Rotavirus gastroenteritis in Indian children\u2009

Sidhartha Giri,Nayana P Nair,Anna Simon,Mohan D Gupte,C P Girish Kumar,M A Mathew,S Suresh Kumar,Sanjay Mehendale,Gagandeep Kang,B Manohar,Tejinder Singh,Ann Mathew,Rashmi Arora,Sudhir Babji,S Venkatasubramanian

doi:10.1186/s12889-019-6406-0

Abstract

BackgroundIn 2016, the Government of India introduced the oral rotavirus vaccine (ROTAVAC, Bharat Biotech, India) in 4 states of India as part of the Universal Immunization Programme, and expanded to 5 more states in 2017. We report four years of data on rotavirus gastroenteritis in hospitalized children < 5 years of age prior to vaccine introduction.MethodsChildren from 7 sites in southern and northern India hospitalized for diarrhoea were recruited between July 2012 and June 2016. Stool samples were screened for rotavirus using enzyme immunoassay (EIA). The EIA positive samples were genotyped by reverse-transcription polymerase chain reaction.ResultsOf the 5834 samples from the 7 sites, 2069 (35.5%) were positive for rotavirus by EIA. Genotyping was performed for 2010 (97.1%) samples. G1P[8](56.3%), G2P[4](9.1%), G9P[4](7.6%), G9P[8](4.2%), and G12P[6](3.7%) were the common genotypes in southern India and G1P[8](36%), G9P[4](11.4%), G2P[4](11.2%), G12P[6](8.4%), and G3P[8](5.9%) in northern India.ConclusionsThe study highlights the high prevalence of rotavirus gastroenteritis in India and the diversity of rotavirus genotypes across different geographical regions. Pre- vaccine surveillance data is necessary to evaluate the potential change in admission rates for gastroenteritis and circulating rotavirus genotypes after vaccine introduction, thus assessing impact.

Highlights

In 2016, the Government of India introduced the oral rotavirus vaccine (ROTAVAC, Bharat Biotech, India) in 4 states of India as part of the Universal Immunization Programme, and expanded to 5 more states in 2017
Rotavirus causes an estimated 11.37 million episodes of acute gastroenteritis (AGE) in children < 5 years annually in India, requiring 3.27 million outpatient visits and 872,000 inpatient admissions resulting in total direct costs of Indian Rupee (INR) 10.37 billion per year [2]
We report the findings of a multicentre hospital-based surveillance from July 2012 to June 2016 from 7 Indian sites on the clinical, epidemiological, and virological features of severe rotavirus disease among Indian children < 5 years of age, with the use of standardized protocols for enrolment and diagnostic evaluation

Summary

Introduction

In 2016, the Government of India introduced the oral rotavirus vaccine (ROTAVAC, Bharat Biotech, India) in 4 states of India as part of the Universal Immunization Programme, and expanded to 5 more states in 2017. We report four years of data on rotavirus gastroenteritis in hospitalized children < 5 years of age prior to vaccine introduction. Group A rotavirus is the most important cause of severe acute diarrhoea in infants and young children globally [1]. Rotavirus consists of 11 segments of double stranded RNA, surrounded by 3 layers of proteins. Rotavirus causes an estimated 11.37 million episodes of acute gastroenteritis (AGE) in children < 5 years annually in India, requiring 3.27 million outpatient visits and 872,000 inpatient admissions resulting in total direct costs of Indian Rupee (INR) 10.37 billion per year [2]. In 2011, it is estimated that there were 78,000 deaths due to rotavirus associated AGE in India, with the majority (75.6%, 59,000) in the first 2 years in life [2]

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