Molecular Epidemiology and Clinical Features of Rotavirus Infection Among Pediatric Patients in East Java, Indonesia During 2015–2018: Dynamic Changes in Rotavirus Genotypes From Equine-Like G3 to Typical Human G1/G3

Abstract

Group A rotavirus (RVA) is the most important cause of severe gastroenteritis among children worldwide, and effective RVA vaccines have been introduced in many countries. Here we performed a molecular epidemiological analysis of RVA infection among pediatric patients in East Java, Indonesia, during 2015-2018. A total of 432 stool samples were collected from hospitalized pediatric patients with acute gastroenteritis. None of the patients in this cohort had been immunized with an RVA vaccine. The overall prevalence of RVA infection was 31.7% (137/432), and RVA infection was significantly more prevalent in the 6-to 11-month age group than in the other age groups (P < 0.05). Multiplex reverse transcription-PCR (RT-PCR) revealed that the most common G-P combination was equine-like G3P[8] (70.8%), followed by equine-like G3P[6] (12.4%), human G1P[8] (8.8%), G3P[6] (1.5%), and G1P[6] (0.7%). Interestingly, the equine-like strains were exclusively detected until May 2017, but in July 2017 they were completely replaced by a typical human genotype (G1 and G3), suggesting that the dynamic changes in RVA genotypes from equine-like G3 to typical human G1/G3 in Indonesia can occur even in the country with low RVA vaccine coverage rate. The mechanism of the dynamic changes in RVA genotypes needs to be explored. Infants and children with RVA-associated gastroenteritis presented more frequently with some dehydration, vomiting, and watery diarrhea, indicating a greater severity of RVA infection compared to those with non-RVA gastroenteritis. In conclusion, a dynamic change was found

Magnitude of Rotavirus A and Campylobacter jejuni infections in children with diarrhea in Twin cities of Rawalpindi and Islamabad, Pakistan

“…In the present study RVA infection was detected mostly in children of 6–11 months of age. These results are in accordance with previous studies from Pakistan showing majority of children effected with RVA infection are <2 years of age [33, 35, 38, 39] and other countries of the world [40–43]. The reason of high RVA infection in lower age may be due to low immunity in children of less age.…”

Molecular and clinical characterization of the equine-like G3 rotavirus that caused the first outbreak in Japan, 2016

“…Among the eG3 strains found in countries other than Japan, only the STM050 strain isolated in Indonesia during 2015 showed extremely high nucleotide identity to the whole genomes of the eG3 strains in this study [36]. Furthermore, two eG3 strains (IS1090 and MI1125) detected in another region of Japan in 2016 [13] have extremely high nucleotide identity to the eG3 strains in this study, suggesting that the eG3 strain was introduced from south-eastern Asia (e.g.…”

“…The DS-1-like G1P[8] and G8P[8] have been mainly detected in Asia since 2012; [24–26, 30] whereas, eG3 strains have been detected both in Asia and the rest of the world, and have been predominant in several countries (e.g. Australia, Indonesia, Spain and Germany) [14–16, 31, 33–39]. In the postvaccine era, there has been a relative decrease in Wa-like G1P[8] and a relative increase in G2P[4], with a traditional DS-1-like constellation, and RV genotype diversity has been reported in Australia and England [40, 41].…”

“…In previous reports, differences in the GPI genotypes did not generally affect the severity of the RV infection (G8 vs non-G8, G1P[8]I1 vs G1P[8]I2 vs G2P[4]I2 vs G9P[8]I1, and G1 vs G9) [18, 27, 42]. With regards to the eG3 strains, there were also no significant differences reported in the clinical characteristics (frequency of diarrhoea, vomiting and dehydration) or prognosis of hospitalized children in Indonesia infected with eG3 and non-eG3 RV (human G1 and G3) [36]. Therefore, the emergence and global spread of eG3 strains cannot be attributed to their clinical virulence.…”

Genotypic determination of human group A rotaviruses from Goa and Meghalaya states, India

“…These data are consistent with the studies from various countries including Saudi Arabia and Ghana, which indicate that genotype G1P[8] is the most commonly reported and severe diarrhea associated strain followed by G2P[4] and G9P[8] genotypes, respectively ( Almalki, 2018 ; Damanka et al., 2019 ). In contrast, the proportion of G3 strains (P[8] and P[6]) was significantly higher with the P[8] as the dominant genotype (80.3%) followed by P[6] (14.6%) among patients admitted to the hospital with severe dehydrating diarrhea ( Athiyyah et al., 2019 ) was observed in Indonesia. Limited studies on rotaviral genotypes in Eastern India revealed G1 (57%) as the most predominant type followed by mixed types (20%), G2 (13%) and G4 (9%) (NICED, Annual Report, 2002–03), while, G1P[8] genotype was frequently isolated from Western India ( Chitamber et al., 2012 ; Jain et al., 2016 ; Maher et al., 2016 ).…”