Thus, WHO could not recommend their inclusion into national immunization programs until safety and efficacy were demonstrated in Asia and Africa [1]. Consequently, large multi-center randomized, double-blinded, placebo controlled trials were designed and implemented for each new vaccine [14] and [15]. Among the sites in five countries (3 in Africa and 2 in Asia) participating in two PRV trials, HIV seroprevalence

was high only in the Kenya site, with 14.9% in adults 15–49 years old being infected with HIV (2007) [16]. In this report, we evaluate the safety of PRV among participants in Kenya with respect to (1) all serious adverse inhibitors events (SAE) that occurred

within 14 days LY2157299 concentration of any vaccination, and intussusception cases, deaths and vaccine-related SAEs throughout the study; and (2) all adverse events following immunizations (AEFI) with attention to vomiting, diarrhea, and elevated temperature for a subset of subjects (“intensive safety surveillance”) followed for 42 days following each dose. We also assessed serious and non-serious adverse events for a limited number of participants that were identified to be HIV-infected or selleck compound HIV-exposed, which is the first systematic evaluation of PRV in HIV-infected and -exposed infants. The PRV Phase 3 safety and efficacy trial in Kenya was conducted in Karemo division, Nyanza province, Western Kenya; Kenya was one of three sites in the multicenter trial conducted in Africa (the other two were in Mali and Ghana). A second safety and efficacy trial was conducted in Bangladesh and Vietnam [14] and [15]. In addition to a high prevalence of HIV/AIDS [16], Karemo is endemic for malaria [17] and high levels of malnutrition [18]. Consequently, Karemo also has among the highest rates of infant, child and maternal mortality rates in Kenya. According to the KEMRI/CDC Health and Demographic Surveillance System (HDSS), in Karemo in 2008, the infant mortality ratio was 107/1000 live births,

the under five mortality ratio was 203/1000 live births and the maternal ADAMTS5 mortality ratio was 600 per 100,000 live births [17]. The Phase III trial study design has been described elsewhere [14] and [15]. In brief, a double-blind, placebo controlled, randomized phase III trial of PRV was conducted from 2007 to 2009. In Kenya, the trial was conducted from July 7, 2009 through September 30, 2009. Healthy infants aged 4–12 weeks were eligible for enrollment. Enrollment of infants with clinical evidence of any acute infection or febrile illness including active gastrointestinal disease (i.e., vomiting, diarrhea, elevated temperature) was delayed until these symptoms resolved.