Racial disparities in diarrhea-associated hospitalizations among children in five US States, before and after introduction of rotavirus vaccine

Yen, Catherine; Steiner, Claudia; Barrett, Marguerite L; Curns, Aaron T.; Hunter, Katherine; Wilson, Emily; Parashar, Umesh D.

doi:10.1016/j.vaccine.2010.08.094

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…Hospitalization rates due to diarrhea were higher in black children under six months of age when compared to white children, and this difference was not modified following introduction of the rotavirus vaccine 34 . African-American children showed greater risk of hospitalization from asthma/wheezing and greater risk of readmission than white children, and this inequality was attributed to differences in access to health care and associated socioeconomic variables 34 .…”

Section: Discussionmentioning

confidence: 92%

Características e fatores associados à hospitalização nos primeiros anos de vida: coorte de nascimentos de Pelotas de 2004, Rio Grande do Sul, Brasil

et al. 2017

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Section: Discussionmentioning

confidence: 92%

Características e fatores associados à hospitalização nos primeiros anos de vida: coorte de nascimentos de Pelotas de 2004, Rio Grande do Sul, Brasil

et al. 2017

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“…This is substantiated by studies conducted prior to rotavirus vaccine licensure, which illustrate a higher burden of rotavirus among Hispanic or Native American populations, particularly among young age groups. 25,26 Historically, such findings have been explained as stemming from the influences of lower socioeconomic status. Whereas socioeconomic status and other related factors remain important, genetics may also influence differential rates of severe rotavirus gastroenteritis by Hispanic ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic Association BetweenFUT2Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States

et al. 2015

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IMPORTANCE A genetic polymorphism affecting FUT2 secretor status in approximately one-quarter of humans of European descent affects the expression of histo-blood group antigens on the mucosal epithelia of human respiratory, genitourinary, and digestive tracts. These histo-blood group antigens serve as host receptor sites necessary for attachment and infection of some pathogens, including norovirus.OBJECTIVE We investigated whether an association exists between FUT2 secretor status and laboratory-confirmed rotavirus infections in US children. DESIGN, SETTING, AND PARTICIPANTSMulticenter case-control observational study involving active surveillance at 6 US pediatric medical institutions in the inpatient and emergency department clinical settings. We enrolled 1564 children younger than 5 years with acute gastroenteritis (diarrhea and/or vomiting) and 818 healthy controls frequency matched by age and month, from December 1, 2011, through March 31, 2013. MAIN OUTCOMES AND MEASURESPaired fecal-saliva specimens were tested for rotavirus and for secretor status. Comparisons were made between rotavirus test-positive cases and healthy controls stratified by ethnicity and vaccination status. Adjusted multivariable analyses assessed the preventive association of secretor status against severe rotavirus gastroenteritis.RESULTS One (0.5%) of 189 rotavirus test-positive cases was a nonsecretor, compared with 188 (23%) of 818 healthy control participants (P < .001). Healthy control participants of Hispanic ethnicity were significantly less likely to be nonsecretors (13%) compared with healthy children who were not of Hispanic ethnicity (25%) (P < .001). After controlling for vaccination and other factors, children with the nonsecretor FUT2 polymorphism appeared statistically protected (98% [95% CI, 84%-100%]) against severe rotavirus gastroenteritis. CONCLUSIONS AND RELEVANCESevere rotavirus gastroenteritis was virtually absent among US children who had a genetic polymorphism that inactivates FUT2 expression on the intestinal epithelium. We observed a strong epidemiologic association among children with rotavirus gastroenteritis compared with healthy control participants. The exact cellular mechanism behind this epidemiologic association remains unclear, but evidence suggests that it may be rotavirus genotype specific. The lower prevalence of nonsecretors among Hispanic children may translate to an enhanced burden of rotavirus gastroenteritis among this group. Our findings may have bearing on our full understanding of rotavirus infections and the effects of vaccination in diverse populations.

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“…As non-secretors are less susceptible to the globally common P genotypes P [4] and P [8], countries with a high proportion of non-secretors would accordingly have less rotavirus disease caused by these genotypes. Some studies have indeed suggested that rotavirus burden is dependent on ethnicity [18,30], although it is difficult to rule out other factors such as socioeconomics.…”

Section: Figurementioning

confidence: 99%

The Impact of Human Genetic Polymorphisms on Rotavirus Susceptibility, Epidemiology, and Vaccine Take

Sharma

Hagbom

Svensson

et al. 2020

Viruses

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Innate resistance to viral infections can be attributed to mutations in genes involved in the immune response, or to the receptor/ligand. A remarkable example of the latter is the recently described Mendelian trait resistance to clinically important and globally predominating genotypes of rotavirus, the most common agent of severe dehydrating gastroenteritis in children worldwide. This resistance appears to be rotavirus genotype-dependent and is mainly mediated by histo-blood group antigens (HBGAs), which function as a receptor or attachment factors on gut epithelial surfaces. HBGA synthesis is mediated by fucosyltransferases and glycosyltransferases under the genetic control of the FUT2 (secretor), FUT3 (Lewis), and ABO (H) genes on chromosome 19. Significant genotypic and phenotypic diversity of HBGA expression exists between different human populations. This genetic diversity has an effect on genotype-specific susceptibility, molecular epidemiology, and vaccine take. Here, we will discuss studies on genetic susceptibility to rotavirus infection and place them in the context of population susceptibility, rotavirus epidemiology, vaccine take, and public health impact.

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Racial disparities in diarrhea-associated hospitalizations among children in five US States, before and after introduction of rotavirus vaccine

Cited by 7 publications

References 14 publications

Características e fatores associados à hospitalização nos primeiros anos de vida: coorte de nascimentos de Pelotas de 2004, Rio Grande do Sul, Brasil

Características e fatores associados à hospitalização nos primeiros anos de vida: coorte de nascimentos de Pelotas de 2004, Rio Grande do Sul, Brasil

Epidemiologic Association BetweenFUT2Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States

The Impact of Human Genetic Polymorphisms on Rotavirus Susceptibility, Epidemiology, and Vaccine Take

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