SummaryMost infections with pandemic Vibrio cholerae are thought to result in subclinical disease... more SummaryMost infections with pandemic Vibrio cholerae are thought to result in subclinical disease and are not captured by surveillance. Previous estimates of the ratio of infections to clinical cases have varied widely (2 to 100). Understanding cholera epidemiology and immunity relies on the ability to translate between numbers of clinical cases and the underlying number of infections in the population. We estimated the infection incidence during the first months of an outbreak in a cholera-naive population using a Bayesian vibriocidal antibody titer decay model combining measurements from a representative serosurvey and clinical surveillance data. 3,880 suspected cases were reported in Grande Saline, Haiti, between 20 October 2010 and 6 April 2011 (clinical attack rate 18.4%). We found that more than 52.6% (95% Credible Interval (CrI) 49.4-55.7) of the population ≥2 years showed serologic evidence of infection, with a lower infection rate among children aged 2-4 years (35.5%; 95%Cr...
de establecer una buena comunicarse con quienes toman decisiones para tomarlas de manera colectiv... more de establecer una buena comunicarse con quienes toman decisiones para tomarlas de manera colectiva. Se compartió la experiencia costarricense del uso de la epidemiologia para facilitar la prestación de servicios de salud a los pacientes con COVID-19. Asimismo, enfatizaron que la desinformación, propagada en internet y algunos otros medios, tuvo un impacto negativo y se relató la experiencia de educación a las personas trabajando para los medios informativos. Se comentó que se necesita una mayor agilidad para responder tempranamente a eventos que puedan desembocar en una pandemia. Los panelistas agregaron que como nunca antes se comprobó la importancia de tener estrategias de comunicación adecuadas para informar al público.
Background. Streptococcus pneumoniae, or pneumococcus, is a leading cause of morbidity and mortal... more Background. Streptococcus pneumoniae, or pneumococcus, is a leading cause of morbidity and mortality in children worldwide. Pneumococcal conjugate vaccines (PCV) reduce carriage in the nasopharynx, preventing disease. We conducted a pneumococcal carriage study to estimate the prevalence of pneumococcal colonization, identify risk factors for colonization, and describe antimicrobial susceptibility patterns among pneumococci colonizing young children in Port-au-Prince, Haiti, before introduction of 13-valent PCV (PCV13). Methods. We conducted a cross-sectional study of children aged 6-24 months at an immunization clinic in Port-au-Prince between September 2015 and January 2016. Consenting parents were interviewed about factors associated with pneumococcal carriage; nasopharyngeal swabs were collected from each child and cultured for pneumococcus after broth enrichment. Pneumococcal isolates were serotyped and underwent antimicrobial susceptibility testing. We compared frequency of demographic, clinical, and environmental factors among pneumococcus-colonized children (carriers) to those who were not colonized (noncarriers) using unadjusted bivariate analysis and multivariate logistic regression. Results. Pneumococcus was isolated from 308 of the 685 (45.0%) children enrolled. Overall, 157 isolates (50.8%) were PCV13 vaccine-type serotypes; most common were 6A (13.3%), 19F (12.6%), 6B (9.7%), and 23F (6.1%). Vaccine-type isolates were significantly more likely to be nonsusceptible to ≥1 antimicrobial (63.1% vs 45.4%, P = .002). On bivariate analysis, carriers were significantly more likely than noncarriers to live in a household without electricity or running water, to share a bedroom with ≥3 people, to have a mother or father who did not complete secondary education, and to have respiratory symptoms in the 24 hours before enrollment (P < .05 for all comparisons). On multivariable analysis, completion of the pentavalent vaccination series (targeting diphtheria, pertussis, tetanus, hepatitis B, and Haemophilus influenzae type b) remained significantly more common among noncarriers. Conclusions. Nearly a quarter of healthy children surveyed in Haiti were colonized with vaccine-type pneumococcal serotypes. This baseline carriage study will enable estimation of vaccine impact following nationwide introduction of PCV13.
