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MMWR. Morbidity and Mortality Weekly Report. 2011 Dec 2; 60:1611-4.Rotavirus disease is the leading cause of childhood morbidity and mortality related to diarrhea in Latin America and the Caribbean (LAC), where an estimated 8,000 deaths related to rotavirus diarrhea occur annually among children aged <5 years. After two safe and effective rotavirus vaccines became available, the World Health Organization (WHO) in 2007 recommended inclusion of rotavirus vaccine in the immunization programs of Europe and the Americas, and in 2009 expanded the recommendation to all infants aged <32 weeks worldwide. This report describes progress in the introduction of rotavirus vaccine in LAC, where it was first introduced in 2006 in Brazil, El Salvador, Mexico, Nicaragua, Panama, and Venezuela; by January 2011, it was included in the national immunization schedules of 14 countries in LAC. Estimated national rotavirus vaccine coverage (2 doses of the monovalent vaccine or 3 doses of the pentavalent vaccine) among children aged <1 year in 2010 ranged from 49% to 98% (median: 89%) in the 11 LAC countries with vaccine introduction before 2010. Of the 14 countries that had introduced rotavirus vaccine into their national immunization programs, 13 participate in a hospital-based rotavirus surveillance network. Data from some countries in this network and from other monitoring efforts in LAC countries have shown declines in hospitalizations and deaths related to severe diarrhea after rotavirus vaccine introduction. The rapid introduction of rotavirus vaccine in LAC demonstrates the benefits of the early commitment of national decision makers to introduce these vaccines in low-income and middle-income countries at the same time as in high-income countries.
Implementing the new recommendations on the clinical management of diarrhoea: guidelines for policy makers and programme managers.
Geneva, Switzerland, WHO, 2006. 34 p.WHO and UNICEF have released revised recommendations aimed at dramatically cutting the number of deaths due to diarrhoea. These new recommendations take into account two significant recent advances: demonstration of the increased efficacy of a new formulation for ORS containing lower concentrations of glucose and salt, and success in using zinc supplementation in addition to rehydration therapy in the management of diarrhoeal diseases. Prevention and treatment of dehydration with ORS and fluid commonly available at home, breastfeeding, continued feeding, selective use of antibiotics, and providing zinc supplementation for 10 to 14 days are the critical therapies that will help us achieve these goals. This manual provides policy makers and programme managers with the information they need to introduce and/or scale up a national decision to introduce the new ORS formulation and zinc supplementation as part of the clinical management of diarrhoeal diseases. (excerpt)