Abstract
Human rotavirus infection is the leading cause of diarrhoea in infants and young children worldwide. In South Africa, diarrhoea is a major cause of childhood morbidity and mortality in children less than five years old, and before the vaccine was introduced rotavirus had been reported as causing one-third of all diarrhoeal related hospital admissions. This study assessed factors influencing the prevalence of rotavirus in children aged five years and under in KwaZulu-Natal, South Africa between June 2014 and June 2015. In addition, genotypes of the rotaviruses were determined. A stool specimen was collected from children presenting with diarrhoea to a regional hospital. Clinical, vaccination status, seasonal and sociodemographic information was collected using a structured questionnaire. ELISA (enzyme linked immunosorbent assay) was performed to detect rotavirus antigen in the stool. Rotavirus from selected positives specimens were genotyped using RT–PCR (reverse transcriptase polymerase chain reaction). The data were analysed using SPSS. In total, 365 stool specimens were collected. Rotavirus antigen was detected in 83 (23%) patients. The prevalence of rotavirus was not affected by vaccination status (p = 0.3; OR 1.5; CI 0.7–3.1), HIV status (p = 0.2; OR 0.6; CI 0.2–1.5), breastfeeding (p = 0.9; OR 1.1; CI 0.5–2.5) and administration of anti-helminth treatment (p = 0.6; OR 0.8; CI 0.3–1.9). The highest rotavirus prevalence was observed in the winter season (p 0.001; OR 43.3; CI 14.9–125.0). The G9P[8] was the most prevalent genotype (21%) followed by G9P[4] (14%). Rotavirus remains a major contributor to childhood diarrhoeal aetiology and hospitalisation in KwaZulu-Natal. Further investigation is needed to better understand the key drivers of rotavirus infection despite a successful vaccination programme in South Africa.
Highlights
IntroductionRotavirus belongs to the family of Reoviridae
Rotavirus belongs to the family of Reoviridae.1 This family includes 12 genera, of which rotavirus is the most clinically significant and is the leading cause of acute infantile diarrhoea worldwide.1 Approximately 576,000 diarrhoeal deaths are recorded worldwide among children less than five years old annually and rotavirus accounts for 215,000 (37.3%) of these deaths.2 About 50% of these rotavirus infections occur in developing countries.2 In South Africa, diarrhoeal diseases are ranked as the third cause of childhood mortality in children less than five years of age.3 Rotavirus has been documented as causing one-third of all admissions to hospital for diarrhoea prior to the introduction of the rotavirus vaccine
The prevalence of rotavirus infection among the under two years and above two years age group was significantly different in the univariate but not in the multivariate analysis
Summary
Rotavirus belongs to the family of Reoviridae.. Rotavirus belongs to the family of Reoviridae.1 This family includes 12 genera, of which rotavirus is the most clinically significant and is the leading cause of acute infantile diarrhoea worldwide.. 576,000 diarrhoeal deaths are recorded worldwide among children less than five years old annually and rotavirus accounts for 215,000 (37.3%) of these deaths.. About 50% of these rotavirus infections occur in developing countries.. In South Africa, diarrhoeal diseases are ranked as the third cause of childhood mortality in children less than five years of age.. Rotavirus has been documented as causing one-third of all admissions to hospital for diarrhoea prior to the introduction of the rotavirus vaccine.
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