TY - JOUR
T1 - Estimating the incidence of rotavirus infection in children from India and Malawi from serial anti-rotavirus IgA titres
AU - Bennett, Aisleen
AU - Nagelkerke, Nico
AU - Heinsbroek, Ellen
AU - Premkumar, Prasanna S.
AU - Wnęk, Małgorzata
AU - Kang, Gagandeep
AU - French, Neil
AU - Cunliffe, Nigel A.
AU - Bar-Zeev, Naor
AU - Lopman, Ben
AU - Iturriza-Gomara, Miren
N1 - Funding Information:
This work was supported by the Wellcome Trust [grant numbers 063144 to GK, 091909/Z/10/Z to NAC and NF, 102466/Z/13/A to AB and the Karonga Prevention Study Core Award]. MI-G is supported by the NIHR Health Protection Research Unit in Gastrointestinal Infections at the University of Liverpool in partnership with Public Health England (PHE). Professor Peter Teunis provided valuable insights into this analysis. MI-G is supported by the NIHR Health Protection Research Unit in Gastrointestinal Infections at the University of Liverpool in partnership with Public Health England (PHE).
Publisher Copyright:
© 2017 Bennett et al. 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.
PY - 2017/12
Y1 - 2017/12
N2 - Accurate estimates of rotavirus incidence in infants are crucial given disparities in rotavirus vaccine effectiveness from low-income settings. Sero-surveys are a pragmatic means of estimating incidence however serological data is prone to misclassification. This study used mixture models to estimate incidence of rotavirus infection from anti-rotavirus immunoglobulin A (IgA) titres in infants from Vellore, India, and Karonga, Malawi. IgA titres were measured using serum samples collected at 6 month intervals for 36 months from 373 infants from Vellore and 12 months from 66 infants from Karonga. Mixture models (two component Gaussian mixture distributions) were fit to the difference in titres between time points to estimate risk of sero-positivity and derive incidence estimates. A peak incidence of 1.05(95% confidence interval [CI]: 0.64, 1.64) infections per child-year was observed in the first 6 months of life in Vellore. This declined incrementally with each subsequent time interval. Contrastingly in Karonga incidence was greatest in the second 6 months of life (1.41 infections per child year [95% CI: 0.79, 2.29]). This study demonstrates that infants from Vellore experience peak rotavirus incidence earlier than those from Karonga. Identifying such differences in transmission patterns is important in informing vaccine strategy, particularly where vaccine effectiveness is modest.
AB - Accurate estimates of rotavirus incidence in infants are crucial given disparities in rotavirus vaccine effectiveness from low-income settings. Sero-surveys are a pragmatic means of estimating incidence however serological data is prone to misclassification. This study used mixture models to estimate incidence of rotavirus infection from anti-rotavirus immunoglobulin A (IgA) titres in infants from Vellore, India, and Karonga, Malawi. IgA titres were measured using serum samples collected at 6 month intervals for 36 months from 373 infants from Vellore and 12 months from 66 infants from Karonga. Mixture models (two component Gaussian mixture distributions) were fit to the difference in titres between time points to estimate risk of sero-positivity and derive incidence estimates. A peak incidence of 1.05(95% confidence interval [CI]: 0.64, 1.64) infections per child-year was observed in the first 6 months of life in Vellore. This declined incrementally with each subsequent time interval. Contrastingly in Karonga incidence was greatest in the second 6 months of life (1.41 infections per child year [95% CI: 0.79, 2.29]). This study demonstrates that infants from Vellore experience peak rotavirus incidence earlier than those from Karonga. Identifying such differences in transmission patterns is important in informing vaccine strategy, particularly where vaccine effectiveness is modest.
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U2 - 10.1371/journal.pone.0190256
DO - 10.1371/journal.pone.0190256
M3 - Article
AN - SCOPUS:85039845024
SN - 1932-6203
VL - 12
JO - PLoS One
JF - PLoS One
IS - 12
M1 - e0190256
ER -