Burden and Epidemiology of Rotavirus Diarrhea in Selected African Countries: Preliminary Results from the African Rotavirus Surveillance Network

Abstract

Severe rotavirus diarrhea in children <5 years of age is a major public health problem; however, limited regional and country specific data on rotavirus disease burden are available from sub-Saharan Africa. In June 2006, the World Health Organization Regional Office for Africa initiated rotavirus surveillance in selected African countries. With use of standardized methodology developed by the World Health Organization, children <5 years of age who were hospitalized with severe diarrhea were enrolled, and stool specimens were collected for detection of rotavirus strains with use of a commercial enzyme immunoassay. Rotavirus strains were further characterized for G and P types with use of a reverse-transcriptase polymerase chain reaction. From June 2006 through December 2008, rotavirus surveillance was established at 14 sites in 11 African countries. Of 5461 stool samples collected from children enrolled in 8 countries with 1 or 2 complete years of data, 2200 (40%) were positive for rotavirus. Ninety percent of all rotavirus hospitalizations occurred among children aged 3-12 months. Predominant types included G1P[8] (21%), G2P[4] (7%), and P [8] (29%); however, unusual types were also detected, including G8P[6] (5%), G8P[8] (1%), G12P[6] (1%), and G12P[6] (1%). A high percentage of mixed rotavirus infections was also detected. These preliminary results indicate that rotavirus is a major cause of severe diarrheal disease in African children.

Selected Enteropathogens and Clinical Course in Children Hospitalized with Severe Acute Gastroenteritis in Barbados

“…(19)(20)(21)(22)(23) This report clearly raises the question about the preponderance of Rotavirus as an enteropathogen in severe form of infectious AGE in the Caribbean. The findings in the study are supported by the findings from a recently published population based study by of the AGE in Barbados.…”

An ensemble approach to predicting the impact of vaccination on rotavirus disease in Niger

“…This is analogous to the dynamics of specific influenza strains, which are commonly inferred from non-specific time series surveillance of influenza-like illness (ILI) that includes infection by multiple influenza strains (influenza A and B), as well as additional viral infections, for example parainfluenza, coronavirus, rhinovirus [35,10]. In sub-Saharan Africa, the cause of diarrheal disease is often unknown due to a lack of diagnostic capacity [28]. Even when the cause of disease is known, an unknown fraction of cases will occur in the community and never be recorded by the health system, leading to a potentially significant level of under-reporting.…”

Prevalence of severe acute rotavirus gastroenteritis and intussusceptions in Ghanaian children under 5 years of age

“…The majority of these deaths occur in developing countries [1,2]. Rotavirus causes about 30-50% of diarrheal diseases in young children and the prevalence of severe rotavirus disease has remained high [3,4] despite improvements in sanitation. An explanation for this may be that improved hygienic practices and oral rehydration therapy have resulted in a greater decline of hospitalization from bacterial and parasitic diarrheal diseases than hospitalization from rotavirus disease [5,6].…”

“…The World Health Organization (WHO) recommends that countries conduct local surveillance studies prior to the introduction of new vaccines [3,15]. We report on the prevalence of severe rotavirus AGE, common rotavirus genotypes, and intussusceptions in Ghanaian children younger than five years old.…”