Norovirus and rotavirus in children hospitalised with diarrhoea after rotavirus vaccine introduction in Burkina Faso.

Y Rönnelid,I J O Bonkoungou,L Svensson,N Barro,J Nordgren,N Ouedraogo

doi:10.1017/s0950268820002320

Abstract

Several studies report norovirus as the new leading cause of severe gastroenteritis in children after the global introduction of rotavirus vaccines. Burkina Faso introduced general rotavirus vaccination with the oral pentavalent vaccine RotaTeq in November 2013 and quickly reached a vaccine coverage of >90%. This study describes detection rates, clinical profiles and the molecular epidemiology of norovirus and rotavirus infections in 146 children aged <5 years with severe acute gastroenteritis in Ouagadougou, consecutively enrolled from a hospital between January 2015 and December 2015. Virus detection was performed with an antigen test or real-time polymerase chain reaction (PCR) and genotyping was performed by nucleotide sequencing or multiplex PCR. Rotavirus was found in 14% and norovirus in 20% of faecal samples. Norovirus infection was significantly more associated with severe dehydration compared to rotavirus (P < 0.001). Among genotyped norovirus samples 48% (12/25) belonged to GII.4 which caused significantly more diarrhoeal episodes than non-GII.4 genotypes (P = 0.01). The most common rotavirus genotypes were G2P[4] (30%), G12P[6] (25%) and G12P[8] (20%). Fifty percent of the rotavirus positive children were infected with fully or partly heterotypic strains. In conclusion, this study found a higher proportion of norovirus causing more severe symptoms in children with diarrhoea in Burkina Faso after the introduction of rotavirus vaccination.

Highlights

Infectious gastroenteritis is an important cause of childhood morbidity and mortality worldwide, especially in low- and middle-income countries
Norovirus was more common in the age group 7–12 months, where it was found in 27% (17/63) of the samples and was not found at all in the age group over 24 months while rotavirus was found in all age groups and varied between minimum 10% (6/63) in the age group 7–12 months and maximum 18% (4/22) in the age group 0–6 months (Table 1)
All of the rotavirus positive samples were detected during the cold dry season and the following months with a peak detection rate in January when rotavirus was found in 57% (8/14) of screened samples

Summary

Introduction

Infectious gastroenteritis is an important cause of childhood morbidity and mortality worldwide, especially in low- and middle-income countries. Rotavirus group A (hereafter called rotavirus) and norovirus are the most common viral causes of childhood diarrhoea and are every year responsible for about 300 000 to 500 000 deaths in children

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