Is rotavirus still a major cause for diarrheal illness in hospitalized pediatric patients after rotavirus vaccine introduction in the Saudi national immunization program?

Hegazi, Moustafa Abdelaal; Sayed, Mohamed H.; Sindi, Haifa Hasan; Bekhit, Osama; El-Deek, Basem; Alshoudri, Faisal M. Yaqoub; Noorelahi, Amroo Khaled

doi:10.1097/md.0000000000006574

Cited by 14 publications

(9 citation statements)

References 30 publications

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“…The number of rotavirus infections was lowest in patients <3 months of age, presumably because of the presence of maternal antibodies from breastfeeding. As found in our study, male patients have been reported as more likely to be affected with rotavirus acute gastroenteritis [57][58][59]. Similar to the findings in the countries of the Indian subcontinent [11,34], the G12 detected in Sabah were in combination with P [6].…”

Section: Plos Onesupporting

confidence: 89%

Emergence of equine-like G3 strains as the dominant rotavirus among children under five with diarrhea in Sabah, Malaysia during 2018–2019

et al. 2021

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Rotavirus infection is a dilemma for developing countries, including Malaysia. Although commercial rotavirus vaccines are available, these are not included in Malaysia’s national immunization program. A scarcity of data about rotavirus genotype distribution could be partially to blame for this policy decision, because there are no data for rotavirus genotype distribution in Malaysia over the past 20 years. From January 2018 to March 2019, we conducted a study to elucidate the rotavirus burden and genotype distribution in the Kota Kinabalu and Kunak districts of the state of Sabah. Stool specimens were collected from children under 5 years of age, and rotavirus antigen in these samples was detected using commercially available kit. Electropherotypes were determined by polyacrylamide gel electrophoresis of genomic RNA. G and P genotypes were determined by RT-PCR using type specific primers. The nucleotide sequence of the amplicons was determined by Sanger sequencing and phylogenetic analysis was performed by neighbor-joining method. Rotavirus was identified in 43 (15.1%) children with watery diarrhea. The male:female ratio (1.9:1) of the rotavirus-infected children clearly showed that it affected predominantly boys, and children 12–23 months of age. The genotypes identified were G3P[8] (74% n = 31), followed by G1P[8] (14% n = 6), G12P[6](7% n = 3), G8P[8](3% n = 1), and GxP[8] (3% n = 1). The predominant rotavirus circulating among the children was the equine-like G3P[8] (59.5% n = 25) with a short electropherotype. Eleven electropherotypes were identified among 34 strains, indicating substantial diversity among the circulating strains. The circulating genotypes were also phylogenetically diverse and related to strains from several different countries. The antigenic epitopes present on VP7 and VP4 of Sabahan G3 and equine-like G3 differed considerably from that of the RotaTeq vaccine strain. Our results also indicate that considerable genetic exchange is occurring in Sabahan strains. Sabah is home to a number of different ethnic groups, some of which culturally are in close contact with animals, which might contribute to the evolution of diverse rotavirus strains. Sabah is also a popular tourist destination, and a large number of tourists from different countries possibly contributes to the diversity of circulating rotavirus genotypes. Considering all these factors which are contributing rotavirus genotype diversity, continuous surveillance of rotavirus strains is of utmost importance to monitor the pre- and post-vaccination efficacy of rotavirus vaccines in Sabah.

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Section: Plos Onesupporting

confidence: 89%

Emergence of equine-like G3 strains as the dominant rotavirus among children under five with diarrhea in Sabah, Malaysia during 2018–2019

et al. 2021

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“…This study provides evidence of reductions in diarrhoea among both unvaccinated children and adults in a middle-income setting. Other studies illustrating this are mostly in high-income countries (HIC) including Saudi Arabia [29] , the USA [ 30 , 31 ]. In poorer countries this is rare but has been reported, eg.…”

Section: Discussionmentioning

confidence: 99%

The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji

Jenney

Reyburn

Ratu

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: In 2012, Fiji became the first independent Pacific island country to introduce rotavirus vaccine. We describe the impact of rotavirus vaccine on all-cause diarrhoea admissions in all ages, and rotavirus diarrhoea in children < 5 years of age. Methods: An observational study was conducted retrospectively on all admissions to the public tertiary hospitals in Fiji (2007-2018) and prospectively on all rotavirus-positive diarrhoea admissions in children < 5 years at two hospital sites (2006-2018, and 2010-2015), along with rotavirus diarrhoea outpatient presentations at one secondary public hospital (2010-2015). The impact of rotavirus vaccine was determined using incidence rate ratios (IRR) of all-cause diarrhoea admissions and rotavirus diarrhoea, comparing the pre-vaccine and post-vaccine periods. All-cause admissions were used as a control. Multiple imputation was used to impute missing stool samples. Findings: All-cause diarrhoea admissions declined among all age groups except among infants ≤2 months old and adults ≥55 years. For children < 5 years, all-cause diarrhoea admissions declined by 39% (IRR) = 0 • 61, 95%CI; 0 • 57-0 • 65, p-value < 0 • 001). There was an 81% (95%CI; 51-94%) reduction in mortality among all-cause diarrhoea admissions in children under < 5 years. Rotavirus diarrhoea admissions at the largest hospital among children < 5 years declined by 87% (IRR = 0 • 13, 95%CI; 0 • 10-0 • 17, p-value < 0 • 001). Among rotavirus diarrhoea outpatient presentations, the IRR was 0 • 39 (95%CI; 0 • 11, 1.21, p-value = 0.077). Interpretations: Morbidity and mortality due to rotavirus and all-cause diarrhoea in Fiji has declined in people aged 2 months to 54 years after the introduction of the RV vaccine.

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“…Attention is therefore being drawn to other enteropathogens in addition to rotavirus. Although rotavirus is still the commonest cause of severe dehydrating diarrhea in underfive children, accounting for about 40% [14][15][16][17] of cases, other pathogens (like Norovirus, E-Coli, Shigella, Campylobacter, Gardia lamblia, etc.) still contribute significantly to morbidity and mortality.…”

Section: The Rotavirus Surveillance Expansionmentioning

confidence: 99%

Need To Support the WHO Global Expanded Rotavirus Surveillance to Include Other Enteropathogens

Tagbo¹

2018

JIDTM

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Is rotavirus still a major cause for diarrheal illness in hospitalized pediatric patients after rotavirus vaccine introduction in the Saudi national immunization program?

Cited by 14 publications

References 30 publications

Emergence of equine-like G3 strains as the dominant rotavirus among children under five with diarrhea in Sabah, Malaysia during 2018–2019

Emergence of equine-like G3 strains as the dominant rotavirus among children under five with diarrhea in Sabah, Malaysia during 2018–2019

The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji

Need To Support the WHO Global Expanded Rotavirus Surveillance to Include Other Enteropathogens

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