20 e journées nationales d'infectiologie / Médecine et maladies infectieuses 49 (2019) S110-S117 ... more 20 e journées nationales d'infectiologie / Médecine et maladies infectieuses 49 (2019) S110-S117 S113 Conclusion Ces résultats concordent avec les expériences publiées de centres pluridisciplinaires. Les liens établis avec les MT facilitent le diagnostic de BL et le parcours de soins. Le nombre de diagnostics différentiels ou associés confirment la complexité du diagnostic de BL sans omettre d'autres diagnostics. Une prise en charge pluridisciplinaire permet un diagnostic plus précis et une prise en charge personnalisée des patients. Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
Bulletin de la société de pathologie exotique, 2018
Haiti, like most limited-resources countries in the world, faces numerous neglected infectious di... more Haiti, like most limited-resources countries in the world, faces numerous neglected infectious diseases. They represent a real public health issue with lethal consequences especially in children. We are reviewing here the available literature on four neglected infectious diseases, mansonelliasis, tungiasis, leprosy and anthrax. Filariasis, due to Mansonella ozzardi, has been totally neglected since its discovery in 1920 in Haiti; it persists in coastal homes with a high prevalence in adults when an effective treatment is available. The skin lesions caused by Tunga penetrans have existed since the pre-Columbian period in Haiti. They persist in the most retreated and hard-to-reach areas where the population lives in precarious conditions and in extreme poverty. New available research data show the importance of the problem with very high prevalence rates in some rural communities far away from any healthcare center. Cases of leprosy are recently reemerging as no monitoring program has been in place since 2004. Finally, anthrax is still endemic; small epidemics resurfacing periodically in families in rural areas. Screening of people for these diseases and managing the cases are necessary to improve health and reduce morbidity and mortality in Haiti.
Background Haiti’s first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread... more Background Haiti’s first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread throughout the country. The objective of this study was to describe clinical manifestations of COVID-19 in Haitian outpatients and to identify risk factors for severity of clinical manifestations. Methods We conducted a retrospective study of COVID-19 outpatients diagnosed from March 18-August 4, 2020, using demographic, epidemiological, and clinical data reported to the Ministry of Health (MoH). We used univariate and multivariate analysis, including multivariable logistic regression, to explore the risk factors and specific symptoms related to persons with symptomatic COVID-19 and the severity of symptomatic COVID-19 disease. Results Of 5,389 cases reported to MOH during the study period, 1,754 (32.5%) were asymptomatic. Amongst symptomatic persons 2,747 (75.6%) had mild COVID-19 and 888 (24.4%) had moderate-to-severe disease; the most common symptoms were fever (69.6%), cough (51.9%)...
Background An effective laboratory system is an essential component of a public health system car... more Background An effective laboratory system is an essential component of a public health system caring for patients with communicable and non-communicable diseases. Unfortunately, in developing countries this system is often sub-optimal, which negatively impacts health care. This paper describes the current situation of the clinical laboratory sector in Haiti and highlights challenges that exist in Haiti and other developing countries as they try to establish a clinical laboratory system. Method A cross-sectional survey was conducted in 30 laboratories across Haiti from January 19 to February 4, 2016. The laboratories surveyed were public or mixed public-private sector facilities belonging to different levels of the healthcare hierarchy. Labs were visited and directors of the health care institutions, lab managers, and members of their teams were interviewed and National Public Health Laboratory documents and information about the legal framework of the laboratory system was reviewed....
The American Journal of Tropical Medicine and Hygiene, 2021
ABSTRACT. Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean... more ABSTRACT. Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean. Haiti introduced the monovalent rotavirus vaccine in April 2014. The objective of this analysis is to describe the impact of the rotavirus vaccine on hospitalizations among Haitian children younger than 5 years old during the first 5 years after introduction. This analysis includes all children with diarrhea who were enrolled as part of a sentinel surveillance system at two hospitals from May 2013 to April 2019. We compare the proportion of rotavirus-positive specimens in each post-vaccine introduction year to the pre-vaccine period. To account for the potential dilution of the proportion of rotavirus-positive specimens from a waning cholera outbreak, we also analyzed annual trends in the absolute number of positive stools, fit a two-component finite-mixture model to the negative specimens, and fit a negative binomial time series model to the pre-vaccine rotavirus-positive specimens to...
