ABSTRACT
BACKGROUND: Rotavirus is the leading cause of acute watery diarrhoea among children and is vaccine preventable. The aim of this hospital-based sentinel surveillance was to study the prevalence, demographic and clinical characteristics of rotavirus infections and to describe rotavirus genotype distribution patterns among children under five years of age hospitalized for acute watery diarrhea during the period of 2009-2016. METHODS: Prospective, sentinel hospital-based surveillance was conducted in Lady Ridgeway Hospital (LRH) from 2009 to 2016. Stool samples of children admitted with acute watery diarrhea were tested by rotavirus antigen detection 'ProSpecT' Enzyme Immunoassay (EIA) at Department of Virology, Medical Research Institute, Colombo. Specimens that tested positive for rotavirus were further analyzed at the Regional Reference Laboratory (RRL) participating in the World Health Organization (WHO)-coordinated Global Rotavirus Surveillance Network (GRSN) to determine the genotype of strains by reverse-transcriptase polymerase chain reaction. RESULTS: Of the 6090 children with diarrhea admitted, 1801 (29.5%) had stools taken and tested. In years with at least 11â¯months of data (2010 and 2013) rotavirus was detected in 36.5% (228/624) of specimens. Genotype G1P[8] was the most common genotype detected throughout the surveillance period (30.1%; 123/408) with G2P [8], G9P[8] and G3P[8] also detected. CONCLUSIONS: Rotavirus is a common cause of pediatric diarrhea hospitalizations in Sri Lanka. National introduction of rotavirus vaccine could reduce the burden of pediatric diarrhea.
Subject(s)
Diarrhea/epidemiology , Hospitalization/statistics & numerical data , Rotavirus Infections/epidemiology , Sentinel Surveillance , Acute Disease , Antigens, Viral , Case-Control Studies , Child, Preschool , Diarrhea/virology , Enzyme-Linked Immunosorbent Assay , Feces/virology , Female , Gastroenteritis/epidemiology , Gastroenteritis/virology , Genotype , Humans , Infant , Infant, Newborn , Male , Prevalence , Prospective Studies , RNA, Viral/genetics , Rotavirus/genetics , Rotavirus/isolation & purification , Sri Lanka/epidemiologyABSTRACT
Fifty years after narrowly missing the opportunity to eliminate malaria from SriLanka in the 1960s, the country has now interrupted malaria transmission andsustained this interruption for more than 12 months – no indigenous malariacases have been reported since October 2012. This was achieved through aperiod overlapping with a 30-year separatist war in areas that were endemic formalaria. The challenge now, of sustaining a malaria-free country and preventingthe reintroduction of malaria to Sri Lanka, is examined here in the context of rapidpostwar developments in the country. Increased travel to and from the country toexpand development projects, businesses and a booming tourist industry, and theinflux of labour and refugees from neighbouring malarious countries combine withthe continued presence of malaria vectors in formerly endemic areas, to makethe country both receptive and vulnerable to the reintroduction of malaria. Theabsence of indigenous malaria has led to a loss of awareness among the medicalprofession, resulting in delayed diagnosis of malaria despite the availability ofan extensive malaria diagnosis service. Highly prevalent vector-borne diseasessuch as dengue are competing for health-service resources. Interventions thatare necessary at this critical time include sustaining a state-of-the-art surveillanceand response system for malaria, and advocacy to maintain awareness amongthe medical profession and at high levels of government, sustained funding for theAnti-Malaria Campaign and for implementation research and technical guidanceon elimination. The malaria-elimination effort should be supported by rigorousanalyses to demonstrate the clear economic and health benefits of eliminatingmalaria, which exceed the cost of a surveillance and response system. An annualWorld Health Organization review of the programme may also be required.
