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About the Authors:
Carl D. Kirkwood
* E-mail: [email protected]
Affiliation: Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
A. Duncan Steele
Affiliation: Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, Washington, United States of AmericaCitation: Kirkwood CD, Steele AD (2017) Rotavirus vaccine will have an impact in Asia. PLoS Med 14(5): e1002298. https://doi.org/10.1371/journal.pmed.1002298
Published: May 9, 2017
Copyright: © 2017 Kirkwood, Steele. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors received no funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: CI, confidence interval; DPT, diphtheria-pertussis-tetanus vaccine; ORS, oral rehydration salt; WHO, the World Health Organization
Provenance: Commissioned; not externally peer-reviewed
Diarrhea remains the second leading infectious cause of death among children under five years of age, with more than half a million deaths each year. Rotavirus disease accounts for 25%-30% of all severe diarrhea cases [1]. While every child is at risk of rotavirus infection, the vast majority of rotavirus deaths occur in low- and middle-income countries, particularly in sub-Saharan Africa and South Asia, where access to treatment for severe rotavirus-related diarrhea may be limited or absent. Rotavirus immunization is well recognized as the best approach to protect children from mortality and morbidity caused by severe rotavirus disease.
In 2009, the World Health Organization (WHO) recommended that all countries should include rotavirus vaccines in their national immunization programs, particularly those with high child mortality due to diarrhea [2]. Currently, 84 countries have introduced rotavirus vaccines into their national immunization programs, including 41 Gavi-eligible countries with financial support for vaccine procurement. The uptake of rotavirus vaccines in sub-Saharan Africa and the Americas has been excellent; however, progress in Asia has been insignificant, with a notable lack of introductions into national immunization programs despite the well-characterized burden of rotavirus disease [3,4]. Rotavirus disease and hospitalization have been significantly reduced in high- and middle-income countries, with multiple vaccine-effectiveness studies documenting their powerful impact [5]. Moreover, recent vaccine-effectiveness studies in low-middle-and low-income countries in Latin America and Africa have shown dramatic reductions in...