Prevalence, Pattern and Genetic Diversity of Rotaviruses among Children under 5 Years of Age with Acute Gastroenteritis in South Africa: A Systematic Review and Meta-Analysis.

Cornelius A Omatola,Ademola O Olaniran,Ropo E Ogunsakin

doi:10.3390/v13101905

Cornelius A Omatola, Ademola O Olaniran + Show 1 more

Open Access

https://doi.org/10.3390/v13101905

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Journal: Viruses	Publication Date: Sep 23, 2021
Citations: 11	License type: CC BY 4.0

Affiliation: University of KwaZulu-Natal

Abstract

Rotavirus is the most significant cause of severe acute gastroenteritis among children under 5 years of age, worldwide. Sub-Saharan Africa particularly bears the brunt of the diarrheal deaths. A meta-analysis was conducted on 43 eligible studies published between 1982 and 2020 to estimate the pooled prevalence of rotavirus infection and changes in the main rotavirus strains circulating before and after vaccine introduction among under-five children in South Africa. The pooled national prevalence of rotavirus infection was estimated at 24% (95% CI: 21–27%) for the pre-vaccination period and decreased to 23% (95% CI: 21–25%) in the post-vaccination period. However, an increased number of cases was observed in the KwaZulu-Natal (21–28%) and Western Cape (18–24%) regions post-vaccination. The most dominant genotype combinations in the pre-vaccine era was G1P[8], followed by G2P[4], G3P[8], and G1P[6]. After vaccine introduction, a greater genotype diversity was observed, with G9P[8] emerging as the predominant genotype combination, followed by G2P[4], G12P[8], and G1P[8]. The introduction of the rotavirus vaccine was associated with a reduction in the burden of rotavirus-associated diarrhea in South Africa, although not without regional fluctuation. The observed changing patterns of genotype distribution highlights the need for ongoing surveillance to monitor the disease trend and to identify any potential effects associated with the dynamics of genotype changes on vaccine pressure/failure.

Highlights

Rotavirus is the leading etiology of severe acute gastroenteritis accounting for approximately 258 million morbidity cases and 128,000 diarrheal deaths annually among neonates and children younger than 5 years, in both developed and developing countries [1]
This review evaluated the status of rotavirus infection and the impact of rotavirus (RV) vaccine introduction on the prevalence, distribution of RV genotypes in South Africa
The pooled rotavirus prevalence among under-five children in South African study sites obtained in this study was 24%, very similar to the 23% and 24.3%

Summary

Introduction

Rotavirus is the leading etiology of severe acute gastroenteritis accounting for approximately 258 million morbidity cases and 128,000 diarrheal deaths annually among neonates and children younger than 5 years, in both developed and developing countries [1]. Diarrheal disease is ranked the second most frequent cause of childhood mortality across the globe [3]. Rotavirus is recognized as the most significant causal agent of severe gastroenteritis in young children worldwide [4,5]. In South Africa, diarrheal diseases are currently rated as the third major cause of death in children under 5 years [9], and before the use of rotavirus vaccine, most children in the country became infected with rotavirus before their third birthday [10,11]. New strains emerge because of high frequencies of genetic changes that accompany genomic re-assortment, gene recombination, accumulation of point mutations, and interspecies transmission mechanism events [12,13]

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