Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil

Luna Cruz, María Edilia

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Título :	Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil
Creador:	Luna Cruz, María Edilia
Nivel de acceso:	Open access
Palabras clave :	Rotavirus - Vacunas
Descripción :	Background Because postlicensure surveillance dctermined that a previous rotavirus vacci ne. RotaShield, ca u sed int ussuscept ion in 1 of every 10.000 recipients. we assessed t he associat ion ofthe new monovalent rotavirus vaccine (RV 1) with intussusception after routine immunization of infants in Mexico and Brazil. Methods We used case-series and case- cont rol methods to assess the association between RVI and intussusception. lnfants wit h intussusception were ident ified through active surveillance at 69 hospitals (16 in Mex icoand 53 m Brazil). and age-matched inl~1nts from the same neighborhood were enrolled as controls. l'accination dates "·ere verified by a review of vaccination cards or clinic records. Res ults We enrolled 615 case patients (285 in Mexico and 330 in Brazi l) and 2050 controls. An increased risk ofintussusccption 1 to 7 days after the first dose ofRVI was identified among infams in Mexico "ith the use ofboth the case-series method (incidcnce ratio. 5.3: 95% confidence interval (CI]. 3.0 to 9.3) and the case-control method (odds rmio. 5.8: 95% Cl. 2.6 to 13.0). No significan! risk 1\<lS lound atler thc first dose among infants in Brazil. but an increased risk. albeit smaller than that seen after the first dose in Mexico-an increase by a factor or 1.9 to 2.6-was seen 1 to 7 davs alkr the sccond dose. r\ combined annual exccss of96 cases or intussusception in Mexico (approximately 1 per 51.000 in!'ants) and in Brazil (approximatelv 1 per 68.000 ini'ants) and of 5 deaths due to intussusception 11nS attributable to Rl' l. Ho11e1er. Rl' l prevented approximately 80.000 hospitalizations and 1300 d~aths rrom diarrhea each year in these t wo count ries. Conclusions Rl'l was associated with a short-tcrm risk of imussusception in approximmely 1 of cvery 51.000 to 68.000 vacci nated in!'ants. Thc absolute number of dcaths and hospital izations a verted beca use ofvacci nat ion lar exceeded the numb~r of i nt ussusception cases that may have been associated with vacci nation. (Fundcd in pan bv the G.-\V I Alliance and the U S Depart ment or Heal th and Human Sen'ices.)
Colaborador(es) u otros Autores:	Otero Mendoza Francisco Javier
Fecha de publicación :	2012
Tipo de publicación:	Otros
Formato:	pdf
URI :	http://repositorio.pediatria.gob.mx:8180/handle/20.500.12103/888
Idioma:	spa
Aparece en las colecciones:	Tesis

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