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Mutua MM, Kathiiko C, Wachira MN, Muriithi B, Nyangao J, Khamadi SA, Komoto S, Morita K, Ichinose Y, Wandera EA. Epidemiological trends of diarrheal viruses in central and western Kenya before and after Rotavirus vaccine introduction. Trop Med Health 2025; 53:60. [PMID: 40287779 PMCID: PMC12034208 DOI: 10.1186/s41182-025-00716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 02/21/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND Rotavirus, norovirus, adenovirus (type 40/41) and astrovirus are the most significant viral etiological agents of acute gastroenteritis in young children globally. Kenya introduced the rotavirus vaccine into her National Immunization Program in July 2014, which has led to a significant decline in the prevalence of rotavirus. We sought to assess the impact of rotavirus vaccination on the epidemiological trends of other diarrhea-associated enteric viruses across different regions in Kenya. METHODOLOGY Using conventional and multiplex RT-PCR, we analyzed a total of 716 fecal samples for adenovirus, astrovirus and norovirus from children aged below 5 years presenting with acute gastroenteritis but tested negative for rotavirus at Mbita Sub-County Referral Hospital in Western Kenya and Kiambu County Referral Hospital in Central Kenya before (2011-2013) and after (2019-2020) rotavirus vaccine introduction. RESULTS Following the rotavirus vaccine introduction, there was no significant difference in norovirus and astrovirus prevalence post-vaccine introduction in both Central (norovirus- 5.4% vs 5.9%; astrovirus- 2% vs 2.4%) and Western Kenya (norovirus- 2% vs 3%; astrovirus 3.3% vs 5.9%). Although the prevalence of adenovirus increased substantially in Western Kenya (9% vs 12.4%), there was a significant decrease in adenovirus in Central Kenya (17%, vs 6%, p = 0.007). Before the introduction of the rotavirus vaccine, a large proportion of adenovirus cases occurred at 6-8 months in Central Kenya and 12-23 months in Western Kenya, while norovirus prevalence was highest at 12-23 months in Central and 3-5 months in Western Kenya. Astrovirus infections in Central Kenya were predominantly among children aged 12-23 months, both before and after the vaccine. Following vaccine introduction, a large proportion of adenovirus cases occurred among children aged 12-23 months in both regions. Norovirus peaked at 12-23 months in Central Kenya and showed dual peaks at 3-5 and 9-11 months in Western Kenya. Astrovirus infections in Western Kenya shifted from peaks at 6-8 and 24-59 months pre-vaccine to 9-11 months post-vaccine. CONCLUSION Our data demonstrate the burden and changing epidemiology of enteric viruses in Western and Central Kenya and underscores the need for continued monitoring to guide the design and implementation of appropriate public health interventions.
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Affiliation(s)
- Maurine Mumo Mutua
- Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, Nairobi, Kenya
- KEMRI Graduate School of Health, Nairobi, Kenya
| | - Cyrus Kathiiko
- Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, Nairobi, Kenya
| | - Mary N Wachira
- Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, Nairobi, Kenya
| | - Betty Muriithi
- Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, Nairobi, Kenya
| | - James Nyangao
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Samoel A Khamadi
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Satoshi Komoto
- Division of One Health, Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan
| | - Kouichi Morita
- Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, Nairobi, Kenya
| | - Yoshio Ichinose
- Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, Nairobi, Kenya
| | - Ernest A Wandera
- Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, Nairobi, Kenya.
