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Introduction: Rotavirus vaccine was introduced in Mauritania in December 2014. We investigated hospitalizations with diarrhea during pre and post-vaccination periods among children aged 0-5 years in Nouakchott, the capital of Mauritania., Methods: We conducted a retrospective review of hospital admission registries from November 1st 2012 through October 31th 2017 at all referral hospitals in Nouakchott. We described admissions of children aged 0-5 years by diagnosis, data of admission, age and sex, and compared the proportion of all childhood hospitalizations with diarrhea before and after rotavirus vaccine introduction., Results: In total, 6552 (19%) of all 34,329 hospitalizations in 0-5 year-olds had diarrhea. Of these, 3523/16,952 (20.7%) were recorded during the pre-vaccine period, 1373/6897 (19.9%) during the transition period (November 2014-October 2015), and 1656/10,480 (15.8%) during the post-vaccination period. The proportion of all childhood hospitalizations with diarrhea during the pre-vaccine period was 22.6% among males and 18.7% among females. Approximately one third (32.3%) of hospitalizations with diarrhea occurred in children aged 6-11 months. During the post-vaccination period, the proportion of hospitalizations with diarrhea declined by 24%, and the highest reduction (74%) was observed in children aged 2 to 5 years (P < 0.001)., Conclusions: The proportion of childhood hospitalizations with diarrhea in Nouakchott was reduced by about one fourth after introduction of rotavirus vaccination in Mauritania, indicating a major impact for public health for children in the capital city., (Copyright © 2019 Elsevier Ltd. All rights reserved.)