Prevalence and genetic diversity of rotavirus infection in children with acute gastroenteritis in a hospital setting, Nairobi Kenya in post vaccination era: a cross-sectional study

Introduction: Rotavirus is the leading cause of severe diarrhoea among infants and young children. Each year more than 611 000 children die from rotavirus gastroenteritis, and two million are hospitalized, worldwide. In Kenya, the impact of recent rotavirus vaccinations on morbidities has not been estimated. The study aimed at determining the prevalence and identity of rotavirus strains isolated from rotavirus-associated diarrhoea in vaccinated children presenting with acute gastroenteritis.Methods: Two hundred and ninety eight specimen from children presented at Gertrude Childrens' Hospital from January to June 2012 were tested by EIA (Enzyme-linked Immunosorbent Assay) for rotavirus antigens. Molecular characterization was conducted on rotavirus-positive specimens. Extracted viral RNA was separated by polyacrylamide gel electrophoresis (PAGE) and the specific rotavirus VP4 (P-types) and VP7 (G-types) determined.Results: The prevalence rate of rotavirus was 31.5% (94/298). Of the rotavirus dsRNA, 57 (60.1%) gave visible RNA profiles, 38 (40.4%) assigned long electropherotypes while 19 (20.2%) were short electropherotypes. The strains among the vaccinated were G3P [4], G12P [6], G3P [6], G9P [4], G mixed G9/3P [4] and G1/3P [4]. Specifically, the G genotypes were G9/3 (5.3%), G9 (4.3%), G3 (4.3%), G12 (2.1%) and mixed G1/3 (1.1%). The P genotypes detected were P [4] (5.3%) and P [6] (5.3%).Conclusion: The present study demonstrates diversity in circulating genotypes with emergence of genotypes G3, G9, G12 and mixed genotypes G9/3 and recommends that vaccines should be formulated with a broad range of strains to include G9 and G12

Prevalence of rotavirus among children under five years of age with diarrhea in Kaduna State, Nigeria

Rotavirus (RV) is a major etiological agent of acute infantile gastroenteritis and is associated with 20%-25% of diarrhea cases in infants. Nigeria continues to be among the first five countries with greatest number of RV disease associated deaths per year. The objective was to determine some demographic factors that might be associated with rotavirus diarrhea among children in Kaduna State. From September 2013-August 2014, 401 diarrheic stool samples were collected from children under 5 years of age in Kaduna State, Nigeria and analyzed for RV antigen using ELISA. An overall RV prevalence of 32.2% (129/401) was obtained with the infection occurring throughout the study period. The infection was higher in males (33.0%:63/111) compared to females (31.4%:66/210). The highest burden was detected in children 25 -36 months of age (37.3%:22/59). Highest prevalence was detected in children whose parents had primary education (35.8%:19/53) and those whose parents were civil servants (35.6%:36/101). There was no statistically significant association between breast feeding and RV infection (P> 0.05). The study has revealed that rotavirus remains an important cause of acute diarrhea in children under five years in Kaduna State, Nigeria. Hence the need to introduce the vaccines into the childhood immunization program in the country

Rotavirus Disease Burden in Africa and the Need to Accelerate Introduction of Vaccines

It is important to establish the burden of rotavirus disease before and after the introduction of a rotavirus vaccine. Regional effortshave focused on building an unequivocal evidence base for rotavirus diarrhoea to support decisionmaking and sustained investment in new vaccine introduction. WHO recommends routine use ofrotavirus vaccines in all countries; particularlyin those with high mortality attributable todiarrhoeal disease. In countries where diarrhoeal deaths account for more than 10 of mortality inchildren aged under five years; the introduction of the vaccine is strongly recommended. This article reviews the available literature and summarizesthe estimated number of deaths in children underfive years attributable to rotavirus diarrhoea in the WHO African Region. Based on the available data; it can be concluded that the rotavirus disease burden is very high and that the introduction of rotavirus vaccines should be accelerated in the Region

Surveillance for Diseases Targeted by new Vaccines: Progress; Challenges and Way Forward

Thirteen years ago; WHO-AFRO proposed the establishment of a sentinel disease surveillance network as part of efforts to improve surveillance for invasive bacterial diseases (IBD) including paediatric pneumonia and meningitis and rotavirus diarrhoea in all Member States as part of surveillance for vaccine-preventable diseases and in line with the regional strategy integrated disease surveillance and response (IDSR). This was prompted by the eminent availability of new and prospective vaccines against Haemophilus influenzae type b (Hib); Streptococcus pneumoniae (S. pneum); Neisseria meningitides (Nm) and rotavirus vaccines. The Regional Office for Africa developed guidelines and tools and standardized methodology; including cases definitions to be used to recruit eligible cases. This article outlines the challenges and results of this initiative to date and aims for the future

Rotavirus Gastroenteritis Surveillance and Prevalence Assessment among Under Five Children in Rwanda

