhea, suggesting the need for monitoring of vaccine impact.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249714&type=printable
spellingShingle Sozinho Acácio
Tacilta Nhampossa
Llorenç Quintò
Delfino Vubil
Marcelino Garrine
Quique Bassat
Tamer Farag
Sandra Panchalingam
James P Nataro
Karen L Kotloff
Myron M Levine
Sharon M Tennant
Pedro L Alonso
Inácio Mandomando
Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.
PLoS ONE
title Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.
title_full Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.
title_fullStr Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.
title_full_unstemmed Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.
title_short Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence.
title_sort rotavirus disease burden pre vaccine introduction in young children in rural southern mozambique an area of high hiv prevalence
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249714&type=printable
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