Rotavirus Enteritis in Dadaab Refugee Camps: Implications for Immunization Programs in Kenya and Resettlement Countries

Clinical Infectious Diseases (CID)
Volume 59 Issue 1 July 1, 2014
http://cid.oxfordjournals.org/content/current

Crossing Borders: One World, Global Health
Clive M. Brown and Martin S. Cetron, Section Editors
Rotavirus Enteritis in Dadaab Refugee Camps: Implications for Immunization Programs in Kenya and Resettlement Countries
Maurice Ope, Steve B. Ochieng, Collins Tabu, Nina Marano.

Dadaab refugee camp, established in Kenya in 1991, is host to >500 000 refugees, most of whom are Somali in origin [1]. Annually, the United States resettles approximately 11 000 refugees from Africa, 4000 of them from Kenya. Although substantial progress has been made to provide safe water and improve sanitation in Dadaab, diarrheal disease remains among the leading causes of morbidity and mortality. Several disease outbreaks, including hepatitis E virus [2], cholera [3], and wild poliovirus [4], have been attributed to poor sanitation in the camps…
Editorial comment (C. B.) …Along with the provision of safe water and ensuring proper sanitation and hygiene, important strategies for the control of diarrheal diseases (depending on age) include breastfeeding, using oral rehydration solution, and, if diarrhea is moderate to severe, intravenous fluids, zinc supplementation, and immunization with rotavirus vaccine. Overall, rotavirus vaccine has been shown to be 30% effective against all-cause severe gastroenteritis, and 51%–93% protective against rotavirus gastroenteritis [14–16]. In addition to recommending rotavirus vaccine inclusion in national immunization programs, for countries where diarrheal deaths account for ≥10% of mortality among children aged <5 years, WHO strongly recommends introduction of the vaccine. The prevalence in this refugee camp was twice that value; thus, evaluating rotavirus vaccine as a childhood vaccine in refugee camps will provide important information for its efficacy in this setting and potentially support attaining MDG4 goals