Case-area targeted interventions (CATIs) against cholera are conducted by rapid response teams, a... more Case-area targeted interventions (CATIs) against cholera are conducted by rapid response teams, and may include various activities like water, sanitation, hygiene measures. However, their real-world effectiveness has never been established. We conducted a retrospective observational study in 2015–2017 in the Centre department of Haiti. Using cholera cases, stool cultures and CATI records, we identified 238 outbreaks that were responded to. After adjusting for potential confounders, we found that a prompt response could reduce the number of accumulated cases by 76% (95% confidence interval, 59 to 86) and the outbreak duration by 61% (41 to 75) when compared to a delayed response. An intense response could reduce the number of accumulated cases by 59% (11 to 81) and the outbreak duration by 73% (49 to 86) when compared to a weaker response. These results suggest that prompt and repeated CATIs were significantly effective at mitigating and shortening cholera outbreaks in Haiti.
The American journal of tropical medicine and hygiene, 2017
Haiti's health system has faced many challenges over the years, with competing health priorit... more Haiti's health system has faced many challenges over the years, with competing health priorities in the context of chronic financial and human resource limitations. As a result, the existing notifiable disease surveillance system was unable to provide the most basic epidemiologic data for public health decision-making and action. In the wake of the January 2010 earthquake, the Haitian Ministry of Public Health and Population collaborated with the U.S. Centers for Disease Control and Prevention, the Pan American Health Organization, and other local and international partners to implement a functional national surveillance system. More than 7 years later, it is important to take the opportunity to reflect on progress made on surveillance and response in Haiti, including disease detection, reporting, outbreak investigation, and response. The national epidemiologic surveillance network that started with 51 sites in 2010 has been expanded to 357 sites as of December 2015. Disease out...
The American journal of tropical medicine and hygiene, 2017
Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of can... more Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, lab...
Clinical Microbiology and Infectious Diseases, 2016
Malaria continues to persist in Haiti, with 17,583 reported cases in 2015. The island of Hispanio... more Malaria continues to persist in Haiti, with 17,583 reported cases in 2015. The island of Hispaniola, the last locale of malaria in the Caribbean, recently adopted a bi-national agreement between the Dominican Republic and Haiti with the goal of eliminating malaria by 2020. In January 2015, the
Background. In a Latin American trial, a monovalent G1P[8] rotavirus vaccine showed high efficacy... more Background. In a Latin American trial, a monovalent G1P[8] rotavirus vaccine showed high efficacy against severe rotavirus diarrhea. Protection was lower against serotypically unrelated G2P[4] strains, which circulated infrequently. This case-control study was undertaken to assess the effectiveness of this monovalent G1P[8] rotavirus vaccine against G2P[4] strains in Brazil. Methods. Case patients were children with severe G2P[4] rotavirus diarrhea who presented at a hospital in Recife, Brazil, from March 2006 through September 2008. Vaccination rates among case patients were compared with rates among 2 groups of control participants-children with rotavirus-negative diarrhea and children admitted for acute respiratory tract infection (ARI)-to calculate vaccine effectiveness, after controlling for the birth month and year. Results. We enrolled 70 G2P[4] rotavirus-positive case patients with severe diarrhea, 484 rotavirus-negative control participants with diarrhea, and 416 control participants with ARI, aged у6 months. Among children aged 6-11 months, the effectiveness of the vaccine against G2P[4] diarrhea was 77% (95% confidence interval [CI], 42%-91%) and 77% (95% CI, 43%-90%) among the rotavirus-negative control participants with diarrhea and control participants with ARI, respectively. Vaccine effectiveness in children aged у12 months decreased to Ϫ24% (95% CI, Ϫ190% to 47%) and 15% (95% CI, Ϫ101 to 64) among the rotavirus-negative control groups with diarrhea and ARI, respectively. Conclusions. This monovalent G1P[8] rotavirus vaccine was effective against severe G2P[4] rotavirus diarrhea among children aged 6-11 months. Effectiveness declined among children aged у12 months, which suggests waning immunity.