Rotavirus remains the most common cause of severe childhood diarrhea worldwide and of diarrheal mortality in developing countries. Despite the efforts made by the government of Rwanda and the stakeholders to reduce children mortality; the prevalence of rotavirus among under five children in Rwanda remains to be determined. We conducted a hospital-based cross-sectional study that aimed at determining the prevalence of rotavirus infection in under fie children presenting with gastroenteritis in eight hospitals in Rwanda. From June 2013 and August 2014 we collected and tested stool samples for the presence ofrotavirus using an enzyme immunoassay and a Real Time-Polymerase Chain Reaction for genotyping. In 969 stool samples; 232 (23.94 and 5.1) while the lowest one was observed in March (0.00). Muhima Hospital had the highest prevalence (33.33) whereas Kabgayi and Rwamagana Hospitals had the lowest (15.62 and 18.18; respectively). Male children were more affected than females (25.8 versus 21.5). We found that the prevalence was higher (31.10) in children aged between 12 and 24 months than in other age groups. For genotyping; G9 [P8] was the most prevalent genotype as G9 prevalence was 54.6 whereas [P8] prevalence was 73.9.In conclusion; the prevalence of rotavirus gastroenteritis was high among children aged less than 5 years; and it was different according to age groups and among different hospitals

Clinical Features of Rotavirus Infections : Influence of Child Age on Clinical Manifestations

Objectifs : Decrire les caracteristiques cliniques des infections a Rotavirus et comparer les symptomes observes en fonction de l'age des enfants. Malades et methodes : Les dossiers cliniques de 278 enfants de moins de 5 ans infectes par le Rotavirus ont ete consultes retrospectivement. La presence d'antigenes de Rotavirus du groupe A dans les selles a ete detectee par la technique immunoenzymatique. Une correlation statistique entre les signes cliniques et l'age des enfants a ete recherchee au moyen des tests de correlation de Pearson. Resultats : Parmi les 278 enfants positifs a Rotavirus; 93;9ont presente une diarrhee; 79;1des vomissements; 71;6de la fievre; 37;4des signes respiratoires et 33;1des troubles neurologiques. Une rehydratation intraveineuse requise pour 59;7des enfants. D'une facon generale; la diarrhee (p = 0;001); les vomissements (p = 0;007); la fievre (p=0;045); les troubles respiratoires (p = 0;01) et la deshydratation (p 0;001) etaient significativement plus frequents chez les nourrissons de 1-24 mois par rapport aux autres enfants infectes. Conclusion : La severite du syndrome clinique induit par les infections a Rotavirus semble etre directement influencee par l'age de l'enfant. Il etait interessant de noter que les nourrissons de 1 a 5 mois ont presente des formes cliniques souvent aussi severes que ceux de 6 a 24 mois

Rotavirus infection in four states in north-western Nigeria

Background: Rotaviruses are associated with 611;000 deaths worldwide and with 33;000 deaths in Nigeria in children 5 years of age annually. However; limited data exit on rotavirus (RV) infection in North-western Nigeria. This study surveyed RV infection in four states in Northwestern Nigeria. Methods: During July 2002 to July 2004; 1063 (869 diarrhoeic and 194 control) stool samples were collected from children 0.05). The highest RV burden was detected in children aged below six months. The infection occurred throughout the study period. The most common clinical features associated with RV were fever (71);vomiting (64.1) and a combination of fever and vomiting (48.2). Vomiting was strongly associated with RV (p 0.01). There was a statistically significant association between food type and rotavirus infection (p 0.05); with the highest prevalence occurring amongst children exclusively breast-fed. The majority of the RV positive samples revealed long electropherotypes and VP6 subgroup I + II specificity. Conclusion: Rotavirus was shown to be an important cause of diarrhoea in children 0-5 years of age in Northwestern Nigeria. An effective vaccine would therefore need to be administered at birth for children in the study area since there is no effective way to completely eliminate rotavirus infection other than vaccination. There is also a need for additional studies in Nigeria to provide data required to hasten vaccine introduction

Etude epidemio-clinique des diarrhees aigues a rotavirus chez les nourrissons a l'hopital Jason Sendwe de Lubumbashi; Republique Democratique du Congo

