Reduction in hospitalisations for acute gastroenteritis-associated childhood seizures since introduction of rotavirus vaccination: a time-series and change-point analysis of hospital admissions in England

Hungerford, Daniel James ORCID: 0000-0002-9770-0163, French, Neil ORCID: 0000-0003-4814-8293, Iturriza-Gomara, Miren ORCID: 0000-0001-5816-6423, Read, Jonathan M, Cunliffe, Nigel A ORCID: 0000-0002-5449-4988 and Vivancos, Roberto (2019) Reduction in hospitalisations for acute gastroenteritis-associated childhood seizures since introduction of rotavirus vaccination: a time-series and change-point analysis of hospital admissions in England. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 73 (11). pp. 1020-1025.

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Official URL: http://dx.doi.org/10.1136/jech-2019-213055

Abstract

<h4>Introduction</h4>The incidence of severe childhood diarrhoea has fallen substantially following the introduction of rotavirus vaccine in the UK in July 2013. Since children with rotavirus infection may experience febrile and afebrile seizures, we evaluated the impact of rotavirus vaccination on seizure hospitalisations in children in England.<h4>Methods</h4>Using data from Hospital Episode Statistics, we employed interrupted time-series analyses to assess changes in monthly hospital admissions for seizures among children aged <5 years from July 2000 to June 2017. Outcome measures comprised all seizures and febrile seizures, with and without a co-diagnosis of acute gastroenteritis (AGE). Models were adjusted for pneumococcal conjugate vaccine (PCV) introduction. Change-point analysis was used to independently identify step-changes in the time-series.<h4>Results</h4>Among hospitalised children aged <5 years, the incidence of any seizures and febrile seizures with AGE decreased post-vaccine introduction by 23% (95% CI: 11% to 33%) and 31% (95% CI: 19% to 41%), respectively. For febrile seizures with AGE, a single change-point was identified in July 2013 (95% CI: June 2013 to December 2013). Reductions in seizure incidence were higher during the rotavirus season (49%, 95% CI: 37% to 58%) compared with out-of-season (13%, 95% CI: -4 to 28%) and showed no relation to PCV introduction. There were small reductions in any seizures with any co-diagnosis (4%, 95% CI: 0% to 8%) and in febrile seizures with any co-diagnosis (10%, 95% CI: 2% to 16%).<h4>Conclusion</h4>Rotavirus vaccination has reduced hospitalisations for seizures associated with AGE in England, providing additional evidence of population-level impact of rotavirus vaccination on seizure incidence in high-income countries.

Item Type:	Article
Uncontrolled Keywords:	vaccination, time-series, diarrhoea, epidemiological methods, effectiveness
Depositing User:	Symplectic Admin
Date Deposited:	27 Aug 2019 10:07
Last Modified:	02 Jul 2023 03:43
DOI:	10.1136/jech-2019-213055
Open Access URL:	https://jech.bmj.com/content/early/2019/09/10/jech...
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3052631