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BMC Public Health
Published in: BMC Public Health 3/2011

Open Access 01-12-2011 | Review

Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size

Authors: Christa L Fischer Walker, Robert E Black

Published in: BMC Public Health | Special Issue 3/2011

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Abstract

Background

Diarrhea mortality remains a leading cause of child death and rotavirus vaccine an effective tool for preventing severe rotavirus diarrhea. New data suggest vaccine efficacy may vary by region.

Methods

We reviewed published vaccine efficacy trials to estimate a regional-specific effect of vaccine efficacy on severe rotavirus diarrhea and hospitalizations. We assessed the quality of evidence using a standard protocol and conducted meta-analyses where more than 1 data point was available.

Results

Rotavirus vaccine prevented severe rotavirus episodes in all regions; 81% of episodes in Latin America, 42.7% of episodes in high-mortality Asia, 50% of episodes in sub-Saharan Africa, 88% of episodes low-mortality Asia and North Africa, and 91% of episodes in developed countries. The effect sizes observed for preventing severe rotavirus diarrhea will be used in LiST as the effect size for rotavirus vaccine on rotavirus-specific diarrhea mortality.

Conclusions

Vaccine trials have not measured the effect of vaccine on diarrhea mortality. The overall quality of the evidence and consistency observed across studies suggests that estimating mortality based on a severe morbidity reduction is highly plausible.
Appendix
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Metadata
Title
Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size
Authors
Christa L Fischer Walker
Robert E Black
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue Special Issue 3/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-S3-S16

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