Epidemiology and burden of rotavirus infection among children in Hangzhou, China

Lou, Jin-Tu; Xu, Xiao‐Jun; Wu, Yidong; Tao, Ran; Tong, Meiqin

doi:10.1016/j.jcv.2010.10.003

Cited by 18 publications

(14 citation statements)

References 16 publications

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“…This result was similar to other studies conducted previously in China 4,5 as well as other countries prior to the introduction of rotavirus vaccination. 11,12 However, a different pattern was observed in USA, which introduced a rotavirus vaccination program in 2006, resulting in an expected sharp decline in prevalence of rotavirus , consequentially allowing norovirus to become the most predominant enteropathogen in children aged <5 years.…”

Section: Discussionsupporting

confidence: 92%

Etiology of diarrhea among children under the age five in China: Results from a five-year surveillance

Jing

Lai

et al. 2015

Journal of Infection

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Summary Objectives Diarrhea is a leading cause of morbidity and mortality for children, although sparse data is available on the etiology of diarrhea in China. This study was conducted to determine main causes that underlie childhood diarrhea and related diseases. Method Surveillance data for diarrhea was collected from 213 participating hospitals between 2009 and 2013. These stool specimens, from children aged 0e59 months, were then analyzed for a panel of etiological agents consisting of 5 viruses, 8 bacteria and 3 protozoa. The proportion of children who tested positive for each pathogen was calculated and seasonal patterns for major organisms were determined. Results Pathogens were identified in 44.6% of the 32,189 samples from children with diarrhea. The most commonly detected pathogens were rotavirus (29.7% of cases), norovirus (11.8%), Diarrheagenic Escherichia coli (DEC; 5.0%), adenovirus (4.8%), non-typhoidal Salmonella (NTS; 4.3%), and Shigella spp. (3.6%). A strong seasonal pattern was observed for these organisms, including rotavirus (winter), norovirus (autumn), and DEC, NTS, and Shigella (summer). Conclusion: A wide range of enteropathogens were detected in this five-year surveillance study; rotavirus and norovirus were most common among children under the age five. These findings should serve as robust evidence for public health entities when planning and developing national intervention programs in China.

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Section: Discussionsupporting

confidence: 92%

Etiology of diarrhea among children under the age five in China: Results from a five-year surveillance

Jing

Lai

et al. 2015

Journal of Infection

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“…10 Our rates were lower than Hangzhou of China (21/10,000) during 2007–2008 from a hospital-based study, 12 and lower than Hong Kong of China (20/10,000) during 1987–1996. 13 The inpatient rate (24/10,000) associated with rotavirus AGE in the subset of children younger than 3 years in our study was similar (22.5/10,000) to that found for children of this age in the United States during the last year before widespread use of rotavirus vaccines there, 2006. 9 …”

Section: Discussionsupporting

confidence: 84%

“…3,7 The rotavirus test-positive proportion (28.2%) of hospitalized children in Beijing Municipality decreased 20% compared with 36% during 2003–2007 3 and this was lower than the prevalence found in Morocco and Japan (44–56%) 14,15 and was higher than that observed in Hong Kong. 13 …”

Section: Discussionmentioning

confidence: 99%

Active, Population-based Surveillance for Rotavirus Gastroenteritis in Chinese Children

