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. 2019 Jan 11;19(1):47.
doi: 10.1186/s12879-018-3615-6.

Rates of hospitalization and death for all-cause and rotavirus acute gastroenteritis before rotavirus vaccine introduction in Kenya, 2010-2013

Richard Omore  1   2 , Sammy Khagayi  3 , Billy Ogwel  3 , Reuben Onkoba  3 , John B Ochieng  3 , Jane Juma  3 , Stephen Munga  3 , Collins Tabu  4 , Sergon Kibet  5 , J Pekka Nuorti  6 , Frank Odhiambo  3 , Jason M Mwenda  7 , Robert F Breiman  8 , Umesh D Parashar  9 , Jacqueline E Tate  9
Affiliations

Rates of hospitalization and death for all-cause and rotavirus acute gastroenteritis before rotavirus vaccine introduction in Kenya, 2010-2013

Richard Omore et al. BMC Infect Dis. .

Abstract

Background: Rotavirus vaccine was introduced in Kenya immunization program in July 2014. Pre-vaccine disease burden estimates are important for assessing vaccine impact.

Methods: Children with acute gastroenteritis (AGE) (≥3 loose stools and/or ≥ 1 episode of unexplained vomiting followed by loose stool within a 24-h period), hospitalized in Siaya County Referral Hospital (SCRH) from January 2010 through December 2013 were enrolled. Stool specimens were tested for rotavirus (RV) using an enzyme immunoassay (EIA). Hospitalization rates were calculated using person-years of observation (PYO) from the Health Demographic Surveillance System (HDSS) as a denominator, while adjusting for healthcare utilization at household level and proportion of stool specimen collected from patients who met the case definition at the surveillance hospital. Mortality rates were calculated using PYO as the denominator and number of deaths estimated using total deaths in the HDSS, proportion of deaths attributed to diarrhoea by verbal autopsy (VA) and percent positive for rotavirus AGE (RVAGE) hospitalizations.

Results: Of 7760 all-cause hospitalizations among children < 5 years of age, 3793 (49%) were included in the analysis. Of these, 21% (805) had AGE; RV was detected in 143 (26%) of 541 stools tested. Among children < 5 years, the estimated hospitalization rates per 100,000 PYO for AGE and RVAGE were 2413 and 429, respectively. Mortality rate associated with AGE and RVAGE were 176 and 45 per 100,000 PYO, respectively.

Conclusion: AGE and RVAGE caused substantial health care burden (hospitalizations and deaths) before rotavirus vaccine introduction in Kenya.

Keywords: Children; Kenyan; Morbidity; Mortality; Rotavirus.

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Conflict of interest statement

Ethics approval and consent to participate

Written informed consent was obtained from all the guardians or caretakers of the children before enrolment into the study. This study was approved as part of the HDSS by both the Ethical Review Committee of the Kenya Medical Research Institute and CDC-Atlanta.

Consent for publication

Not applicable.

Competing interests

None declared.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow diagram of Karemo DSS residents < 5 yrs. who were hospitalized and enrolled in the study from Siaya county referral hospital, western Kenya 2010–2013
Fig. 2
Fig. 2
Rotavirus infection trends among hospitalized children < 5 years from Karemo DSS resident population seeking Care from Siaya County Referral Hospital, western Kenya 2010–2013
See this image and copyright information in PMC

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