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The Epidemiological Trend of Rotavirus Gastroenteritis in Children in a Single Center from 2004 to 2012: A Retrospective Study

2004-2012년 소아 로타바이러스 위장관염의 역학적 추세에 관한 단일 기관 연구

  • Lee, Hae Sung (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Kim, Dong Yeon (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Kim, Jung Are (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Choi, Soo-Han (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center)
  • 이해성 (한전의료재단 한전병원 소아청소년과) ;
  • 김동연 (한전의료재단 한전병원 소아청소년과) ;
  • 김정아 (한전의료재단 한전병원 소아청소년과) ;
  • 최수한 (한전의료재단 한전병원 소아청소년과)
  • Received : 2014.06.17
  • Accepted : 2014.09.01
  • Published : 2014.12.25

Abstract

Purpose: This study was performed to investigate the epidemiological trend of rotavirus acute gastroenteritis (RV-AGE) in children. Methods: A retrospective review was performed in patients (1 month to 18 years of age) with acute gastroenteritis at KEPCO Medical Center from September 2004 to August 2013. Comparative analyses were performed based on periods: pre-vaccine (2004-2006) and post-vaccine (2008-2012) in all patients; 2004-2006 (period A), 2007-2009 (period B) and 2010-2012 (period C) in patients under 5 years of age. Results: Proportion of RV-AGE decreased from 25.0% (337/1,346) in pre-vaccine period to 20.8% (459/2,210) in post-vaccine period (rate ratio (RR), 0.83 [95% CI, 0.73-0.93]; P=0.0029). The median age of patients with RV-AGE in post-vaccine period (2.6 years) was significantly (P<0.0001) higher than that in pre-vaccine period (1.6 years). In patients hospitalized with AGE, proportion of RV-AGE was significantly reduced in patients 6 to 23 months old (RR, 0.62 [95% CI, 0.51-0.75]; P<0.0001). Significant decline in proportion of RV-AGE was observed in patients under 5 years of age: period A, 26.9% (308/1,144); period B, 22.7% (295/1,299); period C, 20.6% (186/902) (P =0.0007). After the introduction of rotavirus vaccine, a significant decreasing trend of RV-AGE proportion was observed in patients 6 to 11 months old (P =0.0018) and 12 to 23 months old (P =0.0152). Conclusion: Decrease in RV-AGE proportion and increase in age of patients with RV-AGE were observed after the introduction of rotavirus vaccine in this single center study. Continued and systematic surveillance is needed to assess the impact of rotavirus vaccine.

목적: 본 연구는 국내 로타바이러스 백신 도입 전후 시기의 지역사회 소아 로타바이러스 위장관염의 역학에 대하여 조사하고자 하였다. 방법: 2004년 9월부터 2013년 8월까지 한전병원에서 급성 위장염 환자 중 로타바이러스 분변 항원검사를 시행했던 1개월 이상 18세 이하 환자를 후향적으로 분석하였다. 전체 환자에서 백신 도입 전(2004-2006년) 및 도입 이후(2008-2012년) 시기로 구분하여 비교 분석하였고, 5세 미만 환자에서는 백신 전(2004-2006년), 이행(2007-2009년), 백신 후(2010-2012년) 시기로 구분하여 비교 분석하였다. 결과: 전체 대상 환자에서 로타바이러스 위장관염 비율은 백신 도입 전 시기 25.0% (337/1,346)에서 도입이후 시기 20.8% (459/2,210)로 유의한 감소를 보였다(비율비, 0.83, [95% CI, 0.73-093]; P=0.0029). 백신 도입 이후 시기의 로타바이러스 위장관염 환자의 중앙연령은 2.6세로 도입 전 시기 1.6세 보다 유의하게 높았다(P<0.0001). 급성 위장관염 입원 환자 중 로타바이러스 감염 비율은 6-23개월 환자들에서 유의한 감소를 보였다(비율비, 0.62, [95% CI, 0.51-0.75]; P<0.0001). 5세 미만 환자들에서 백신 전, 이행, 백신 후 시기의 로타바이러스 위장관염의 비율은 각각 26.9% (308/1,144), 22.7% (295/1,299), 20.6% (186/902)로 유의한 감소추세를 보였다(P =0.0007). 백신 도입 이후 각 연도별 추세에서, 6-11개월(P=0.0018)과 12-23개월(P=0.0152) 환자군에서 유의한 감소 추세를 보였다. 결론: 단일기관 연구에서 로타바이러스 백신 도입 이후 로타바이러스 위장염 환자의 비율 감소와 연령 상승을 확인하였다.

