{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:54:21Z","timestamp":1762005261607,"version":"3.37.3"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01HD061265"],"award-info":[{"award-number":["R01HD061265"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Rotavirus vaccine (RV) and pneumococcal vaccine (PCV) decrease diarrheal and respiratory disease incidence and severity, but there are few data about the effects of these vaccines among HIV-exposed uninfected (HEU) children.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We recorded RV and PCV vaccination history in a placebo-controlled trial that studied the need for cotrimoxazole among HEU infants in Botswana (the Mpepu Study). We categorized infants by enrollment before or after the simultaneous April 2012 introduction of RV and PCV, and compared diagnoses of diarrhea and pneumonia (grade 3\/4), hospitalizations, and deaths from both disease conditions through the 12-month study visit by vaccine era\/status across two sites (a city and a village) by Kaplan-Meier estimates.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Two thousand six hundred and thirty-five HEU infants were included in this secondary analysis, of these 1689 (64%) were enrolled in Gaborone (344 pre-vaccine, 1345 vaccine) and 946 (36%) in Molepolole (209 pre-vaccine, 737 vaccine). We observed substantial reduction in hazard of hospitalization or death for reason of diarrhea and pneumonia in the vaccine era versus the pre-vaccine era in Molepolole (hazard ratio, HR = 0.44, 95% confidence interval, CI = 0.28, 0.71) with smaller reduction in Gaborone (HR = 0.91, 95% CI = 0.57, 1.45). Similar downward trends were observed for diagnoses of diarrhea and pneumonia separately during the vaccine versus pre-vaccine era.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Although temporal confounding cannot be excluded, significant declines in the burden of diarrheal and respiratory illness were observed among HEU children in Botswana following the introduction of RV and PCV. RV and PCV may maximally benefit HEU children in rural areas with higher disease burden.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0244100","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T18:29:01Z","timestamp":1608575341000},"page":"e0244100","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Decreased diarrheal and respiratory disease in HIV exposed uninfected children following vaccination with rotavirus and pneumococcal conjugate vaccines"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5408-4823","authenticated-orcid":true,"given":"Gbolahan","family":"Ajibola","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen M.","family":"Powis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Leidner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7078-9041","authenticated-orcid":true,"given":"Samuel","family":"Kgole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oganne","family":"Batlang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mompati","family":"Mmalane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Makhema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahin","family":"Lockman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Shapiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"volume-title":"Levels & Trends in Child Mortality: Report 2018, Estimates developed by the United Nations Inter-Agency Group for Child Mortality Estimation\u2019","year":"2018","author":"United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME)","key":"pone.0244100.ref001"},{"key":"pone.0244100.ref002","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1186\/s13104-017-2818-z","article-title":"Morbidity and mortality of children aged 2\u201359 months admitted in the Tanzania Lake Zone\u2019s public hospitals: a cross-sectional study","volume":"10","author":"K Lugangira","year":"2017","journal-title":"BMC Res Notes"},{"issue":"1","key":"pone.0244100.ref003","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/2049936117744429","article-title":"The global problem of childhood diarrheal diseases: emerging strategies in prevention and management","volume":"5","author":"M Mokomane","year":"2018","journal-title":"Ther Adv Infectious Dis"},{"issue":"1","key":"pone.0244100.ref004","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.pcl.2015.08.003","article-title":"Prevention and Control of Childhood Pneumonia and Diarrhea","volume":"63","author":"D. 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