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
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Damtie D, Gelaw A, Wondimeneh Y, Aleka Y, Kick MK, Tigabu Z, Sack U, Mekuria ZH, Vlasova AN, Tessema B. Rotavirus A Infection Prevalence and Spatio-Temporal Genotype Shift among Under-Five Children in Amhara National Regional State, Ethiopia: A Multi-Center Cross-Sectional Study. Vaccines (Basel) 2024; 12:866. [PMID: 39203992 PMCID: PMC11360187 DOI: 10.3390/vaccines12080866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 07/24/2024] [Accepted: 07/28/2024] [Indexed: 09/03/2024] Open
Abstract
Background: Globally, rotavirus (RV) A (RVA) is the most common cause of severe and sometimes fatal diarrhea in young children. It is also the major cause of acute gastroenteritis among children in Ethiopia. Currently, the WHO has prequalified four RVA vaccines for universal childhood immunization. Ethiopia introduced the monovalent Rotarix vaccine into its national immunization program in 2013. Since then, only a few studies on the burden and genotype distribution of RVA infection post-vaccine introduction have been conducted (mostly at sentinel surveillance sites). Therefore, this study aimed to assess RVA prevalence and genotype distribution among children under five years in Ethiopia (February 2021-December 2022). Methods: This multi-center hospital-based cross-sectional study involved 537 diarrheic children under-five years old. Rotavirus A detection was conducted using a one-step reverse-transcriptase polymerase chain reaction (RT-PCR). Genotyping was conducted by Sanger sequencing of the VP7 (complete) and VP4 (partial) genes. Descriptive analysis and Pearson's chi-squared test were carried out using SPSS version 29. Phylogenetic analysis with 1000 bootstrap replicates was performed using MEGA version 11 software. Statistical significance was set at p < 0.05 for all analyses. Results: The prevalence of RVA infection among diarrheic children was 17.5%. The most prevalent G-types identified were G3 (37%), the previously uncommon G12 (28%), and G1 (20%). The predominant P-types were P[8] (51%), P[6] (29%), and P[4] (14%). The three major G/P combinations observed were G3P[8] (32.8%), G12P[6] (28.4%), and G1P[8] (19.4%). Phylogenetic analysis revealed clustering of Ethiopian strains with the globally reported strains. Many strains exhibited amino acid differences in the VP4 (VP8* domain) and VP7 proteins compared to vaccine strains, potentially affecting virus neutralization. Conclusions: Despite the high RVA vaccination rate, the prevalence of RVA infection remains significant among diarrheic children in Ethiopia. There is an observable shift in circulating RVA genotypes from G1 to G3, alongside the emergence of unusual G/P genotype combinations such as G9P[4]. Many of these circulating RVA strains have shown amino acid substitutions that may allow for neutralization escape. Therefore, further studies are warranted to comprehend the emergence of these unusual RVA strains and the diverse factors influencing the vaccine's diminished effectiveness in developing countries.
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Affiliation(s)
- Debasu Damtie
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; (A.G.); (Y.W.); (B.T.)
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;
- Ohio State University Global One Health Initiative LLC, Eastern Africa Regional Office, Bole Road, Noah Plaza, 2nd Floor, Addis Ababa, Ethiopia
- Center for Food Animal Health, Department of Animal Sciences, College of Food Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA;
| | - Aschalew Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; (A.G.); (Y.W.); (B.T.)
| | - Yitayih Wondimeneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; (A.G.); (Y.W.); (B.T.)
| | - Yetemwork Aleka
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, 04103 Leipzig, Germany;
| | - Maryssa K. Kick
- Center for Food Animal Health, Department of Animal Sciences, College of Food Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA;
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Zemene Tigabu
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;
| | - Ulrich Sack
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, 04103 Leipzig, Germany;
| | - Zelalem H. Mekuria
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA;
- Global One Health initiative (GOHi), The Ohio State University, Columbus, OH 43210, USA
| | - Anastasia N. Vlasova
- Center for Food Animal Health, Department of Animal Sciences, College of Food Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA;
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Belay Tessema
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; (A.G.); (Y.W.); (B.T.)
- Institute of Clinical Immunology, Faculty of Medicine, University of Leipzig, 04103 Leipzig, Germany;
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Eugenia Afocha E, Abiodun Iwalokun B, Deji-Agboola MA, Ayorinde James B, Abayomi Banjo T, Adu F, Chukwujekwu Ezechi O, Adegbola R, Lawal Salako B. Prevalence and spatiotemporal distribution of rotavirus diarrhea among children younger than five years old in Lagos, Nigeria. J Immunoassay Immunochem 2023; 44:117-132. [PMID: 36576163 DOI: 10.1080/15321819.2022.2159430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Data on spatiotemporal distribution of rotavirus diarrhea are limited in many endemic settings. This study determined the prevalence and seasonal distribution of rotavirus among Nigerian children with diarrhea. Here, a total of 406 fecal samples were collected from patients attending six health facilities in Lagos between January - December 2019. Socio-demographic data of each enrolled child were collected. Rotavirus VP6 antigen was detected by enzyme-linked immunoassay (ELISA) and confirmation by VP7 gene detection by reverse transcription polymerase-chain reaction. The overall rotavirus diarrhea prevalence was 16.3% by ELISA with children above 2 years having 29.2% of this prevalence and higher occurrence in females (59.1%) than males (40.9%) (P < .05). Rotavirus diarrhea diagnosis using RT-PCR showed 100% concordance with ELISA. Cases of rotavirus diarrhea were detected from March to July and from September to November with the highest number of cases detected in May and June (22.7% each), followed by July (21.2%). The prevalence of rotavirus diarrhea remains high in Lagos with an emerging higher disease activity in children above 2. A different rotavirus transmission dynamics compared to previous studies from Nigeria and other African countries was found. VP6 ELISA may reliably be used for continuous rotavirus surveillance in Nigeria.
