Blood samples were collected from 147 (98%) participants 14 days post dose 3 for the immunogenicity evaluation of PRV (Table 2). The results of efficacy and immunogenicity have been reported previously [21]. During the study, 39 SAEs, including 6 deaths, occurred among study participants

and there were no deaths due to gastroenteritis. The most common SAEs were pneumonia (Table 3). PRV/placebo was received 8 times from the sponsor, and stool/blood was shipped to the sponsor 18 times. PRV/placebo was stored initially in the cold room at the ICDDR, B Dhaka and transferred to Matlab from time to time IOX1 (17 times). From Matlab, the vaccine was taken to the field in cold boxes. The temperature of the PRV/placebo was monitored continuously during each shipment, during storage in Dhaka and Matlab, and during transport to the field. There were no excursions of temperature during storage and transportation of vaccine at any time. This clinical trial was the first Phase III efficacy study of a rotavirus vaccine conducted in Bangladesh. It involved identifying all infants who were eligible to receive vaccine at a very early age from this demographically defined population, obtaining written informed consent form a parent, providing

vaccine on schedule along with the other standard EPI vaccines, collection of blood samples from a sub-set for determination of immunogenicity and maintaining clinical surveillance for gastroenteritis Afatinib manufacturer among the study

participants in the entire study area over an extended period of time. It also included follow up of subjects in their homes or through telephone (when mothers were away due to social visit), and collection of stool specimens when they reported to the diarrhoea treatment centres. All of these activities were conducted following procedures consistent with good clinical practices. While this type of study has been carried out in other developing countries, the study in Bangladesh was notable that all children were enrolled from an area where there is an ongoing HDSS, 99.6% those of the participants completed follow up for at least one year, and 99.9% of the required stool specimens were actually collected. (The one missed stool sample occurred when a child was re-hospitalized and it was not clear if this was a separate episode.). However, some children (about 10%) were not enrolled in the study as their mothers reported that they could not be available during follow up period. This was possible because the availability of the participants could be known beforehand with the support of the existing HDSS and is important for any vaccine trial because availability of the participants for follow up is crucial for vaccine efficacy assessment. Also, the cold chain was consistently maintained for the vaccine, and all SAEs were reported on time as required.