ArticleThe Lancet. Global health2016
Effect of pentavalent rotavirus vaccine introduction on hospital admissions for diarrhoea and rotavirus in children in Rwanda: a time-series analysis.
Article in The Lancet. Global health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Leveraging multisectoral approach to understand the determinants of childhood stunting in Rwanda: a systematic review and meta-analysis.Systematic reviews · 2024Pooled it
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- Using routine health information data for research in low- and middle-income countries: a systematic review.BMC health services research · 2020Pooled it
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- Incidence and aetiology of diarrhoeal disease among children under five years in the post-rotavirus vaccine introduction era in Manhiça District, Mozambique.Tropical medicine and health · 2026Article
- Determinants of stunting among Indonesian children: a cross-sectional study on the role of child, maternal, and vaccination factors.BMC pregnancy and childbirth · 2026Article
- Burden of diarrheal diseases among children under five in East Africa, 2000-2023: insights from the global burden of disease 2023 study.BMC infectious diseases · 2026Article
- Impact of rotavirus vaccination in Malawi from 2012 to 2022 compared to model predictions.NPJ vaccines · 2024Article
- Healthcare as a driver, reservoir and amplifier of antimicrobial resistance: opportunities for interventions.Nature reviews. Microbiology · 2024Review
- Impact of rotavirus vaccination in Malawi from 2012 to 2022 compared to model predictions before, during, and after the COVID-19 pandemic.medRxiv : the preprint server for health sciences · 2024Article
- Understanding rapid implementation from discovery to scale: Rwanda's implementation of rotavirus vaccines and PMTCT in the quest to reduce under-5 mortality.BMC pediatrics · 2024Article
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- The Full Impact of Rotavirus Vaccines in Africa Has Yet to Be Realized.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Rotavirus infections and their genotype distribution in Rwanda before and after the introduction of rotavirus vaccination.PloS one · 2023Article
- Household Factors of Foodborne Diarrhea in Children under Five in Two Districts of Maputo, Mozambique.International journal of environmental research and public health · 2022Article
- Understanding Rotavirus Vaccine Efficacy and Effectiveness in Countries with High Child Mortality.Vaccines · 2022Review
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Authors and funding
9 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundIn May, 2012, Rwanda became the first low-income African country to introduce pentavalent rotavirus vaccine into its routine national immunisation programme. Although the potential health benefits of rotavirus vaccination are huge in low-income African countries that account for more than half the global deaths from rotavirus, concerns remain about the performance of oral rotavirus vaccines in these challenging settings.
methodsWe conducted a time-series analysis to examine trends in admissions to hospital for non-bloody diarrhoea in children younger than 5 years in Rwanda between Jan 1, 2009, and Dec 31, 2014, using monthly discharge data from the Health Management Information System. Additionally, we reviewed the registries in the paediatric wards at six hospitals from 2009 to 2014 and abstracted the number of total admissions and admissions for diarrhoea in children younger than 5 years by admission month and age group. We studied trends in admissions specific to rotavirus at one hospital that had undertaken active rotavirus surveillance from 2011 to 2014. We assessed changes in rotavirus epidemiology by use of data from eight active surveillance hospitals.
findingsCompared with the 2009-11 prevaccine baseline, hospital admissions for non-bloody diarrhoea captured by the Health Management Information System fell by 17-29% from a pre-vaccine median of 4051 to 2881 in 2013 and 3371 in 2014, admissions for acute gastroenteritis captured in paediatric ward registries decreased by 48-49%, and admissions specific to rotavirus captured by active surveillance fell by 61-70%. The greatest effect was recorded in children age-eligible to be vaccinated, but we noted a decrease in the proportion of children with diarrhoea testing positive for rotavirus in almost every age group.
interpretationThe number of admissions to hospital for diarrhoea and rotavirus in Rwanda fell substantially after rotavirus vaccine implementation, including among older children age-ineligible for vaccination, suggesting indirect protection through reduced transmission of rotavirus. These data highlight the benefits of routine vaccination against rotavirus in low-income settings.
fundingGavi, the Vaccine Alliance and the Government of Rwanda.
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