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Affiliation(s)
- Ebelechukwu Eugenia Afocha
- Medical Microbiology & Parasitology Department, Olabisi Onabanjo University, Nigeria.,Centre for Infectious Disease Research, Microbiology Department, Nigerian Institute of Medical Research, Nigeria
| | - Bamidele Abiodun Iwalokun
- Medical Microbiology & Parasitology Department, Olabisi Onabanjo University, Nigeria.,Molecular Biology & Biotechnology Department, Nigerian Institute of Medical Research, Nigeria.,Central Research Laboratory Department, Nigerian Institute of Medical Research, Nigeria
| | | | | | - Taiwo Abayomi Banjo
- Medical Microbiology & Parasitology Department, Olabisi Onabanjo University, Nigeria
| | - Festus Adu
- All Saints University Medical School, Cnr Hillborough and Great George Street, Common Wealth of Dominica, West Indies
| | | | - Richard Adegbola
- Centre for Infectious Disease Research, Microbiology Department, Nigerian Institute of Medical Research, Nigeria
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Peer V, Schwartz N, Green MS. A Pooled Analysis of Sex Differences in Rotaviral Enteritis Incidence Rates in Three Countries Over Different Time Periods. WOMEN'S HEALTH REPORTS 2022; 3:228-237. [PMID: 35262061 PMCID: PMC8896211 DOI: 10.1089/whr.2021.0096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 12/13/2022]
Abstract
Background: Sex differences in incidence rates (IRs) of infectious diseases could provide clues to the mechanisms of infection. The results of studies on sex differences in the incidence of rotaviral enteritis have been inconsistent. Methods: We carried out a pooled analysis of sex differences in IRs for rotaviral enteritis in three countries for a period of 7–22 years. Male-to-female incidence rate ratios (IRRs) were computed by age group, country, and years of reporting. A meta-analytic methodology was used to combine IRRs. Metaregression was performed to evaluate the contribution of age group, country, and years of reporting to the IRR. Results: Significantly higher IRs in males were found in the age groups 0–4, 5–9, and 10–14 years, with pooled IRRs (with 95% confidence intervals [CIs]) of 1.12 (1.09–1.14), 1.07 (1.05–1.09), and 1.13 (1.05–1.21), respectively. In adults, the sex differences were reversed with higher rates in females. The pooled male-to-female IRRs (with 95% CIs) were 0.66 (0.64–0.68), 0.78 (0.72–0.85), and 0.78 (0.72–0.84) for the age groups 15–44, 45–64, and 65+ years, respectively. Metaregression results demonstrated that age is responsible for much of the variation in IRRs. Conclusions: The higher rotaviral enteritis IRs in males at a very early age suggest that sex-related factors unrelated to exposure may play a role. The higher IRs in adult females could result, at least partly, from behavioral and occupational factors.
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Affiliation(s)
- Victoria Peer
- School of Public Health, University of Haifa, Haifa, Israel
| | - Naama Schwartz
- School of Public Health, University of Haifa, Haifa, Israel
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Ali S, Khan S, Khan SN, Rauf M, Khan MF, Majid A, Dawar FU, Akbar NU, Ullah R, Bari A, Khan MY. Molecular detection and prevalence of Rotavirus with acute gastroenteritis among the children of rural and urban areas. BRAZ J BIOL 2021; 83:e244365. [PMID: 34932615 DOI: 10.1590/1519-6984.244365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
Rotavirus is the main infective agent of acute gastroenteritis (AGE) in children under the age of five years and causing significant morbidity as well as mortality throughout the world. The study was carried out to detect the prevalence rate, genotypes strain and risk factors of Rotavirus among the children of rural and urban areas of district Bannu Khyber Pakhtunkhwa Pakistan. A total of 180 stool samples were collected from children under the age of 5 years from two major hospitals of Bannu from January to December (2015). The samples were analyzed by Reverse-transcriptase Polymerase Chain Reaction (RT-PCR) for the detection of Rotavirus, positive samples were further processed for genotyping (G and P type) through specific PCR. Of the total, 41 (23%) samples were positive for Rotavirus. The most prevalent G genotypes found were: G3, G8, G9 (each 29%), followed by G10 (15%), and G11 (10%). Whereas the prevalent P genotypes were: P-8 (25%), P-4 and P-10 (each 20%), P-9 (15%), followed by P-6 and P-11 (each 10%). Moreover, Rotavirus infection was more prevalent in summer (23.73%) and winter (22.7%) than spring (20%) and autumn (21.4%). Rotavirus infection exhibited high frequency in June (14%), October (8%) and November (6%). It is concluded that Rotavirus is more prevalent in children and various genotypes (G and P) of Rotavirus are present in the study area. Lack of studies, awareness and rarer testing of Rotavirus are the principal reasons of virus prevalence in district Bannu, Pakistan.
