Abstract
Background: Rotavirus is the leading cause of severe diarrhea and diarrhea associated morbidity in Indian children. Vaccination is one of the most effective approaches to reduce the morbidity. Vaccine composition depends on the prevalence of most common strains. Therefore, it is important to understand the burden of rotavirus gastroenteritis (RVGE) and prevalence of different strains. This systematic review was aimed to estimate the burden of rotavirus gastroenteritis (RVGE) and distribution of rotavirus strains in India. Methods & Materials: A systemic search of published literature was carried out using PubMed, Elsevier ScienceDirect, Cochrane library databases and Google scholar (from 1990 to April 2015) by two independent reviewers. Reference list of the related articles was also screened to find out the relevant studies. Newcastle Ottawa scale was used to assess the study quality. Publication bias was assessed by using funnel plot. Cochrane Q-statistics test and I2 statistics were used to assess the heterogeneity. Random effect model was used. Comprehensive Meta-Analysis software (Version 2.2, Biostat, Englewood NJ) was used. Results: A total of 44 studies, covering a total of 33313 hospitalized children suffering from diarrhea. Maximum number of studies belongs to north followed by studies from south, east and west part of country (15, 10, 7 and 5 studies, respectively). Seven studies were Multi-centric. The number of participants varied from 106 to 6765. The proportion of gastroenteritis cases due to rotavirus was 23.9% (95% confidence interval [CI], 21.1-26.9). Among G type, G1 was found most commonly prevalent followed by G2 and G9 (27.7%, 25.8% and 13%, respectively). The most common P type were P8, P4 and P6 (31.9%, 24.9%, and 11.1%, respectively). G2P[4] was found most prevalent in GP combinations, followed by G1P8 and G9P8 (16.5%, 16.1%, and 6.0%, respectively). The most prevalent GP combinations were G3P[8] (32.1%), G1P[8] (23.0%), and G2P[4] (7.9%). Conclusion: Rotavirus gastroenteritis (RVGE) is an important cause of diarrheal disease in Indian children. G1 and P8 were found most prevalent strains in G and P type, respectively. Vaccination programme with broad serotype vaccine may help in decreasing the RVGE burden in India.
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