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Figure S1. Agarose gel electrophoresis of RT-PCR VP7 (A) and VP4 (B) gene products obtained from the sera of ten rotavirus-positive children with gastroenteritis in Belém, Brazil. (PPTX 121 kb)

Search methods: detailed search strategy. Web-appendix 2. Criteria for trial eligibility. Web-appendix 3. Extraction sheet for trials assessing efficacy/safety and effectiveness/impact of rotavirus vaccine. Web-appendix 4. Extraction sheet for risk of bias assessment in trials evaluating efficacy/safety of rotavirus vaccine. Web-appendix 5. Selected studies for efficacy/safety evaluation of rotavirus vaccine. Web-appendix 6. Risk of bias graph. Web-appendix 7. Summary of the characteristics of studies included for assessing efficacy/safety of rotavirus vaccines. Web-appendix 8. Forest plot of meta-analysis for severe diarrhea of any cause. Web-appendix 9. Forest plot of meta-analysis for treatment-related mortality. Web-appendix 10. Forest plot of meta-analysis for treatment-related intussusception. Web-appendix 11. Common severe adverse events occurring in rotavirus immunized and placebo groups. Web-appendix 12. Forest plot of meta-analysis for treatment-related severe adverse events. Web-appendix 13. Identified studies for effectiveness evaluation of rotavirus vaccine. Web-appendix 14. Summary of the characteristics of studies included for evaluate effectivenes of rotavirus vaccine. Web-appendix 15. Summary of results of studies assessing effectiveness of rotavirus vaccine. (DOCX# 123 bytes)

Ministerio de Salud. Universidad Central de Venezuela. Instituto de Biomedicina. Caracas, VE. Universidad de Carabobo. Insalud. Ciudad Hospitalaria ?Dr. Enrique Tejera". Valencia, VE. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n. Ciudad M?xico, M?xico. Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n. Ciudad M?xico, M?xico. GlaxoSmithKline Biologicals. Rixensart, Belgium. GlaxoSmithKline Biologicals. Rixensart, Belgium. The effect of nutritional status on protective efficacy of a live attenuated human rotavirus vaccine (RIX4414) was studied. Vaccine protection was evaluated through a secondary analysis of data from an efficacy study conducted in Brazil, Mexico, and Venezuela. Vaccine efficacy against rotavirus gastroenteritis (RVGE) was similar in well-nourished and malnourished infants: 74.1 percent (95 percent confidence interval [CI], 52.2 percent?86.2 percent) and 73 percent (95 percent CI, 11.2 percent?92.3 percent) for severe RVGE and 60.9 percent (95 percent CI, 37.4 percent?75.4 percent) and 61.2 percent (95 percent CI, 10.4 percent?83.1 percent) for RVGE of any severity, respectively. RIX4414 significantly decreased the rate of RVGE regardless of nutritional status, which suggests that this patient group can also benefit from rotavirus vaccination.

Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Cl?nica de Medicina Preventiva de Par?. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Minist?rio da Sa?de. Funda??o Nacional de Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. A tetravalent rhesus-human reassortant rotavirus (RRV-TV) vaccine (4 x 10(4) plaque-forming units/dose) was evaluated for safety, immunogenicity and efficacy in a prospective, randomized, double-blind, placebo-controlled trial involving 540 Brazilian infants. Doses of vaccine or placebo were given at ages, 1, 3 and 5 months. No significant differences were noted in the occurrence of diarrhoea or vomiting in vaccine and placebo recipients following each dose. Low-grade fever occurred on days 35 in 23% of vaccinees after the first dose, but not after the second or third doses of vaccine. An IgA antibody response to rhesus rotavirus (RRV) occurred in 58% of vaccinees and 33% of placebo recipients. Neutralizing antibody responses to individual serotypes did not exceed 20% when measured by fluorescent focus reduction, but exceeded 40% when assayed by plaque reduction neutralization. There were 91 cases of rotavirus diarrhoea among the 3-dose (vaccine or placebo) recipients during two years of follow-up, 36 of them among children given the vaccine. Overall vaccine efficacy was 8% (P = 0.005) against any diarrhoea and 35% (P = 0.03) against any rotavirus diarrhoea. Protection during the first year of follow-up, when G serotype 1 rotavirus predominated, was 57% (P = 0.008), but fell to 12% in the second year. Similar results were obtained when analysis was restricted to episodes in which rotavirus was the only identified pathogen. There was a tendency for enhanced protection by vaccine against illness associated with an average of 6 or more stools per day. These results are sufficiently encouraging to warrant further studies of this vaccine in developing countries using a higher dosage in an attempt to improve its immunogenicity and efficacy.

Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1989 Two hundred and one samples obtained from 61 children were examined for Cryptosporidium infection during a period of 12 months. One hundred fifteen specimens were collected during diarrhoea episodes and the remaining 86 obtained out of diarrhoea period, as controls. All samples were examined by a modified Ziehl-Neelsen staining method. Cryptosporidium was detected in 6 (5.2%) of 115 samples from diarrhoeic children. All non-diarrhoeic control patients were negative for Cryptosporidum. The present study suggests that Cryptosporidium is an agent of self-limited diarrhoea among immunocompetent children from Belém, Pará. Universidad de Costa Rica. Instituto de Investigaciones en Salud. Universidade de São Paulo UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones en Salud (INISA)