Epidemiologic and Genotypic Characteristics of Rotavirus Strains Detected in Children Less Than 5 Years of Age With Gastroenteritis Treated at 3 Pediatric Hospitals in Zimbabwe During 2008–2011

Mukaratirwa, Arnold; Berejena, Chipo; Nziramasanga, Pasipanodya; Shonhai, Annie; Mamvura, Tafadzwa S.; Chibukira, Paradzai; Mucheuki, Isabel; Mangwanya, Douglas; Kamupota, Mary; Manangazira, Portia; Tapfumaneyi, Christopher; Gerede, Regina; Munyoro, Mary; Mwenda, Jason M.; Mphahlele, M. Jeffrey; Seheri, Mapaseka; Peenze, Ina; Gonah, Archebold N.; Maruta, Anna; Tengende, Margaret B.

doi:10.1097/inf.0000000000000050

Cited by 19 publications

(14 citation statements)

References 13 publications

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“…Our findings have shown that 91% of infected children are < 2 years of age with the highest prevalence (44.7%) between 6 -11 months old which is comparable with previous studies in Zimbabwe, Uganda and Nigeria [9][10][11]. This onset of infection correlates very well with the decline of maternally acquired antibodies that disappear around 5 months of age.…”

Section: Discussionsupporting

confidence: 78%

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Prevalence of Rotavirus in Under 5 Year Old Children Hospitalized for Acute Gastroenteritis, Swaziland, 2013 - 2014

Maphalala¹

2017

SJPH

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Abstract:Background: Rotavirus is the most common cause of severe diarrhoea among children < 5 years of age worldwide. To determine the prevalence of severe rotavirus infection in children admitted with acute gastroenteritis attending Mbabane Government Referral Hospital in the Hhohho region and Raleigh Fitkin Memorial (RFM) Hospital in the Manzini Region of Swaziland, sentinel surveillance was conducted in January 2013 -December 2014. Methods: This is hospital based sentinel surveillance study. A total of 331 children under the age of five years with acute diarrhoea that were admitted to the hospitals were enrolled into the sentinel surveillance and 302 cases had stool samples tested for rotavirus antigens by enzyme immunoassay Pro Spec T Rotavirus kit. The G and P genotypes were established by multiplex nested reverse transcription polymerase chain reaction. Results: Rotavirus was detected in 159 (52.6%) of the 302 children with acute diarrhoea that had stool specimens collected and 108 (68%) of positive cases of rotavirus gastroenteritis were between 6-11 months of age and 91% were below the age of two years. Rotavirus infection occurred with peaks between June -August. During the 2013 -2014 period, 146 samples were subjected for reverse transcription polymerase chain reaction and genotyping assays. The most common genotypes detected in Swaziland were 82% G2P [4] in 2013 and 93% G1P [8] in 2014. Conclusion: Swaziland would benefit by introducing rotavirus vaccine and hence reduce the hospitalization burden of managing acute diarrhoea cases attributed to Rotavirus. The data from the sentinel hospitals can also be used to monitor the effectiveness of the vaccine once introduced.

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Section: Discussionsupporting

confidence: 78%

“…In temperate climates, rotavirus diarrhoea is predominantly a winter disease and few or no cases occur other than at the seasonal peak (Ho eta al 1988, LeBaron et al 1990, Ryan et al 1996. Similar findings were reported in Zimbabwe [9] which has a similar temperate climate like Swaziland.…”

Section: Discussionsupporting

confidence: 77%

Prevalence of Rotavirus in Under 5 Year Old Children Hospitalized for Acute Gastroenteritis, Swaziland, 2013 - 2014

Maphalala¹

2017

SJPH

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“…Over the years, this surveillance network has determined which strains are circulating in Africa using the RVA binary classification system by genotyping the two outer capsid proteins (G and P). This method has identified infections containing multiple G and/or P genotypes, as reported from different African countries (Abebe et al, 2014; Boula et al, 2014; Hokororo et al, 2014; Kiulia et al, 2014; Mukaratirwa et al, 2014; Odiit et al, 2014; Pursem et al, 2014; Seheri et al, 2014; Tsolenyanu et al, 2014). Most strains with G1P[8], G3P[8], G4P[8] and G9P[8] G and P genotype combinations usually belong to the Wa-like genogroup because they have a Wa-like genotype constellation (Gx-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1) composed primarily of genotype 1 genes, whereas G2P[4] strains are considered DS-1-like genogroup members because they have a DS-1-like constellation (G2-P[4]-I2-R2-C2-M2-A2-N2-T2-E2-H2) composed of genotype 2 genes (Matthijnssens et al, 2008, 2011; Matthijnssens and Van Ranst, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…In Africa, strain diversity is extensive, and several G and P genotype combinations have been reported from multiple countries. These include, but are not limited to, G1P[6], G1P[8], G2P[4], G2P[6], G3P[6], G8P[6], G9P[8] and G12P[8], as well as mixed/multiple G and/or P types and also stains regarded as untypeable with available primer sets (Abebe et al, 2014; Banga-Mingo et al, 2014; Boula et al, 2014; Hokororo et al, 2014; Kiulia et al, 2014; Mukaratirwa et al, 2014; Odiit et al, 2014; Page et al, 2010; Pukuta et al,2014; Pursem et al, 2014; Seheri et al, 2014; Tsolenyanu et al, 2014). In addition, some studies have also reported the detection of animal or animal-human reassortant strains circulating among humans (Esona et al, 2009, Esona et al, 2010; Jere et al, 2012; 2014; Page et al, 2010; Nyaga et al, 2013; 2014).…”

