Abstract
AbstractGroup A rotavirus (RVA) diarrhea disease and mortality are yet unabated, particularly in developing countries. As global knowledge of specific strains associated with infant mortality is crucial for successful vaccination efforts, candidate RVA strains detected in mortality and fatal cases of severely diarrheic hospitalized infants in Akure, Nigeria were investigated.Fecal samples from comatose patients were tested for RVAs, other diarrhea viruses, and enteric bacterial pathogens. Genomic dsRNA was extracted from 10% rotavirus positive stool suspension, the VP4 and VP7 genes were reverse transcribed and amplified by one-step reverse transcription polymerase chain reaction (PCR) and genotyped by seminested multiplex PCR. Amplicons were sequenced, aligned by ClustalW, and phylogenetic analyses were conducted in MEGA6. Sequences data were deposited to GenBank and DDBJ.Medical examination and microbiological analyses upheld viral diarrhea. EIA revealed RVA and enterovirus. PCR identified virulent RVA strain GIP[6] whose VP7 nucleotide sequences shared a common cluster with Cuban isolate G1P[6], while the VP4 P[6] sequences were related to Asian strains. Reassortant RVA G1P[6] was found in fatal diarrhea cases and mortality of a Nigerian child. RVA coinfection with enterovirus and associated biomarkers of environmental enteric dysfunction in infantile diarrhea should henceforth be evaluated. Current rotavirus vaccines may fare badly against the prevailing virulent strains. The disease severity and outcome necessitates a wider epidemiological study, a review and inclusion of the P[6] genotype in future rotavirus vaccines.
Highlights
The rotavirus remains the major global cause of diarrhea-associated morbidity and mortality in under 5-year-old children, and was responsible for almost 260 million episodes of diarrhea and 30% of all diarrhea-related mortality in 2016.3 In the developing countries, it was estimated that 500,000 to 870,000 deaths occur annually because of severe dehydrating diarrhea caused by human rotaviruses with 150,000 to 200,000 deaths occurring in children below 5 years of age in Africa
Earlier global breakup of estimated annual infant mortality due to rotavirus gastroenteritis showed that India had 100,800, followed by China with 34,553, Nigeria with 32,802, Pakistan with 25,158, Ethiopia and Congo with 19,950 each, and Tanzania with 14 deaths in 2003.5 As at 2009, it was estimated that approximately 50,000 rotavirus deaths occur annually in Nigeria, thereby indicating an increase over the 2003 report
Phylogenetic analysis of the VP7 gene genotype G1 of the mortality virulent strain (RVA/Human-wt/NGR-AKR15/ 2012/G1P[6]) and other G1 strains in this study showed high sequence homology (97–99%) clustering in lineage IV alongside Cuba, India and Iran, but closely related to a previous G1P[8] Nigerian isolate reported in year 2013 (87% nucleotide identity)
Summary
Earlier global breakup of estimated annual infant mortality due to rotavirus gastroenteritis showed that India had 100,800, followed by China with 34,553, Nigeria with 32,802, Pakistan with 25,158, Ethiopia and Congo with 19,950 each, and Tanzania with 14 deaths in 2003.5 As at 2009, it was estimated that approximately 50,000 rotavirus deaths occur annually in Nigeria, thereby indicating an increase over the 2003 report.. Earlier global breakup of estimated annual infant mortality due to rotavirus gastroenteritis showed that India had 100,800, followed by China with 34,553, Nigeria with 32,802, Pakistan with 25,158, Ethiopia and Congo with 19,950 each, and Tanzania with 14 deaths in 2003.5 As at 2009, it was estimated that approximately 50,000 rotavirus deaths occur annually in Nigeria, thereby indicating an increase over the 2003 report.6 This trend continues as it was reported by World Health Organization that Nigeria in 2013 was the second country with the highest number of rotavirus-associated mortality of under 5-year-old children in Africa RVA G1P[6] Associated Fatalities Babalola MO e111 the fact that there are 10 different pathogens that together are responsible for the vast majority of cases. The rotavirus remains the major global cause of diarrhea-associated morbidity and mortality in under 5-year-old children, and was responsible for almost 260 million episodes of diarrhea and 30% of all diarrhea-related mortality in 2016.3 In the developing countries, it was estimated that 500,000 to 870,000 deaths occur annually because of severe dehydrating diarrhea caused by human rotaviruses with 150,000 to 200,000 deaths occurring in children below 5 years of age in Africa. Earlier global breakup of estimated annual infant mortality due to rotavirus gastroenteritis showed that India had 100,800, followed by China with 34,553, Nigeria with 32,802, Pakistan with 25,158, Ethiopia and Congo with 19,950 each, and Tanzania with 14 deaths in 2003.5 As at 2009, it was estimated that approximately 50,000 rotavirus deaths occur annually in Nigeria, thereby indicating an increase over the 2003 report. This trend continues as it was reported by World Health Organization that Nigeria in 2013 was the second country with the highest number of rotavirus-associated mortality of under 5-year-old children in Africa
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