Paediatrics (RCH) - Research Publications

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Start date: 2009 × Author: Mulholland, Edward × Author: Russell, Fiona × Author: Jenney, Adam × Author: Kirkwood, Carl ×

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    The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji
    Jenney, AWJ ; Reyburn, R ; Ratu, FT ; Tuivaga, E ; Nguyen, C ; Covea, S ; Thomas, S ; Rafai, E ; Devi, R ; Bright, K ; Jenkins, K ; Temple, B ; Tikoduadua, L ; Kado, J ; Mulholland, EK ; Kirkwood, CD ; Fox, KK ; Bines, JE ; Grabovac, V ; Khan, AS ; Kama, M ; Russell, FM (ELSEVIER, 2021-01)
    BACKGROUND: In 2012, Fiji became the first independent Pacific island country to introduce rotavirus vaccine. We describe the impact of rotavirus vaccine on all-cause diarrhoea admissions in all ages, and rotavirus diarrhoea in children <5 years of age. METHODS: An observational study was conducted retrospectively on all admissions to the public tertiary hospitals in Fiji (2007-2018) and prospectively on all rotavirus-positive diarrhoea admissions in children <5 years at two hospital sites (2006-2018, and 2010-2015), along with rotavirus diarrhoea outpatient presentations at one secondary public hospital (2010-2015). The impact of rotavirus vaccine was determined using incidence rate ratios (IRR) of all-cause diarrhoea admissions and rotavirus diarrhoea, comparing the pre-vaccine and post-vaccine periods. All-cause admissions were used as a control. Multiple imputation was used to impute missing stool samples. FINDINGS: All-cause diarrhoea admissions declined among all age groups except among infants ≤2 months old and adults ≥55 years. For children <5 years, all-cause diarrhoea admissions declined by 39% (IRR)=0•61, 95%CI; 0•57-0•65, p-value<0•001). There was an 81% (95%CI; 51-94%) reduction in mortality among all-cause diarrhoea admissions in children under <5 years. Rotavirus diarrhoea admissions at the largest hospital among children <5 years declined by 87% (IRR=0•13, 95%CI; 0•10-0•17, p-value<0•001). Among rotavirus diarrhoea outpatient presentations, the IRR was 0•39 (95%CI; 0•11, 1.21, p-value=0.077). INTERPRETATIONS: Morbidity and mortality due to rotavirus and all-cause diarrhoea in Fiji has declined in people aged 2 months to 54 years after the introduction of the RV vaccine. FUNDING: Supported by WHO and the Australian Government.
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    The burden of hospitalised rotavirus infections in Fiji
    Jenney, A ; Tikoduadua, L ; Buadromo, E ; Barnes, G ; Kirkwood, CD ; Boniface, K ; Bines, J ; Mulholland, K ; Russell, F (ELSEVIER SCI LTD, 2009-11-20)
    Rotavirus is the most common cause of acute severe dehydrating diarrhoea in young children worldwide. We describe the burden of rotavirus disease and the rotavirus types causing it in the largest city in Fiji. During 2006 and 2007, 592 children under 5 years of age were admitted to hospital in Suva, Fiji with acute diarrhoea. Of the 454 children for whom a stool specimen was tested, 39% were positive for rotavirus and the predominant strain found was the serotype G3[P8]. There is a significant burden of disease due to rotavirus in Fiji and the introduction of rotavirus vaccines into the national immunization schedule may drastically reduce inpatient diarrhoeal disease.