SummaryMost infections with pandemic Vibrio cholerae are thought to result in subclinical disease... more SummaryMost infections with pandemic Vibrio cholerae are thought to result in subclinical disease and are not captured by surveillance. Previous estimates of the ratio of infections to clinical cases have varied widely (2 to 100). Understanding cholera epidemiology and immunity relies on the ability to translate between numbers of clinical cases and the underlying number of infections in the population. We estimated the infection incidence during the first months of an outbreak in a cholera-naive population using a Bayesian vibriocidal antibody titer decay model combining measurements from a representative serosurvey and clinical surveillance data. 3,880 suspected cases were reported in Grande Saline, Haiti, between 20 October 2010 and 6 April 2011 (clinical attack rate 18.4%). We found that more than 52.6% (95% Credible Interval (CrI) 49.4-55.7) of the population ≥2 years showed serologic evidence of infection, with a lower infection rate among children aged 2-4 years (35.5%; 95%Cr...
de establecer una buena comunicarse con quienes toman decisiones para tomarlas de manera colectiv... more de establecer una buena comunicarse con quienes toman decisiones para tomarlas de manera colectiva. Se compartió la experiencia costarricense del uso de la epidemiologia para facilitar la prestación de servicios de salud a los pacientes con COVID-19. Asimismo, enfatizaron que la desinformación, propagada en internet y algunos otros medios, tuvo un impacto negativo y se relató la experiencia de educación a las personas trabajando para los medios informativos. Se comentó que se necesita una mayor agilidad para responder tempranamente a eventos que puedan desembocar en una pandemia. Los panelistas agregaron que como nunca antes se comprobó la importancia de tener estrategias de comunicación adecuadas para informar al público.
Background. Streptococcus pneumoniae, or pneumococcus, is a leading cause of morbidity and mortal... more Background. Streptococcus pneumoniae, or pneumococcus, is a leading cause of morbidity and mortality in children worldwide. Pneumococcal conjugate vaccines (PCV) reduce carriage in the nasopharynx, preventing disease. We conducted a pneumococcal carriage study to estimate the prevalence of pneumococcal colonization, identify risk factors for colonization, and describe antimicrobial susceptibility patterns among pneumococci colonizing young children in Port-au-Prince, Haiti, before introduction of 13-valent PCV (PCV13). Methods. We conducted a cross-sectional study of children aged 6-24 months at an immunization clinic in Port-au-Prince between September 2015 and January 2016. Consenting parents were interviewed about factors associated with pneumococcal carriage; nasopharyngeal swabs were collected from each child and cultured for pneumococcus after broth enrichment. Pneumococcal isolates were serotyped and underwent antimicrobial susceptibility testing. We compared frequency of demographic, clinical, and environmental factors among pneumococcus-colonized children (carriers) to those who were not colonized (noncarriers) using unadjusted bivariate analysis and multivariate logistic regression. Results. Pneumococcus was isolated from 308 of the 685 (45.0%) children enrolled. Overall, 157 isolates (50.8%) were PCV13 vaccine-type serotypes; most common were 6A (13.3%), 19F (12.6%), 6B (9.7%), and 23F (6.1%). Vaccine-type isolates were significantly more likely to be nonsusceptible to ≥1 antimicrobial (63.1% vs 45.4%, P = .002). On bivariate analysis, carriers were significantly more likely than noncarriers to live in a household without electricity or running water, to share a bedroom with ≥3 people, to have a mother or father who did not complete secondary education, and to have respiratory symptoms in the 24 hours before enrollment (P < .05 for all comparisons). On multivariable analysis, completion of the pentavalent vaccination series (targeting diphtheria, pertussis, tetanus, hepatitis B, and Haemophilus influenzae type b) remained significantly more common among noncarriers. Conclusions. Nearly a quarter of healthy children surveyed in Haiti were colonized with vaccine-type pneumococcal serotypes. This baseline carriage study will enable estimation of vaccine impact following nationwide introduction of PCV13.
