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Efficacy of a Low-Cost, Heat-Stable Oral Rotavirus Vaccine in Niger.
Isanaka, Sheila; Guindo, Ousmane; Langendorf, Celine; Matar Seck, Amadou; Plikaytis, Brian D; Sayinzoga-Makombe, Nathan; McNeal, Monica M; Meyer, Nicole; Adehossi, Eric; Djibo, Ali; Jochum, Bruno; Grais, Rebecca F.
Afiliación
  • Isanaka S; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Guindo O; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Langendorf C; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Matar Seck A; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Plikaytis BD; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Sayinzoga-Makombe N; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • McNeal MM; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Meyer N; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Adehossi E; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Djibo A; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Jochum B; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
  • Grais RF; From the Department of Research, Epicentre, Paris (S.I., C.L., R.F.G.); the Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston (S.I.); Epicentre (O.G., A.M.S., N.S.-M.), National Hospital (E.A.), and University of Niamey (A.D.), Niamey, Niger
N Engl J Med ; 376(12): 1121-1130, 2017 03 23.
Article en En | MEDLINE | ID: mdl-28328346
BACKGROUND: Each year, rotavirus gastroenteritis is responsible for about 37% of deaths from diarrhea among children younger than 5 years of age worldwide, with a disproportionate effect in sub-Saharan Africa. METHODS: We conducted a randomized, placebo-controlled trial in Niger to evaluate the efficacy of a live, oral bovine rotavirus pentavalent vaccine (BRV-PV, Serum Institute of India) to prevent severe rotavirus gastroenteritis. Healthy infants received three doses of the vaccine or placebo at 6, 10, and 14 weeks of age. Episodes of gastroenteritis were assessed through active and passive surveillance and were graded on the basis of the score on the Vesikari scale (which ranges from 0 to 20, with higher scores indicating more severe disease). The primary end point was the efficacy of three doses of vaccine as compared with placebo against a first episode of laboratory-confirmed severe rotavirus gastroenteritis (Vesikari score, ≥11) beginning 28 days after dose 3. RESULTS: Among the 3508 infants who were included in the per-protocol efficacy analysis, there were 31 cases of severe rotavirus gastroenteritis in the vaccine group and 87 cases in the placebo group (2.14 and 6.44 cases per 100 person-years, respectively), for a vaccine efficacy of 66.7% (95% confidence interval [CI], 49.9 to 77.9). Similar efficacy was seen in the intention-to-treat analyses, which showed a vaccine efficacy of 69.1% (95% CI, 55.0 to 78.7). There was no significant between-group difference in the risk of adverse events, which were reported in 68.7% of the infants in the vaccine group and in 67.2% of those in the placebo group, or in the risk of serious adverse events (in 8.3% in the vaccine group and in 9.1% in the placebo group); there were 27 deaths in the vaccine group and 22 in the placebo group. None of the infants had confirmed intussusception. CONCLUSIONS: Three doses of BRV-PV, an oral rotavirus vaccine, had an efficacy of 66.7% against severe rotavirus gastroenteritis among infants in Niger. (Funded by Médecins sans Frontières Operational Center and the Kavli Foundation; ClinicalTrials.gov number, NCT02145000 .).
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Rotavirus / Vacunas contra Rotavirus / Gastroenteritis Tipo de estudio: Clinical_trials / Guideline / Health_economic_evaluation / Incidence_studies / Prognostic_studies Límite: Animals / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: N Engl J Med Año: 2017 Tipo del documento: Article País de afiliación: Níger Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Rotavirus / Vacunas contra Rotavirus / Gastroenteritis Tipo de estudio: Clinical_trials / Guideline / Health_economic_evaluation / Incidence_studies / Prognostic_studies Límite: Animals / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: N Engl J Med Año: 2017 Tipo del documento: Article País de afiliación: Níger Pais de publicación: Estados Unidos