O impacto da vacina do rotavírus nas taxas de hospitalização por diarreia aguda em crianças menores de cinco anos

Abstract

In Brazil, the acute diarrhea disease is one of the main health problems presented as the second cause of internment and infantile death in kids under five years old. Among all the reasons which causes diarrhea in children, the rotavirus is detached by the great number of people contaminated, morbidity independently of the sanitary conditions and the mortality in developing countries. In March of 2006, the rotavirus vaccine was included in the National Program of Immunization. The aim of this study was to evaluate the risk of hospitalization due to acute diarrhea in children under five years old in Paraná State between 200 and 2009, comparing the pre and post periods of the rotavirus vaccine introduction, according to the Health Regional, the kids' age, the vaccinal cover and its impact in the hospitalization rates by acute diarrhea in kids under one year old. The data were obtained in Hospital Information System of Health Unique System (SUS), available in electronic address, by using the tenth revision of the International Disease Classification, with codes A00-A09. To analyze the rate reduction of the hospitalization during the period it was used the Poisson regression, Mann - Whitney and test for proportion differences. It was calculated the gross odds ratio, and confidence interval of 95%, analysis by logistic regression and Attributable Risk to verify the attributable fraction to the risk factor. For vaccinal cover analysis they were analyzed the accessibility, abandon rate and Pearson's rate of variation and correlation. It was observed a reduction in the hospitalization rates by acute diarrhea in kids under five years old in Paraná State after the rotavirus vaccine introduction (p= 0,0221). The age under one year old presented a reduction (p< 0,0001) in the internment rates during all the following years after the vaccine, detaching that in Poisson regression only this age presented significance. The kid under one year old presented a 30% reduction of internment comparing the vaccinal pre and post periods and as the age gets higher the probability of internment gets lower and in all age groups the risks of internment due to diarrhea disease decreased 17% after the vaccination. For 2009, eight (36,36%) regionals presented vaccinal cover above 90%, with accessibility rate of 2,53%, abandon rate of 9% and there wasn't any correlation between the hospitalization rates and the vaccinal cover (p= 0,956). The Human Rotavirus Vaccine was effective in the reduction of hospitalization rates by acute diarrhea detaching the year of 2009 with the biggest decrease which is significative in the age group under one year old. The high abandon rate avoids ideal vaccinal cover, being necessary to identify the responsible facts. The discrepancy of hospitalization rates among the regionals suggests that actions in acute diarrhea prevention and the identification of its causes are better evaluated.