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Affiliation(s)
- S Ali
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Khan
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S N Khan
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M Rauf
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M F Khan
- University of Hazara Dhodial, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - A Majid
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - F U Dawar
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - N Ul Akbar
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - R Ullah
- College of Pharmacy, Department of Pharmacognosy, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - A Bari
- King Saud University Riyadh, College of Pharmacy, Department of Pharmaceutical Chemistry, Riyadh, Saudi Arabia
| | - M Y Khan
- Lancaster University, Lancaster Environmental Centre, Lancaster, United Kingdon
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Wa-1 Equine-Like G3P[8] Rotavirus from a Child with Diarrhea in Colombia. Viruses 2021; 13:v13061075. [PMID: 34199978 PMCID: PMC8226935 DOI: 10.3390/v13061075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 12/14/2022] Open
Abstract
Rotavirus A (RVA) has been considered the main cause of diarrheal disease in children under five years in emergency services in both developed and developing countries. RVA belongs to the Reoviridae family, which comprises 11 segments of double-stranded RNA (dsRNA) as a genomic constellation that encodes for six structural and five to six nonstructural proteins. RVA has been classified in a binary system with Gx[Px] based on the spike protein (VP4) and the major outer capsid glycoprotein (VP7), respectively. The emerging equine-like G3P[8] DS-1-like strains reported worldwide in humans have arisen an important concern. Here, we carry out the complete genome characterization of a previously reported G3P[8] strain in order to recognize the genetic diversity of RVA circulating among infants in Colombia. A near-full genome phylogenetic analysis was done, confirming the presence of the novel equine-like G3P[8] with a Wa-like backbone for the first time in Colombia. This study demonstrated the importance of surveillance of emerging viruses in the Colombian population; furthermore, additional studies must focus on the understanding of the spread and transmission dynamic of this important RVA strain in different areas of the country.
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Zhang H, Yan L, Chen X, Zhang C. The association between short-term exposure to air pollutants and rotavirus infection in Wuhan, China. J Med Virol 2021; 93:4831-4839. [PMID: 33942330 DOI: 10.1002/jmv.27047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 04/15/2021] [Accepted: 04/23/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND The impact of various meteorological factors on rotavirus (RV) infection has been previously studied; however, few studies have explored the association between short-term exposure to air pollutants and RV infection. METHODS Daily RV positive cases among children aged 0-6 years were collected from July 2014 to August 2019 in Tongji hospital (Wuhan, China). Daily data on air temperature and air pollutants were obtained from the China Meteorological Network. A distributed lag model to explore the lagged effects of short-term exposure to air pollutants and RV infection was performed. The distribution lag model was used to study the lag effect of short-term exposure to air pollutants and RV infection. RESULTS RV infection was negatively correlated with mean air temperature and O3 concentration. The RV infection risk decreased by 5.2% and 0.47% for every 1℃ increase in average temperature and 1 ug/m3 increase in O3 concentration, respectively. Increased PM2.5 , SO2 , and NO2 concentrations were independent risk factors for an increase in positive rates; their relative risk values were 1.0014 (95% confidence interval [CI], 1.0013-1.0015), 1.0050 (95% CI, 1.0047-1.0053), and 1.0030 (95% CI, 1.0028-1.0032), respectively. The highest RV-positive rates were from January to March and November to December. Additionally, children <18 months of age and boys were more vulnerable to infection. CONCLUSIONS Air pollutants were important factors impacting the RV-positivity of children in Wuhan. These findings may help develop an early environment-based warning system to prevent and control RV infection.
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Affiliation(s)
- Hongbo Zhang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Li Yan
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Xing Chen
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chi Zhang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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