Introduction: le rotavirus est un probleme de sante publique; non seulement dans les pays en developpement ou tous les enfants sont infectes avant l'age de deux a trois ans mais aussi dans les pays developpes ou les conditions d'hygiene sont bonnes. La presente etude est la premiere a fournir des informations sur la prevalence de l'infection a rotavirus dans les diarrhees aigues des nourrissons dans la ville de Lubumbashi. Elle s'est fixee comme objectifs de determiner la frequence hospitaliere ainsi que la saisonnalite; les caracteristiques sociodemographiques; cliniques et evolutives de l'infection a Rotavirus chez les nourrissons admis a l'hopital Jason Sendwe de Lubumbashi pour une diarrhee aigue. Methodes: il s'agit d'une etude descriptive et transversale menee pendant la periode allant du 1er janvier au 31 decembre 2012. Les parametres epidemio-cliniques et evolutifs (age; sexe; saison; signes cliniques; nombre journalier de selles et evolution) des enfants diagnostiques positifs au rotavirus ont ete compares a ceux des enfants dont le test au rotavirus etait negatif. Le degre de signification etait de 5%. Resultats: nous avons recolte 193 cas de diarrhees aigues dont 104 nourrissons etaient infectes par le rotavirus soit 53;8%. Des taux eleves des diarrhees a rotavirus sont enregistres au cours de la saison seche comparativement a la saison des pluies (p0;05). La comparaison des moyennes d'age et celle des proportions d'enfants d'age inferieur ou egal a 12 mois sont statistiquement significatives entre le groupe de diarrhees a rotavirus et celui de diarrhees dues aux autres micro-organismes (p0;05). Le sexe feminin ainsi que les signes d'accompagnement de la diarrhee (vomissements; fievre et lethargie) ne donnent pas de difference statistique entre les deux groupes (p0;05). Par ailleurs; les enfants infectes par le rotavirus etaient 6 fois plus susceptibles de presenter une deshydratation moderee/severe (p0;02). Nous avons enregistre un deces (1% des cas) chez les enfants infectes par le rotavirus et aucun deces chez ceux non infectes par le rotavirus (p0;05). Conclusion: le rotavirus est confirme dans la ville de Lubumbashi et touche souvent les enfants d'age ?12 mois; pendant la saison seche sans distinction de sexe et conduit rapidement a une deshydratation moderee/severe. Une prise en charge adaptee et precoce permet d'eviter les deces et l'assainissement du milieu; le lavage des mains; la prise d'eau potable et la vaccination contre le rotavirus sont les mesures preventives les plus efficaces contre les rotavirus et a conseiller dans notre communaute

Epidemiology of rotavirus and astrovirus infections in children in Northwestern Nigeria

Background: Recent estimates attribute 527 000 deaths in children less than five years of age to rotavirus diarrhea annually, with 145 000 occurring in sub-Saharan Africa. Human astroviruses have been identified as one of the most frequent causes of infantile diarrhea, second in incidence only to rotavirus. This study was conducted to determine the prevalence of rotavirus and astrovirus and also to establish the circulating strains of rotavirus in a community in Nigeria where most diarrheic patients do not visit clinics or health care centers. Methods: A total of 154 stool samples (134 diarrheic and 20 non-diarrheic) were collected from infants and young children less than 5 years of age from January-March 2002. Samples were obtained by house-to-house visit in randomly selected districts in Zaria, Northwestern Nigeria. The samples were screened for rotavirus and astrovirus antigens using commercially available Enzyme Linked Immunosorbent Assay (ELISA) kits. All positive group A rotavirus samples were further subjected to VP6 sub-group ELISA, Polyacrylamide gel electrophoresis (PAGE) to determine their RNA electropherotypes and Reverse transcription polymerase chain reaction (RT-PCR) to determine their VP7 and VP4 genotypes. Results: Rotavirus and astrovirus antigens were detected in 9% (12) and 5% (7) of the 134 diarrheic stool samples respectively. No viral antigen was detected in the non-diarrheic stools. Rotavirus infection was more common in younger children than astrovirus infection. VP6 sub-group II specificity (58.3%), long RNA electropherotypes (41.6%), VP7 genotype G1 (33.3%) and VP4 genotype P [6] (33.3%) were the most common strains in circulation at that time in the community. Of significance is the fact that a large proportion of the rotavirus strains in circulation could not be assigned either a VP6 subgroup or RNA electrophoretic pattern probably as a result of low viral load. Conclusion: In this community-based study, rotavirus and astrovirus were significantly associated with diarrhea. However, the prevalence of rotavirus infection among children appears to be low while that of astrovirus falls in the range seen in hospital-based studies around the continent

Electropherotypes and Subgroups of Group A Rotaviruses Circulating among Diarrhoeic Children in Kano; Nigeria

Background: It is estimated that about 600?000 children die annually as a result of severe dehydrating diarrhea caused by rotaviruses. The virus is a double stranded RNA (dsRNA) virus with 11 segments. Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups; I and II exist. This work was carried out to study the prevalence of rotavirus infection among children 0-5 years with diarrhea in Kano; and to determine the circulating subgroups and electropherotypes and of the rotavirus isolates. Methods: Two hundred and eighteen stool specimens from children 0-60 months (198 diarrheic and 20 non-diarrheic) were collected from different hospitals and health care centers in Kano and subjected to group A rotavirus enzyme linked immunosorbent assay (ELISA) to determine presence of group A rotavirus; subgroup ELISA to determine the VP6 subgroups and polyacrylamide gel electrophoresis (PAGE) to determine the electropherotypes present. Results: The long electropherotypes (47.05) of four variations dominated over the short electropherotype (17.64). About 11.76of the isolates were of mixed infection. Dominance of subgroup II (45) over subgroup I (25); and the presence of both subgroups I and II (10) and neither subgroup I nor II (15) was observed in this study. Conclusion: Information on the genomic diversity of the RNA electropherotypes in this region; Kano; is reported in this study