20 e journées nationales d'infectiologie / Médecine et maladies infectieuses 49 (2019) S110-S117 ... more 20 e journées nationales d'infectiologie / Médecine et maladies infectieuses 49 (2019) S110-S117 S113 Conclusion Ces résultats concordent avec les expériences publiées de centres pluridisciplinaires. Les liens établis avec les MT facilitent le diagnostic de BL et le parcours de soins. Le nombre de diagnostics différentiels ou associés confirment la complexité du diagnostic de BL sans omettre d'autres diagnostics. Une prise en charge pluridisciplinaire permet un diagnostic plus précis et une prise en charge personnalisée des patients. Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
Bulletin de la société de pathologie exotique, 2018
Haiti, like most limited-resources countries in the world, faces numerous neglected infectious di... more Haiti, like most limited-resources countries in the world, faces numerous neglected infectious diseases. They represent a real public health issue with lethal consequences especially in children. We are reviewing here the available literature on four neglected infectious diseases, mansonelliasis, tungiasis, leprosy and anthrax. Filariasis, due to Mansonella ozzardi, has been totally neglected since its discovery in 1920 in Haiti; it persists in coastal homes with a high prevalence in adults when an effective treatment is available. The skin lesions caused by Tunga penetrans have existed since the pre-Columbian period in Haiti. They persist in the most retreated and hard-to-reach areas where the population lives in precarious conditions and in extreme poverty. New available research data show the importance of the problem with very high prevalence rates in some rural communities far away from any healthcare center. Cases of leprosy are recently reemerging as no monitoring program has been in place since 2004. Finally, anthrax is still endemic; small epidemics resurfacing periodically in families in rural areas. Screening of people for these diseases and managing the cases are necessary to improve health and reduce morbidity and mortality in Haiti.
Background Haiti’s first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread... more Background Haiti’s first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread throughout the country. The objective of this study was to describe clinical manifestations of COVID-19 in Haitian outpatients and to identify risk factors for severity of clinical manifestations. Methods We conducted a retrospective study of COVID-19 outpatients diagnosed from March 18-August 4, 2020, using demographic, epidemiological, and clinical data reported to the Ministry of Health (MoH). We used univariate and multivariate analysis, including multivariable logistic regression, to explore the risk factors and specific symptoms related to persons with symptomatic COVID-19 and the severity of symptomatic COVID-19 disease. Results Of 5,389 cases reported to MOH during the study period, 1,754 (32.5%) were asymptomatic. Amongst symptomatic persons 2,747 (75.6%) had mild COVID-19 and 888 (24.4%) had moderate-to-severe disease; the most common symptoms were fever (69.6%), cough (51.9%)...
Background An effective laboratory system is an essential component of a public health system car... more Background An effective laboratory system is an essential component of a public health system caring for patients with communicable and non-communicable diseases. Unfortunately, in developing countries this system is often sub-optimal, which negatively impacts health care. This paper describes the current situation of the clinical laboratory sector in Haiti and highlights challenges that exist in Haiti and other developing countries as they try to establish a clinical laboratory system. Method A cross-sectional survey was conducted in 30 laboratories across Haiti from January 19 to February 4, 2016. The laboratories surveyed were public or mixed public-private sector facilities belonging to different levels of the healthcare hierarchy. Labs were visited and directors of the health care institutions, lab managers, and members of their teams were interviewed and National Public Health Laboratory documents and information about the legal framework of the laboratory system was reviewed....
The American Journal of Tropical Medicine and Hygiene, 2021
ABSTRACT. Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean... more ABSTRACT. Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean. Haiti introduced the monovalent rotavirus vaccine in April 2014. The objective of this analysis is to describe the impact of the rotavirus vaccine on hospitalizations among Haitian children younger than 5 years old during the first 5 years after introduction. This analysis includes all children with diarrhea who were enrolled as part of a sentinel surveillance system at two hospitals from May 2013 to April 2019. We compare the proportion of rotavirus-positive specimens in each post-vaccine introduction year to the pre-vaccine period. To account for the potential dilution of the proportion of rotavirus-positive specimens from a waning cholera outbreak, we also analyzed annual trends in the absolute number of positive stools, fit a two-component finite-mixture model to the negative specimens, and fit a negative binomial time series model to the pre-vaccine rotavirus-positive specimens to...
