Abstract
BackgroundRotavirus immunization has been effective in developed countries where genotype G1P[8] is the predominant rotavirus strain. Knowledge of circulating strains in a population before introduction of rotavirus immunization program will be useful in evaluating the effect of the intervention.MethodsRotavirus was identified by enzyme immuno-assay (EIA) on stool specimens of children (age 0 – 59 months) hospitalized with acute gastroenteritis from August 2007 to February 2011 in Accra, Ghana. Rotavirus positive specimens were further characterized by polyacrylamide gel electrophoresis (PAGE) and reverse-transcriptase polymerase chain reaction (RT-PCR).ResultsOf the 2277 acute gastroenteritis hospitalizations 1099 (48.2%) were rotavirus-positive by EIA. Of the 1099 cases 977 (89%) were PAGE positive. All EIA positive specimens were further subjected to RT-PCR and 876 (79.7%) had sufficient material for characterization. Of these 876 cases, 741 (84.6%) were assigned G genotype, 709 (80.9%) P genotype, and 624 (71.2%) both G and P genotypes. We identified 8 G genotypes (G1, G2, G3, G4, G8, G9, G10, G12) and 3 P genotypes (P[4], P[6], P[8]). G1 (50.9%), G2 (18.8%), G3 (12.8%), P[8] (36.1%) and P[6] (30.7%) were the most prevalent. The most prevalent genotype combination was G1P[8] (28%). Mixed G (7.3%) and P (24.2%) genotypes were not uncommon. There was year-by-year and seasonal variations for most genotypes.ConclusionThere is great diversity of rotavirus strains in children with severe gastroenteritis in southern Ghana. Even though cross-protection with vaccine-induced immunity occurs, continued strain surveillance is recommended after the introduction of rotavirus vaccine in the national immunization program.
Highlights
Rotavirus immunization has been effective in developed countries where genotype G1P[8] is the predominant rotavirus strain
This report presents the rotavirus genotypes identified in children hospitalized with acute gastroenteritis in southern Ghana prior to the introduction of rotavirus vaccination
This report documents the genetic characterization of group A rotaviruses associated with severe acute gastroenteritis in children less than 5 years of age prior to the introduction of rotavirus vaccination in southern Ghana
Summary
Rotavirus immunization has been effective in developed countries where genotype G1P[8] is the predominant rotavirus strain. Knowledge of circulating strains in a population before introduction of rotavirus immunization program will be useful in evaluating the effect of the intervention. The World Health Organization (WHO) recommends surveillance for the burden of rotavirus disease and circulating rotavirus strains, before and after inclusion of rotavirus vaccination in national expanded programs on immunization [13]. Previous work has been published on rotavirus strains in the dry savannah northern part of Ghana but little is known about circulating rotavirus strains in the warm humid southern part of the country. This report presents the rotavirus genotypes identified in children hospitalized with acute gastroenteritis in southern Ghana prior to the introduction of rotavirus vaccination
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