Abstract
BackgroundOver 34 countries in Africa have introduced rotavirus vaccine to their national immunization programs: monovalent (Rotarix®, RV1) and pentavalent (RotaTeq®, RV5) after South Africa introduced it in 2009. Since then several studies assessing the impact of the vaccine have been conducted. The principal aim of this study was to evaluate the impact of rotavirus vaccine in sub-Saharan Africa.MethodsA Literature search was performed using Mendeley, PubMed, ScienceDirect, grey literature and Web of Science databases of published studies from January 1, 2017, as years of recent publications on rotavirus vaccine impact in sub-Saharan Africa. A meta-analysis was conducted for rotavirus infection in children under 5 years using proportions of pre and post-vaccine introduction in these populations. Random-effect estimates were considered since the samples were from universal populations.ResultsOut of the 935 articles identified, 17 studies met the inclusion for systematic review and meta-analysis. The pooled proportion for pre-vaccination period was 42%, 95% (CI: 38–46%), and reduced to 21%, 95% (CI: 17–25%) during post-vaccination period. Rotavirus diarrhea significantly reduced in children < 12 months as compared to children 12–24 months old. Seasonal peaks of rotavirus diarrhea were between June–September. However, data is limited to one year of post-vaccine introduction, and bias may present due to early vaccine impact.ConclusionWe observed that the introduction of the rotavirus vaccine was partly responsible for the significant reduction in the burden of rotavirus-associated diarrhea in sub-Saharan Africa. Therefore, there is a need to encourage the remaining countries to introduce the vaccine to their routine national immunization programs.
Highlights
Rotavirus is a common cause of severe diarrhea in children less than 5 years old, [1]
The pooled proportion for pre-vaccination period was 42%, 95% (CI: 38–46%), and reduced to 21%, 95% (CI: 17–25%) during post-vaccination period
We observed that the introduction of the rotavirus vaccine was partly responsible for the significant reduction in the burden of rotavirus-associated diarrhea in sub-Saharan Africa
Summary
Rotavirus is a common cause of severe diarrhea in children less than 5 years old, [1]. Morbidity and mortality rates of children under the age of five years in many countries are greatly attributed to diarrheal diseases resulting from rotavirus infection [2]. In sub-Saharan Africa, the majority of children get infected before 18 months of age [2], contributing to 121,000 out of the 215,000 worldwide childhood deaths from rotavirus disease [3]. Half of the rotavirus deaths in the world is accounted for by five countries, including Nigeria, Angola and the Democratic Republic of the Congo (DRC) from sub-Saharan Africa, and India and Pakistan from South Asia [3].
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