Effectiveness of Rotarix ® vaccine in Africa in the first decade of progressive introduction, 2009-2019:  systematic review and meta-analysis

• Published in: Wellcome open research 2020, Vol.5, p.187-187
• Main Authors: Murunga, Nickson, P Otieno, Grieven, Maia, Marta, N Agoti, Charles
• Format: Article
• Language: English
• Subjects: Age; Bias; Diarrhea; Gastroenteritis; Immunization; Meta-analysis; Peer review; Quality; Studies; Systematic Review; Vaccines; Viruses
• ISSN: 2398-502X; 2398-502X
• DOI: 10.12688/wellcomeopenres.16174.2

Randomized controlled trials of licensed oral rotavirus group A (RVA) vaccines, indicated lower efficacy in developing countries compared to developed countries. We investigated the pooled effectiveness of Rotarix in Africa in 2019, a decade since progressive introduction began in 2009. A systematic search was conducted in PubMed to identify studies that investigated the effectiveness of routine RVA vaccination in an African country between 2009 and 2019. A meta-analysis was undertaken to estimate pooled effectiveness of the full-dose versus partial-dose of Rotarix (RV1) vaccine and in different age groups. Pooled odds ratios were estimated using random effects model and the risk of bias assessed using Newcastle-Ottawa scale. The quality of the evidence was assessed using GRADE. By December 2019, 39 (72%) countries in Africa had introduced RVA vaccination, of which 34 were using RV1. Thirteen eligible studies from eight countries were included in meta-analysis for vaccine effectiveness (VE) of RVA by vaccine dosage (full or partial) and age categories. Pooled RV1 VE against RVA associated hospitalizations was 44% (95% confidence interval (CI) 28-57%) for partial dose versus 58% (95% CI 50-65%) for full dose. VE was 61% (95% CI 50-69%), 55% (95% CI 32-71%), 56% (95% CI 43-67%), and 61% (95% CI 42-73%) for children aged