Rotavirus gastroenteritis in Pakistan, 2018: updated disease burden

Nosheen Basharat,Asma Sadiq,Hayat Khan,Hamid Ali,Jadoon Khan,Aamir Aziz,Shahid Ali,Rooh Ullah,Muhammad Dawood,Aamer Ali Shah,Ijaz Ali,Alam Khan

doi:10.1186/s12879-021-06123-6

Abstract

ObjectiveRotavirus A (RVA) is a significant cause of severe diarrheal illness and one of the common causes of death in children under the age of five. This study was aimed at detecting the prevalence of RVA in Pakistan after rotavirus vaccines were introduced. Fecal samples were obtained from 813 children from different hospitals in Rawalpindi and Islamabad, Pakistan, from January 2018 to December 2018. To obtain additional information from the parents / guardians of the children, a standard questionnaire was used.ResultsUsing an enzyme-linked immunosorbent assay kit (ELISA), rotavirus antigen was detected and ELISA positive samples were subjected to reverse transcription PCR (RT-PCR). The findings showed 22% prevalence of RVA in children with acute gastroenteritis (AGE) via ELISA and 21% prevalence via RT-PCR in children with AGE. There was no statistically significant difference between gender, age and RVA infections. The winter, spring and fall/autumn seasons were statistically significant for RVA prevalence.ConclusionThe present study will provide post vaccine prevalence data for the health policy makers. The implementation of rotavirus vaccines, along with adequate nutrition for babies, clean water supply and maternal hygienic activities during infant feeding, is recommended. Furthermore, continuous surveillance is mandatory in the whole country to calculate the disease burden caused by RVA.

Highlights

Rotavirus A (RVA) is one of the leading agents among all the acute gastroenteritis (AGE)-causing pathogens, account for approximately 200,000 deaths each year among children under 5 years of age in underdeveloped nations [1]
The findings showed 22% prevalence of RVA in children with acute gastroenteritis (AGE) via enzyme-linked immunosorbent assay kit (ELISA) and 21% prevalence via reverse transcription PCR (RT-PCR) in children with AGE
In Pakistan, only a few studies have been published on the prevalence of rotavirus infection, so the current study is intended to evaluate the prevalence of rotavirus infection among diarrheal patients admitted to the different health care hospitals in Rawalpindi district

Summary

Introduction

Rotavirus A (RVA) is one of the leading agents among all the AGE-causing pathogens, account for approximately 200,000 deaths each year among children under 5 years of age in underdeveloped nations [1]. It has been estimated that about half (49%) of these RVA fatalities occurred in four developing countries, one of which is Pakistan with rotavirus infants mortality rate 67.6 per 100,000 children [2]. Four live-attenuated RVA vaccines (RotarixTM, RotaTeqTM, RotavacTM and RotaSiilTM) have received prequalification from the World Health Organization (WHO) and are currently available. In 2009, the World Health Organization (WHO) proposed the implementation of rotavirus vaccines in routine vaccination systems worldwide and, in particular, in countries with a high incidence of diarrhoea-related mortality below 5 years of age [6]. The government of Pakistan introduced RVA vaccine (RotarixTM) in the EPI (Expanded program on Immunization) plan of each of the four provinces in 2018 with the support of GAVI, the Vaccine Alliance. In Pakistan, only a few studies have been published on the prevalence of rotavirus infection, so the current study is intended to evaluate the prevalence of rotavirus infection among diarrheal patients admitted to the different health care hospitals in Rawalpindi district

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Results

Discussion

Conclusion