Zhang

Liu

Jia

et al. 2015

Pediatric Infectious Disease Journal

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Background Estimates of population-based incidence for rotavirus inpatient and outpatient visits, as well as their associated medical costs, can provide valuable information to assess the potential benefits of rotavirus vaccination. Methods We conducted active surveillance for rotavirus gastroenteritis at 6 medical institutions for children younger than 5 years from July 2012 to June 2013 in Beijing Municipality and Gansu Province. We collected stool samples of diarrhea patients for testing rotavirus, and epidemiological, clinical and cost data. Results The proportion of rotavirus-positive for inpatient and outpatient visits from Beijing was 28.7% (138/481) and 19.4% (133/687); a statistically lower proportion than observed in Gansu among inpatient visits (45.2%, 245/542, P < 0.001) and among outpatient visits (28.8%, 66/229, P = 0.003), respectively. The G9P[8] genotype was most prevalent in Beijing (60.6%) and in Gansu (77.6%). The median Vesikari scale value was 16 for rotavirus inpatients and 15 for nonrotavirus inpatients. Population-based estimated rates of rotavirus-related hospitalizations were 14.4 (95% CI, 13–16) per 10,000 children, and the rate of rotavirus gastroenteritis in the outpatient setting was 149 (95% CI, 145–153) per 10,000 children younger than 5 years. The estimated total number of rotavirus-related inpatient visits were 3790 (95% CI, 2488–3827) cases and 29,101 (95% CI: 27,748–29,279) outpatient visits. The total cost of rotavirus infection was $1.4 million (95% CI, $0.9–1.4 million) for hospitalizations and $4.2 million (95% CI, $4.0–4.2 million) for outpatient visits per year in Beijing and Gansu. Conclusion Rotavirus gastroenteritis is associated with a large disease burden in Chinese children younger than 5 years in Beijing and Gansu. Rotavirus is the most common cause of severe acute gastroenteritis (AGE) in children younger than 5 years worldwide, accounting for an estimated 25 million clinic visits, 2 million hospitalizations and 453,000 deaths each year.1,2 In China, the world’s most populous nation, surveillance at sentinel hospitals showed that approximately 48% of AGE hospitalizations among children younger than 5 years were attributed to rotavirus from 2003 to 2007, and 13,387 rotavirus deaths were estimated in China in 2002 alone.3,4 The Lanzhou lamb rotavirus vaccine, consisting of serotype G10P[12], was licensed in 2000 but is not included in the National Expanded Program of Immunization vaccine recommendations for Chinese children.5 License applications for new rotavirus vaccines (Rotarix, produced by GlaxoSmithKline Biologicals, and RotaTeq, produced by Merck and Company) have been submitted for administering these vaccines to Chinese infants.

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“…This result was higher than that of in children hospitalized in Lanzhou (5.1%) in the same period [Wang et al, ]. AsV was isolated in 5.52% to 9.26% of cases from 2009 to 2013 and did not differ from previous study in children hospitalized in Lanzhou city [Ye et al, ; Jin et al, ; Lou et al, ]. HuCV have been recognized as second‐most common causative agent after rotavirus, accounting for 4–19% of episodes of severe gastroenteritis in young children [Podewils et al, ].…”

Section: Discussionmentioning

confidence: 58%

“…It implies that traditional measures used to improve hygiene and sanitation may not prevent the enteric viral infection significantly. To explore the effective prevention and control strategies of viral agents‐induced diarrhea, the pathogens’ epidemiology of viral infections has been examined in some studies based on hospitalization and outpatients’ surveillance [Duan et al, ; Lou et al, ; Ouyang et al, ; Tseng et al, ; Chen et al, ; Lu et al, ; Yu et al, ; Zhang et al, ].…”

Section: Introductionmentioning

confidence: 99%

Etiological epidemiology of viral diarrhea on the basis of sentinel surveillance in children younger than 5 years in Gansu, northwest China, 2009-2013

Liu

Meng

et al. 2015

J. Med. Virol.

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To explore the etiological spectrum of diarrhea and its epidemiological characteristics in diarrhea symptoms surveillance cases younger than 5 years from 2009 to 2013 in Gansu province, northwest China. Systematic diarrhea symptoms surveillance were conducted in 27 sentinel sites in Gansu province and outpatients with three or more loose, watery, or sticky pus stools per day were defined as surveillance cases. All stool specimens were tested for Rotavirus, Human calicivirus, Adenovirus, and Astrovirus. Totally, 1,119 cases (51.54%) were identified as any enteric virus. The average isolation rate of Rotavirus was 51.13%, Astrovirus was 10.84%, Adenovirus was 6.94%, and Human calicivirus was 6.60% (P < 0.01). Rotavirus was identified with the highest frequency among these enteric pathogens except in 2011, with a notable downward trend over time (P < 0.01). Rotavirus A was the most proportion in rotavirus, G3P[8] and G9P[8] were the most common combination. Rotavirus mixed Human calicivirus infections was the most common mixed infected patterns. Viral-positive rate was higher among children aged group of 0-12 and 13-24 months (P < 0.01, respectively). The isolation rates of four enteric viral pathogens showed a similar distinct seasonal variation with a higher rate in spring, autumn, and winter months. Rotavirus was the major epidemiological viral pathogen in diarrhea symptom surveillance cases in Gansu province, northwest China, during period 2009-2013. Seasonal and age-related variations were observed in enteric viral pathogen isolation rate. The comprehensive and continuous surveillance is needed to identify the prevalence of different enteric viral pathogens.

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Epidemiology and burden of rotavirus infection among children in Hangzhou, China

Cited by 18 publications

References 16 publications

Etiology of diarrhea among children under the age five in China: Results from a five-year surveillance

Etiology of diarrhea among children under the age five in China: Results from a five-year surveillance

Active, Population-based Surveillance for Rotavirus Gastroenteritis in Chinese Children

Etiological epidemiology of viral diarrhea on the basis of sentinel surveillance in children younger than 5 years in Gansu, northwest China, 2009-2013

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