Titre :
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Development and use of the Lives Saved Tool (LiST) : A model to estimate the impact of scaling up proven interventions on maternal, neonatal and child mortality. The effect of rotavirus vaccine on diarrhoea mortality. (2010)
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Auteurs :
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Melinda-K MUNOS ;
Robert-E BLACK ;
Christa-L FISCHER WALKER ;
VICTORA (Cesar-G) : BRA. Department of Programa de Pos-Graduaçao em Epidemiologia. Universidade Federal de Pelotas. Pelotas.
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Type de document :
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Article
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Dans :
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International journal of epidemiology (vol. 39, 2010)
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Pagination :
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I56-I62
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Langues:
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Anglais
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Mots-clés :
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Vaccin
;
Diarrhée
;
Prévention santé
;
Mortalité
;
Epidémiologie
;
Mortalité infantile
;
Enfant
;
Virus
;
Homme
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Résumé :
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[BDSP. Notice produite par INIST-CNRS Et9R0xkF. Diffusion soumise à autorisation]. Background Approximately 39% of the global diarrhoea deaths in children aged 5 years may be attributable to rotavirus infection. Two rotavirus vaccines were recently introduced to the market, with evidence of efficacy in the USA, Europe and Latin America. We sought to estimate the effectiveness of these vaccines against rotavirus morbidity and mortality. Methods We conducted a systematic review of published efficacy and effectiveness trials of rotavirus vaccines. Study descriptors and outcome measures were abstracted into standardized tables and the quality of each study was graded. We performed meta-analyses for any outcome with two or more data points, and used child health epidemiology reference group (CHERG) Rules for Evidence Review to estimate the effect of the vaccine on rotavirus mortality. Results We identified six papers for abstraction, reporting results from four studies. No studies reported diarrhoea or rotavirus deaths, but all studies showed reductions in hospitalizations due to rotavirus or diarrhoea of any aetiology, severe and any rotavirus infections and diarrhoea episodes of any aetiology in children who received rotavirus vaccine compared with placebo. Effectiveness against very severe rotavirus infection best approximated effectiveness against the fraction of diarrhoea deaths attributable to rotavirus, and was estimated to be 74% (95% confidence interval : 35-90%). Conclusions Rotavirus vaccines are efficacious against rotavirus morbidity and mortality and have the potential to substantially reduce child mortality in low-income countries if implemented appropriately.
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