Section: Introductionmentioning

confidence: 99%

Whole genome detection of rotavirus mixed infections in human, porcine and bovine samples co-infected with various rotavirus strains collected from sub-Saharan Africa

Nyaga

Jere

Esona

et al. 2015

Infection, Genetics and Evolution

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Group A rotaviruses (RVA) are among the main global causes of severe diarrhea in children under the age of 5 years. Strain diversity, mixed infections and untypeable RVA strains are frequently reported in Africa. We analysed rotavirus-positive human stool samples (n=13) obtained from hospitalised children under the age of 5 years who presented with acute gastroenteritis at sentinel hospital sites in six African countries, as well as bovine and porcine stool samples (n=1 each), to gain insights into rotavirus diversity and evolution. Polyacrylamide gel electrophoresis (PAGE) analysis and genotyping with G- (VP7) and P-specific (VP4) typing primers suggested that 13 of the 15 samples contained more than 11 segments and/or mixed G/P genotypes. Full-length amplicons for each segment were generated using RVA-specific primers and sequenced using the Ion Torrent and/or Illumina MiSeq next-generation sequencing platforms. Sequencing detected at least one segment in each sample for which duplicate sequences, often having distinct genotypes, existed. This supported and extended the PAGE and RT-PCR genotyping findings that suggested these samples were collected from individuals that had mixed rotavirus infections. The study reports the first porcine (MRC-DPRU1567) and bovine (MRC-DPRU3010) mixed infections. We also report a unique genome segment 9 (VP7), whose G9 genotype belongs to lineage VI and clusters with porcine reference strains. Previously, African G9 strains have all been in lineage III. Furthermore, additional RVA segments isolated from humans have a clear evolutionary relationship with porcine, bovine and ovine rotavirus sequences, indicating relatively recent interspecies transmission and reassortment. Thus, multiple RVA strains from sub-Saharan Africa are infecting mammalian hosts with unpredictable variations in their gene segment combinations. Whole-genome sequence analyses of mixed RVA strains underscore the considerable diversity of rotavirus sequences and genome segment combinations that result from a complex evolutionary history involving multiple host species.

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“…In Zimbabwe, diarrhea is the second leading cause of childhood deaths, contributing to 10% to 15% of deaths in children <5 years of age in 2015 [1, 4]; rotavirus accounted for 41–56% of acute diarrhea hospitalizations prior to vaccine introduction [5]. In May 2014, the Government of Zimbabwe introduced the 2-dose, oral, monovalent, live attenuated human rotavirus vaccine, Rotarix (GlaxoSmithKline), into its Expanded Programme on Immunization (EPI).…”

Section: Introductionmentioning

confidence: 99%

Reduction in Diarrhea- and Rotavirus-related Healthcare Visits Among Children <5 Years of Age After National Rotavirus Vaccine Introduction in Zimbabwe

Mujuru

Yen

Nathoo

et al. 2017

Pediatric Infectious Disease Journal

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Background: In Zimbabwe, rotavirus accounted for 41%–56% of acute diarrhea hospitalizations before rotavirus vaccine introduction in 2014. We evaluated rotavirus vaccination impact on acute diarrhea- and rotavirus-related healthcare visits in children. Methods: We examined monthly and annual acute diarrhea and rotavirus test-positive hospitalizations and Accident and Emergency Department visits among children <60 months of age at 3 active surveillance hospitals during 2012–2016; we compared prevaccine introduction (2012–2013) with postvaccine introduction (2015 and 2016) data for 2 of the hospitals. We examined monthly acute diarrhea hospitalizations by year and age group for 2013–2016 from surveillance hospital registers and monthly acute diarrhea outpatient visits reported to the Ministry of Health and Child Care during 2012–2016. Results: Active surveillance data showed winter seasonal peaks in diarrhea- and rotavirus-related visits among children <60 months of age during 2012–2014 that were substantially blunted in 2015 and 2016 after vaccine introduction; the percentage of rotavirus test-positive visits followed a similar seasonal pattern and decrease. Hospital register data showed similar pre-introduction seasonal variation and post-introduction declines in diarrhea hospitalizations among children 0–11 and 12–23 months of age. Monthly variation in outpatient diarrhea-related visits mirrored active surveillance data patterns. At 2 surveillance hospitals, the percentage of rotavirus-positive visits declined by 40% and 43% among children 0–11 months of age and by 21% and 33% among children 12–23 months of age in 2015 and 2016, respectively. Conclusion: Initial reductions in diarrheal illness among children <60 months of age, particularly among those 0–11 months of age, after vaccine introduction are encouraging. These early results provide evidence to support continued rotavirus vaccination and rotavirus surveillance in Zimbabwe.

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Epidemiologic and Genotypic Characteristics of Rotavirus Strains Detected in Children Less Than 5 Years of Age With Gastroenteritis Treated at 3 Pediatric Hospitals in Zimbabwe During 2008–2011

Abstract: Rotavirus causes a significant disease burden among children <5 years of age in Zimbabwe. This active surveillance system can serve as a platform to monitor the impact of rotavirus vaccine on disease burden following vaccine introduction.

Cited by 19 publications

References 13 publications

Prevalence of Rotavirus in Under 5 Year Old Children Hospitalized for Acute Gastroenteritis, Swaziland, 2013 - 2014

Prevalence of Rotavirus in Under 5 Year Old Children Hospitalized for Acute Gastroenteritis, Swaziland, 2013 - 2014

Whole genome detection of rotavirus mixed infections in human, porcine and bovine samples co-infected with various rotavirus strains collected from sub-Saharan Africa

Reduction in Diarrhea- and Rotavirus-related Healthcare Visits Among Children <5 Years of Age After National Rotavirus Vaccine Introduction in Zimbabwe

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