Case-area targeted interventions (CATIs) against cholera are conducted by rapid response teams, a... more Case-area targeted interventions (CATIs) against cholera are conducted by rapid response teams, and may include various activities like water, sanitation, hygiene measures. However, their real-world effectiveness has never been established. We conducted a retrospective observational study in 2015–2017 in the Centre department of Haiti. Using cholera cases, stool cultures and CATI records, we identified 238 outbreaks that were responded to. After adjusting for potential confounders, we found that a prompt response could reduce the number of accumulated cases by 76% (95% confidence interval, 59 to 86) and the outbreak duration by 61% (41 to 75) when compared to a delayed response. An intense response could reduce the number of accumulated cases by 59% (11 to 81) and the outbreak duration by 73% (49 to 86) when compared to a weaker response. These results suggest that prompt and repeated CATIs were significantly effective at mitigating and shortening cholera outbreaks in Haiti.
The American journal of tropical medicine and hygiene, 2017
Haiti's health system has faced many challenges over the years, with competing health priorit... more Haiti's health system has faced many challenges over the years, with competing health priorities in the context of chronic financial and human resource limitations. As a result, the existing notifiable disease surveillance system was unable to provide the most basic epidemiologic data for public health decision-making and action. In the wake of the January 2010 earthquake, the Haitian Ministry of Public Health and Population collaborated with the U.S. Centers for Disease Control and Prevention, the Pan American Health Organization, and other local and international partners to implement a functional national surveillance system. More than 7 years later, it is important to take the opportunity to reflect on progress made on surveillance and response in Haiti, including disease detection, reporting, outbreak investigation, and response. The national epidemiologic surveillance network that started with 51 sites in 2010 has been expanded to 357 sites as of December 2015. Disease out...
The American journal of tropical medicine and hygiene, 2017
Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of can... more Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, lab...
Clinical Microbiology and Infectious Diseases, 2016
Malaria continues to persist in Haiti, with 17,583 reported cases in 2015. The island of Hispanio... more Malaria continues to persist in Haiti, with 17,583 reported cases in 2015. The island of Hispaniola, the last locale of malaria in the Caribbean, recently adopted a bi-national agreement between the Dominican Republic and Haiti with the goal of eliminating malaria by 2020. In January 2015, the
Background. In a Latin American trial, a monovalent G1P[8] rotavirus vaccine showed high efficacy... more Background. In a Latin American trial, a monovalent G1P[8] rotavirus vaccine showed high efficacy against severe rotavirus diarrhea. Protection was lower against serotypically unrelated G2P[4] strains, which circulated infrequently. This case-control study was undertaken to assess the effectiveness of this monovalent G1P[8] rotavirus vaccine against G2P[4] strains in Brazil. Methods. Case patients were children with severe G2P[4] rotavirus diarrhea who presented at a hospital in Recife, Brazil, from March 2006 through September 2008. Vaccination rates among case patients were compared with rates among 2 groups of control participants-children with rotavirus-negative diarrhea and children admitted for acute respiratory tract infection (ARI)-to calculate vaccine effectiveness, after controlling for the birth month and year. Results. We enrolled 70 G2P[4] rotavirus-positive case patients with severe diarrhea, 484 rotavirus-negative control participants with diarrhea, and 416 control participants with ARI, aged у6 months. Among children aged 6-11 months, the effectiveness of the vaccine against G2P[4] diarrhea was 77% (95% confidence interval [CI], 42%-91%) and 77% (95% CI, 43%-90%) among the rotavirus-negative control participants with diarrhea and control participants with ARI, respectively. Vaccine effectiveness in children aged у12 months decreased to Ϫ24% (95% CI, Ϫ190% to 47%) and 15% (95% CI, Ϫ101 to 64) among the rotavirus-negative control groups with diarrhea and ARI, respectively. Conclusions. This monovalent G1P[8] rotavirus vaccine was effective against severe G2P[4] rotavirus diarrhea among children aged 6-11 months. Effectiveness declined among children aged у12 months, which suggests waning immunity.
Uploads
Papers by Patrick DELY