Minette AKAME MBANGE1
1Faculty of Medicine and Biomedical Sciences Yaoundé
CaHReF 2018, Yaoundé Congres hall, 08 – 11 January 2019 , OSME034
Background: Rotavirus is the leading cause of severe acute gastroenteritis in children under 5years, leading to hospital admissions and deaths. Morbidity and mortality are high in developing countries. Rotavirus vaccine, Rotarix® was introduced in Cameroon in April 2014. Post vaccine surveillance is key for evaluation of vaccine impact and effectiveness.
Objectif: Determine the impact of Rotavirus Vaccine introduction on acute gastroenteritis hospital admissions in children under 5years of age
Methodology: We conducted a retrospective cross-sectional study at the mother and child center of the Chantal Biya Foundation Yaoundé, Cameroon. Files of children under 5 years admitted to hospital from January 2013 to December 2017, for non-bloody diarrhoea with or without vomiting lasting less than 7days were reviewed. Vaccine impact was determined by comparing pre-vaccine and post vaccine prevalence of acute gastroenteritis hospital admissions, as well as some acute gastroenteritis disease severity indicators. The pre-vaccine period ran from 2013-2014, and the post vaccine from 2015-2017. Chi2 test was used to compare categorical variables, <0.05 was considered statistically significant.
Results: There were 1,958 children under 5years admitted for acute gastroenteritis. Their mean age was 12.62+/-9.53 months. The sex ratio was 1.17, in favour of males. Children aged 0-11months were most affected (59.3%, pre-vaccine=63.6%, post vaccine=55.9%). Acute gastroenteritis admission prevalence was 7.9% in the pre-vaccine period and 6.7% in the post vaccine period, giving a 1.2% difference (p=0.0001), representing a 15.2% rate reduction. Post vaccine introduction, the proportion of children with some dehydration (35.4% to 33.3%) and moderate dehydration (46.7% to 43.1%) decreased, while those with severe dehydration (2.2% to 2.9%) increased (p=0.019). More children were without complications (11.7% to 13.8%). Mortality increased
Conclusion/Recommandation: Rotavirus vaccine introduction in Cameroon led to a considerable reduction (15.2%) in hospital admissions for acute gastroenteritis in children under 5years in the early post vaccine years. It also improved on some acute gastroenteritis severity indicators, although mortality increased. Its use should be encouraged, post vaccine surveillance continued, and sensitisation encouraged on the importance of seeking timely health care for children with diarrhoea or other diseases.
Key Words: Gastroenteritis, Diarrhoea, Rotavirus vaccine, Hospital admission.