Abstract
<i>Background:</i> Rotavirus is the most common cause of severe diarrhoea among children < 5 years of age worldwide. To determine the prevalence of severe rotavirus infection in children admitted with acute gastroenteritis attending Mbabane Government Referral Hospital in the Hhohho region and Raleigh Fitkin Memorial (RFM) Hospital in the Manzini Region of Swaziland, sentinel surveillance was conducted in January 2013 – December 2014. <i>Methods:</i> This is hospital based sentinel surveillance study. A total of 331 children under the age of five years with acute diarrhoea that were admitted to the hospitals were enrolled into the sentinel surveillance and 302 cases had stool samples tested for rotavirus antigens by enzyme immunoassay ProSpec T Rotavirus kit. The G and P genotypes were established by multiplex nested reverse transcription polymerase chain reaction. <i>Results:</i> Rotavirus was detected in 159 (52.6%) of the 302 children with acute diarrhoea that had stool specimens collected and 108 (68%) of positive cases of rotavirus gastroenteritis were between 6-11 months of age and 91% were below the age of two years. Rotavirus infection occurred with peaks between June - August. During the 2013 – 2014 period, 146 samples were subjected for reverse transcription polymerase chain reaction and genotyping assays. The most common genotypes detected in Swaziland were 82% G2P [4] in 2013 and 93% G1P [8] in 2014. <i>Conclusion:</i> Swaziland would benefit by introducing rotavirus vaccine and hence reduce the hospitalization burden of managing acute diarrhoea cases attributed to Rotavirus. The data from the sentinel hospitals can also be used to monitor the effectiveness of the vaccine once introduced. 1. National Reference Laboratory, Ministry of health, Swaziland- MOH 2. World Health Organization, Inter country support team for East and Southern Africa, Zimbabwe, Harare, 3. Ministry of health, Swaziland 4. World Health Organization, Swaziland 5. Mbabane Government Hospital, Swaziland 6. Raleigh Fitkin Memorial Hospital, Swaziland
Highlights
Worldwide, 10% of under 5 years old mortality is caused by diarrhoeal diseases [1]
Between January 2013 – December 2014, a total of 331 children (50.5% males and 49.5% females) below the age of five years were hospitalized for management of acute gastroenteritis (AGE) in the two sentinel site hospitals
Our findings have shown that 91% of infected children are < 2 years of age with the highest prevalence (44.7%) between 6 – 11 months old which is comparable with previous studies in Zimbabwe, Uganda and Nigeria [9,10,11]
Summary
10% of under 5 years old mortality is caused by diarrhoeal diseases [1]. Rotavirus is one of the four common causes of moderate to severe diarrhoea among children under 5 years of age in Sub Saharan Africa and Asia [2]. Sentinel hospital based surveillance in many countries showed that rotavirus accounted for 21%-56% of diarrhoeal hospitalizations among children < 5 years of age in Africa during the pre-vaccine era [5 – 14]. The World Health Organization Regional office for Africa in collaboration with the Ministry of Health of Swaziland undertook the current hospital based sentinel surveillance since 2013 to assess the magnitude of Rotavirus infections among hospitalized children < 5 years of age with acute watery diarrhoea in two hospitals and to generate data that can guide decisions on introduction of Rotavirus vaccine. A total of 331 children under the age of five years with acute diarrhoea that were admitted to the hospitals were enrolled into the sentinel surveillance and 302 cases had stool samples tested for rotavirus antigens by enzyme immunoassay Pro Spec T Rotavirus kit. The data from the sentinel hospitals can be used to monitor the effectiveness of the vaccine once introduced
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