Keywords

References

  1. World Health Organization. Vaccines and diseases, Rotaviruses. Available at http://www.who.int/immunization/diseases/rotavirus/en/ [accessed on 11 Jun 2014].
  2. Kim JS, Kang JO, Cho SC, Jang YT, Min SA, Park TH, et al. Epidemiological profile of rotavirus infection in the Republic of Korea: results from prospective surveillance in the Jeongeub District, 1 July 2002 through 30 June 2004. J Infect Dis 2005;192 Suppl 1:S49-56. https://doi.org/10.1086/431506
  3. Kawai K, O'Brien MA, Goveia MG, Mast TC, El Khoury AC. Burden of rotavirus gastroenteritis and distribution of rotavirus strains in Asia: a systematic review. Vaccine 2012;30:1244-54. https://doi.org/10.1016/j.vaccine.2011.12.092
  4. World Health Organization. Meeting of the Strategic Advisory Group of Experts on immunization, October 2009 - conclusions and recommendations. Weekly epidemiological record 2009;84:517-32.
  5. The Korean Pediatric Society. [Rotavirus Vaccine]. In: Lee HJ, ed. Immunization Guideline. 7th ed. Seoul: The Korean Pediatric Society; 2012:184-94.
  6. Korea Centers for Disease Control and Prevention. National immunization survey in South Korea, 2013. Public Health Weekly Report 2014;7;449-54.
  7. Leshem E, Moritz RE, Curns AT, Zhou F, Tate JE, Lopman BA, et al. Rotavirus vaccines and health care utilization for diarrhea in the united states (2007-2011). Pediatrics 2014;134:15-23. https://doi.org/10.1542/peds.2013-3849
  8. Tate JE, Haynes A, Payne DC, Cortese MM, Lopman BA, Patel MM, et al. Trends in national rotavirus activity before and after introduction of rotavirus vaccine into the national immunization program in the United States, 2000 to 2012. Pediatr Infect Dis J 2013;32:741-4. https://doi.org/10.1097/INF.0b013e31828d639c
  9. Payne DC, Vinje J, Szilagyi PG, Edwards KM, Staat MA, Weinberg GA, et al. Norovirus and medically attended gastroenteritis in U.S. children. N Engl J Med 2013;368:1121-30. https://doi.org/10.1056/NEJMsa1206589
  10. Tate JE, Panozzo CA, Payne DC, Patel MM, Cortese MM, Fowlkes AL, et al. Decline and change in seasonality of US rotavirus activity after the introduction of rotavirus vaccine. Pediatrics 2009;124:465-71. https://doi.org/10.1542/peds.2008-3528
  11. Parez N, Giaquinto C, Du Roure C, Martinon-Torres F, Spoulou V, Van Damme P, et al. Rotavirus vaccination in Europe: drivers and barriers. Lancet Infect Dis 2014;14:416-25. https://doi.org/10.1016/S1473-3099(14)70035-0
  12. Gastanaduy PA, Curns AT, Parashar UD, Lopman BA. Gastroenteritis hospitalizations in older children and adults in the United States before and after implementation of infant rotavirus vaccination. JAMA 2013;310:851-3. https://doi.org/10.1001/jama.2013.170800
  13. Anderson EJ, Shippee DB, Weinrobe MH, Davila MD, Katz BZ, Reddy S, et al. Indirect protection of adults from rotavirus by pediatric rotavirus vaccination. Clin Infect Dis 2013;56:755-60. https://doi.org/10.1093/cid/cis1010
  14. Lopman BA, Curns AT, Yen C, Parashar UD. Infant rotavirus vaccination may provide indirect protection to older children and adults in the United States. J Infect Dis 2011;204:980-6. https://doi.org/10.1093/infdis/jir492
  15. Korea Centers for Disease Control and Prevention. Mole cular epidemiology of group A rotavirus infection in the Republic of Korea. Public Health Weekly Report 2013;6;228-233
  16. Korea Centers for Disease Control and Prevention. Molecular epidemiology of group A rotavirus infection in Korea. Public Health Weekly Report 2008;1;325-8.
  17. Korea Centers for Disease Control and Prevention. Available at http://www.cdc.go.kr/CDC/info/CdcKrInfo0503.jsp?menuIds=HOME001-MNU1175-MNU0048-MNU0051 [accessed on 11 Jun 2014].
  18. Choi UY, Lee SY, Ma SH, Jang YT, Kim JY, Kim HM, et al. Epidemiological changes in rotavirus gastroenteritis in children under 5 years of age after the introduction of rotavirus vaccines in Korea. Eur J Pediatr 2013;172:947-52. https://doi.org/10.1007/s00431-013-1974-y
  19. Centers for Disease Control and Prevention. National, state, and local area vaccination coverage among children aged 19-35 months--United States, 2011. MMWR Morb Mortal Wkly Rep 2012;61:689-96.
  20. Centers for Disease Control and Prevention. National, state, and local area vaccination coverage among children aged 19-35 months - United States, 2012. MMWR Morb Mortal Wkly Rep 2013;62:733-40.
  21. Koran Centers for Disease Control and Prevention. Available at http://www.cdc.go.kr/CDC/info/CdcKrInfo0201.jsp?menuIds=HOME001-MNU1155-MNU1083-MNU1375-MNU0025&cid=20768. [accessed on 11 Jun 2014].
  22. Trimis G, Koutsoumbari I, Kottaridi C, Palaiologou N, Assimakopoulou E, Spathis A, et al. Hospital-based surveillance of rotavirus gastroenteritis in the era of limited vaccine uptake through the private sector. Vaccine 2011;29:7292-5. https://doi.org/10.1016/j.vaccine.2011.07.092
  23. Gagneur A, Nowak E, Lemaitre T, Segura JF, Delaperriere N, Abalea L, et al. Impact of rotavirus vaccination on hospitalizations for rotavirus diarrhea: the IVANHOE study. Vaccine 2011;29:3753-9. https://doi.org/10.1016/j.vaccine.2011.03.035

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