Autor(es):
Acácio, Sozinho ; Nhampossa, Tacilta ; Quintò, Llorenç ; Vubil, Delfino ; Garrine, Marcelino ; Bassat, Quique ; Farag, Tamer ; Panchalingam, Sandra ; Nataro, James P. ; Kotloff, Karen L. ; Levine, Myron M. ; Tennant, Sharon M. ; Alonso, Pedro L. ; Mandomando, Inácio
Data: 2021
Identificador Persistente: http://hdl.handle.net/10362/180761
Origem: Repositório Institucional da UNL
Assunto(s): rotavirus; diarrhea; vaccine; Biochemistry, Genetics and Molecular Biology (miscellaneous); Immunology and Microbiology (miscellaneous); Virology; Epidemiology; Health Policy; Immunology and Allergy; Infectious Diseases; Gastroenterology; Pediatrics, Perinatology, and Child Health; SDG 3 - Good Health and Well-being; SDG 10 - Reduced Inequalities
Descrição
Funding Information: This study is based on the GEMS project, which was supported by the Bill & Melinda Gates Foundation (Project OPP 38874 and OPP1033572) awarded to Myron Mike Levine. CISM is supported by the Government of Mozambique and the Spanish Agency for International Development Cooperation (AECID). ISGlobal receives support from Spanish Ministry of Science and Innovation through the ?Centro de Excel?ncia Severo Ochoa 2019-2023? Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2021 Acácio et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background 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. Methods 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. Results 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. Conclusion 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.
