Impact of oral human rotavirus vaccine on hospitalization rates for
                    children

Masukawa, Maria de Lourdes Teixeira; Moriwaki, Adriana Mayumi; Santana, Rosangela Getirana; Uchimura, Nelson Shozo; Uchimura, Taqueco Teruya

doi:10.1590/1982-0194201500041

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Acta Paulista de Enfermagem

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Original Articles • Acta paul. enferm. 28 (3) • May-Jun 2015 • https://doi.org/10.1590/1982-0194201500041 copy

Impact of oral human rotavirus vaccine on hospitalization rates for children

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate the risk of hospitalization for acute diarrhea in children under five, in the period of ten years before and after the oral rotavirus vaccine.

Methods:

Eco-descriptive-analyticstudy of the rates of hospitalization for acute diarrhea. We used hospitalization rate and the Relative Variation Rate to quantify the difference between the median in the years pre- andpostvaccination. We used logistic regression, odds ratio and attributablerisk to assess for the proportion of cases that could be avoided if exposure was avoided.

Results:

During the study period, the hospitalization rate was 117.41 per 10,000 children. In the prevaccination period, the median rate of hospitalization was 124.2/10,000 children. After the introduction of the vaccine, hospitalization rates were lower when compared to the median of the pre-vaccination years.

Conclusion:

There was a reduction in the hospitalization rates for acute diarrhea, thereby suggesting that the use of the vaccine and other associated factors can reduce the number of cases.

Keywords
Pediatric nursing; Nursing care; Public health nursing; Hospitalization; Rotavirus

Age (years)	Median HR 2000-2005	HR 2006	VR (%)	HR 2007	VR (%)	HR 2008	VR (%)	HR 2009	VR (%)	p<0.001
<1	202.7	155.1	-23.5	141.3	-30.3	167.5	-17.4	137.7	-32.1	0.001
1	191.5	196.9	+2.8	158.7	-17.1	193.5	+1.1	132.8	-30.7	0.467
2	107.2	107.3	+0.1	96.2	-10.3	125.5	+17.1	79.6	-25.8	0.297
3	66.3	71.9	+8.5	59.4	-10.4	79.0	+19.2	56.8	-14.3	0.141
4^ baseline Category	49.9	50.3	+0.7	48.4	-3.2	55.0	-10.1	45.3	-9.4	-
Total	124.5	114.8	-7.8	98.4	-20.9	121.4	-2.5	88.5	-28.9	0.009

Age (years)		2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	χ²
<1
	OR	6.78	5.95	4.49	3.49	3.44	3.28	3.12	2.95	3.08	3.07	1358.70
	CI	6.2-7.3	5.5-6.4	4.1-4.8	3.2-3.7	3.2-3.7	3.0-3.5	2.9-3.3	2.7-3.2	2.8-3.3	2.8-3.3
	P	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01
1
	OR	4.65	5.00	4.19	3.54	3.63	3.62	3.97	3.32	3.57	2.96	181.14
	CI	4.2-5.0	4.6-5.3	3.8-4.5	3.3-3.8	3.3-3.8	3.3-3.8	3.7-4.2	3.0-3.5	3.3-3.8	2.7-3.2
	P	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01
2
	OR	2.26	2.62	2.3	2.22	2.04	2.1	2.14	2.0	2.3	1.76	0.060
	CI	2.0-20.4	2-2.4	2.1-2.4	2.0-2.3	1.8-2.2	1.9-2.2	1.9-2.3	1.8-2.1	2.1-2.4	1.6-1.9
	P	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01
3
	OR	1.3	1.44	1.35	1.45	1.31	1.31	1.43	1.23	1.44	1.26	5.27
	CI	1.2-1.5	1.3-1.5	1.2-1.4	1.3-1.5	1.2-1.4	1.2-1.4	1.3-1.5	1.1-1.3	1.3-1.5	1.1-1.3
	P	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01
Stratified analysis
	MH	3.13	3.63	3.06	2.66	2.59	2.56	2.65	2.35	2.58	2.24	13.73
	CI	3.0-3.2	3.5-3.7	3.1-2.9	2.5-2.7	2.5-2.6	2.4-2.6	2.5-2.7	2.2-2.4	2.4-2.6	2.1-2.3
	P	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.001	<0.01	<0.01

Age(years)		Prevaccination	Postvaccination	AR%	Adjusted OR	p-value
<1
	OR	4.4	3.06	30.45	3.89	<0.001
	CI	4.2-4.5	2.9-3.1
	MH	11685.02	3533.93
	P	0.01	0.01
1
	OR	4.05	3.5	13.54	3.84	<0.001
	CI	3.93-4.17	3.37-3.64
	MH	10026.61	4734.56
	P	0.01	0.01
2
	OR	2.19	2.07	5.48	2.14	<0.001
	CI	2.12-2.26	1.99-2.16
	MH	2434.48	1279.46
	P	0.01	0.01
3
	OR	1.37	1.35		1.36	<0.001
	CI	1.32-1.42	1.29-1.41	1.46
	MH	318.14	179.26
	P	0.01	0.01
Vaccination period					1.16	<0.001
Stratified analysis
	OR	2.97	2.46	17.17
	CI	2.94-3.04	2.44-2.53
	adjusted MH	2.98	2.48
	χ²MH	21683.31	8611.36
	P	0.01	0.01

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[1] Corresponding author Adriana Mayumi Moriwaki Colombo Avenue, 5790, Maringá, PR, Brazil. Zip Code: 87020-800 adrianamoriwaki@gmail.com