RESUMEN

BACKGROUND: The Republic of Armenia was 1 of the 2 earliest countries in the Newly Independent States to introduce rotavirus vaccine into its national immunization program to reduce the burden of rotavirus disease (documented to cause 38% of acute gastroenteritis hospitalizations [AGE] among children aged <5 years). In November 2012, RV1 (Rotarix) was introduced for Armenian infants at ages 6 and 12 weeks. METHODS: The established active surveillance system at 2 hospitals in the capital, Yerevan, whereby children aged <5 years hospitalized for AGE have stool sample tested for rotavirus antigen, was used to assess trends in rotavirus hospitalizations. Immunization records on children enrolled after vaccine introduction were obtained from clinics, and vaccine effectiveness (VE) was estimated using children with AGE who test negative for rotavirus as controls for the rotavirus-positive cases. RESULTS: Among infants, rotavirus hospitalizations were reduced by 48% within the first year after introduction, and by ≥75% in years 2 and 3 following introduction. Reductions of ≥30% in other young children too old to have been vaccinated suggest additional benefit through indirect protection; overall in year 3, rotavirus hospitalizations were reduced by 69% among children aged <5 years. The overall VE of 2 RV1 doses in protecting against rotavirus hospitalization (any severity) was 62% (95% confidence interval [CI], 36%-77%) among children aged 6-23 months; 68% (95% CI, 24%-86%) among those aged 6-11 months, and 60% (95% CI, 20%-80%) in children aged 12-23 months. Against more severe rotavirus disease, VE was 79% (95% CI, 55%-90%) and similarly high in both age groups. CONCLUSIONS: RV1 is effective in young Armenian children and substantially reduced rotavirus hospitalizations shortly after introduction.

Asunto(s)

Gastroenteritis/prevención & control , Programas de Inmunización , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus/inmunología , Antígenos Virales/inmunología , Armenia/epidemiología , Preescolar , Diarrea/epidemiología , Diarrea/prevención & control , Diarrea/virología , Monitoreo Epidemiológico , Heces/virología , Gastroenteritis/epidemiología , Gastroenteritis/virología , Hospitalización/tendencias , Humanos , Lactante , Masculino , Rotavirus/inmunología , Infecciones por Rotavirus/epidemiología , Infecciones por Rotavirus/etnología , Infecciones por Rotavirus/virología , Vacunas contra Rotavirus/administración & dosificación , Vacunación/tendencias , Potencia de la Vacuna , Vacunas Atenuadas/administración & dosificación , Vacunas Atenuadas/inmunología

RESUMEN

The main purpose of this study was to investigate the profile of inflammatory response in patients with acute salmonellosis caused by two serotypes of Salmonella enterica, S. Enteritidis and S. Typhimurium, as well as in convalescent patients with previous acute disease caused by S. Enteritidis. Patients with acute disease showed significantly elevated levels of IL-1ß, IL-17, IL-10, and calprotectin compared to healthy control subjects. In convalescent patients, these markers were also significantly elevated, with the exception of IL-1ß. Multivariate statistical analyses with the use of these variables produced models with a good predictive accuracy resulting in excellent separation of the diseased and healthy cohorts studied. Overall, the results suggest that the profile of inflammatory response in this disease is determined, to a significant degree, by the serotype of Salmonella, and the profile of certain cytokines and calprotectin remains abnormal for a number of months following the acute disease stage.