Temporal trends in diarrhea-related hospitalizations and deaths in children under age 5 before and after the introduction of the rotavirus vaccine in four Latin American countries

Introduction: Rotavirus infection mainly affects children under 5 years of age and causes 453,000 deaths annually throughout the world. Several countries in Latin America have introduced the rotavirus vaccine and the majority have epidemiological data to measure impact following vaccine introduction. Objective: To assess the impact of rotavirus immunization on the number of all-cause diarrhea-related deaths and hospitalizations in children under 1 and 5 years of age in Bolivia, El Salvador, Honduras and Venezuela. Methods: Interrupted time-series analyzed with the integral method and the projection method to evaluate the pre and post-vaccine introduction trend in diarrheal disease compared to Argentina as the control country. The analysis period was from 2002 to 2010, including 2 to 4 post-vaccine years depending on the country. Information sources included records from PAHO, the Ministry of Health, public hospitals, social security, the private health system, the Expanded Programme on Immunization and UNPop 2008. Results: Over the period studied, reductions were observed in trends of diarrhea-related deaths and hospitalizations in children under five. In diarrhea-related deaths, under the integral method, the range of reduction was between 15.7% (13.5-17.9) and 56.8% (56.0-57.5) while with the projection method was between 19.9% (4.9-34.8) and 63.7%(56.1-71.4). In diarrhea-related hospitalizations, under the integral method was 5.6% (4.1-6.7) and 17.9% (16.7-19.1)) while with the projection method was between 5.1%(1.7-8.7) and 11.1% (5.8-16.3). Conclusions: A decrease was observed in the number of diarrhea related deaths and hospitalizations in all countries under study following introduction of the rotavirus vaccine as opposed to the control country. The impact on reduction of deaths was greater than hospitalization.Fil: De Oliveira, L. H.. Pan American Health Organization; Estados Unidos. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Giglio, N.. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Departamento de Medicina; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: García Martí, Sebastián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Kuperman, Marcelo Nestor. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; Argentina. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Sanwogou, N. J.. Pan American Health Organization; Estados Unidos. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Ruiz Matus, C.. Pan American Health Organization; Estados Unidos. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Marinho de Sousa, M. F.. Pan American Health Organization; Estados Unidos. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentin