ArticleThe Lancet. Global health2018
Impact of monovalent rotavirus vaccine on diarrhoea-associated post-neonatal infant mortality in rural communities in Malawi: a population-based birth cohort study.
Article in The Lancet. Global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 35 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Case fatality risk of diarrhoeal pathogens: a systematic review and meta-analysis.International journal of epidemiology · 2022Pooled it
- Vaccines for preventing rotavirus diarrhoea: vaccines in use.The Cochrane database of systematic reviews · 2021Pooled it
- Vaccines for preventing rotavirus diarrhoea: vaccines in use.The Cochrane database of systematic reviews · 2019Pooled it
- Vaccines for preventing rotavirus diarrhoea: vaccines in use.The Cochrane database of systematic reviews · 2019Pooled it
- Trial
- Review
- Rotavirus vaccine effectiveness against rotavirus and acute gastroenteritis mortality: an analysis of pooled case-control studies from the MNSSTER-V dataset.The Lancet. Child & adolescent health · 2026Article
- Cost-Effective Threshold Price for Alternative Infant and Neonatal Rotavirus Vaccines: A Dual-Country Evaluation.medRxiv : the preprint server for health sciences · 2026Article
- Adherence to solar disinfection water treatment reduces diarrheal incidence among children in Malawi: a secondary analysis of a cluster quasi-experimental study.Journal of water and health · 2025Article
- Maternal-infant rotavirus-specific antibody kinetics to inform timing of vaccine boosting in Malawi: An observational study.PLoS medicine · 2025Observational
- Challenges to the Effectiveness and Immunogenicity of COVID-19 Vaccines: A Narrative Review with a Systematic Approach.Vaccines · 2025Review
- Decision-making for childhood vaccination in crisis settings: a survey of practice & barriers.Conflict and health · 2024Article
- Impact of rotavirus vaccination in Malawi from 2012 to 2022 compared to model predictions.NPJ vaccines · 2024Article
- 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
- Association Between Maternal Breastmilk Microbiota Composition and Rotavirus Vaccine Response in African, Asian, and European Infants: A Prospective Cohort Study.The Journal of infectious diseases · 2023Article
- Deployment of Rotavirus Vaccine in Western Kenya Coincides with a Reduction in All-Cause Child Mortality: A Retrospective Cohort Study.Vaccines · 2023Article
- Acute rotavirus infection is associated with the induction of circulating memory CD4Scientific reports · 2023Article
- Drivers of Decline in Diarrhea Mortality Between GEMS and VIDA Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 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
- Rotavirus Genotypes in Hospitalized Children With Acute Gastroenteritis Before and After Rotavirus Vaccine Introduction in Blantyre, Malawi, 1997-2019.The Journal of infectious diseases · 2022Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
16 authors at 8 institutions in 4 countries.
Funding
Abstract
backgroundRotavirus is a major contributor to child mortality. The effect of rotavirus vaccine on diarrhoea mortality has been estimated in middle-income but not low-income settings, where mortality is high and vaccine effectiveness in reducing admissions to hospital is lower. Empirical population-based mortality studies have not been done in any setting. Malawi introduced monovalent rotavirus vaccine (RV1) in October, 2012. We aimed to investigate the impact and effectiveness of the RV1 vaccine in reducing diarrhoea-associated mortality in infants aged 10-51 weeks.
methodsIn this population-based cohort study, we included infants born between Jan 1, 2012, and June 1, 2015, in Mchinji, Central Malawi and analysed data on those surviving 10 weeks. Individual vaccination status was extracted from caregiver-held records or report at home visits at 4 months and 1 year of age. Survival to 1 year was confirmed at home visit, or cause of death ascertained by verbal autopsy. We assessed impact (1 minus mortality rate ratio following vs before vaccine introduction) using Poisson regression. Among vaccine-eligible infants (born from Sept 17, 2012), we assessed effectiveness (1 minus hazard ratio) using Cox regression.
findingsBetween Jan 1, 2012, and June 1, 2015, we recruited 48 672 livebirths in Mchinji, among whom 38 518 were vaccine-eligible and 37 570 survived to age 10 weeks. Two-dose versus zero-dose effectiveness analysis included 28 141 infants, of whom 101 had diarrhoea-associated death before 1 year of age. Diarrhoea-associated mortality declined by 31% (95% CI 1-52; p=0·04) after RV1 introduction. Effectiveness against diarrhoea-mortality was 34% (95% CI -28 to 66; p=0·22).
interpretationRV1 was associated with substantial reduction in diarrhoea-associated deaths among infants in this rural sub-Saharan African setting. These data add considerable weight to evidence showing the impact of rotavirus vaccine programmes.
fundingWellcome Trust and GlaxoSmithKline Biologicals.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.