Rotavirus Gastroenteritis Research Articles

Monovalent Rotavirus Vaccine Efficacy Against Different Rotavirus Genotypes: A Pooled Analysis of Phase II and III Trial Data.

Rotavirus vaccine performance appears worse in countries with high rotavirus genotype diversity. Evidence suggests diminished vaccine efficacy (VE) against G2P[4], which is heterotypic with existing monovalent rotavirus vaccine formulations. Most studies assessing genotype-specific VE have been underpowered and inconclusive. We pooled individual-level data from 10 Phase II and III clinical trials of rotavirus vaccine containing G1 and P[8] antigens (RV1) conducted between 2000 and 2012. We estimated VE against both any-severity and severe (Vesikari score ≥11) rotavirus gastroenteritis (RVGE) using binomial and multinomial logistic regression models for non-specific VE against any RVGE, genotype-specific VE, and RV1-typic VE against genotypes homotypic, partially heterotypic, or fully heterotypic with RV1 antigens. We adjusted models for concomitant oral poliovirus and RV1 vaccination and the country's designated child mortality stratum. Analysis included 87 644 infants from 22 countries in the Americas, Europe, Africa, and Asia. For VE against severe RVGE, non-specific VE was 91% (95% confidence interval [CI]: 87-94%). Genotype-specific VE ranged from 96% (95% CI: 89-98%) against G1P[8] to 71% (43-85%) against G2P[4]. RV1-typic VE was 92% (95% CI: 84-96%) against partially heterotypic genotypes but 83% (67-91%) against fully heterotypic genotypes. For VE against any-severity RVGE, non-specific VE was 82% (95% CI: 75-87%). Genotype-specific VE ranged from 94% (95% CI: 86-97%) against G1P[8] to 63% (41-77%) against G2P[4]. RV1-typic VE was 83% (95% CI: 72-90%) against partially heterotypic genotypes but 63% (40-77%) against fully heterotypic genotypes. RV1 VE is comparatively diminished against fully heterotypic genotypes including G2P[4].

Rotavirus vaccination and the risk of type 1 diabetes and celiac disease: A systematic review and meta-analysis

BackgroundRotavirus vaccination has been proven to effectively protect against rotavirus gastroenteritis. However, there are concerns about the relationship between rotavirus vaccination and the risk of autoimmune disorders. Thus, we conducted a systematic review and meta-analysis to comprehensively assess the association between rotavirus vaccination and type 1 diabetes (T1D) or celiac disease (CD) risk.MethodsA systematic review and meta-analysis were conducted to evaluate the type 1 diabetes or celiac disease associated with rotavirus vaccination. The following journal databases were searched to identify potential studies for inclusion: PubMed, Embase, and Cochrane Library databases.ResultsSeven articles involving more than 5,793,055 children were included. Our results showed that rotavirus vaccination does not alter the subsequent risk of T1D (RR 0.94, 95% CI: 0.82–1.09) or CD (RR 0.86, 95% CI: 0.64–1.17) after vaccination. Furthermore, the risk of T1D was not increased or decreased for children fully exposed to rotavirus vaccination (RR 0.86, 95% CI, 0.54–1.36) and for children partially exposed to rotavirus vaccination (RR 1.05, 95% CI, 0.87–1.26). However, younger (<5 years) vaccinated children at the end of study (RR 0.84, 95% CI = 0.75–0.95) may be at a lower risk for T1D than older (≥5 years) vaccinated children (RR 0.93, 95% CI, 0.81–1.07).ConclusionThe findings of this study suggest that rotavirus vaccination does not appear to be associated with T1D or CD in children. The protective effect of rotavirus vaccination on T1D may be presented by time dependent.

Efficacy, safety and immunogenicity of hexavalent rotavirus vaccine in Chinese infants.

A randomized, double-blind, placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a hexavalent live human-bovine reassortant rotavirus vaccine (HRV) against rotavirus gastroenteritis (RVGE). A total of 6400 participants aged 6–12 weeks were enrolled and randomly assigned to either HRV (n ​= ​3200) or placebo (n ​= ​3200) group. All the subjects received three oral doses of vaccine four weeks apart. The vaccine efficacy (VE) against RVGE caused by rotavirus serotypes contained in HRV was evaluated from 14 days after three doses of administration up until the end of the second rotavirus season. VE against severe RVGE, VE against RVGE hospitalization caused by serotypes contained in HRV, and VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were also investigated. All adverse events (AEs) were collected for 30 days after each dose. Serious AEs (SAEs) and intussusception cases were collected during the entire study. Our data showed that VE against RVGE caused by serotypes contained in HRV was 69.21% (95%CI: 53.31–79.69). VE against severe RVGE and RVGE hospitalization caused by serotypes contained in HRV were 91.36% (95%CI: 78.45–96.53) and 89.21% (95%CI: 64.51–96.72) respectively. VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were 62.88% (95%CI: 49.11–72.92), 85.51% (95%CI: 72.74–92.30) and 83.68% (95%CI: 61.34–93.11). Incidences of AEs from the first dose to one month post the third dose in HRV and placebo groups were comparable. There was no significant difference in incidences of SAEs in HRV and placebo groups. This study shows that this hexavalent reassortant rotavirus vaccine is an effective, well-tolerated, and safe vaccine for Chinese infants.

Cost-effectiveness of rotavirus vaccination in Mozambique

IntroductionRotavirus is one of the most common cause of severe gastroenteritis in children, with the largest mortality burden in low- and middle-income countries. To prevent rotavirus gastroenteritis, Mozambique introduced ROTARIX® vaccine in 2015, however, its cost-effectiveness has never been established in the country. In 2018, additional vaccines became available globally. This study estimates the cost-effectiveness of the recently introduced ROTARIX in Mozambique and compares the cost-effectiveness of ROTARIX®, ROTAVAC®, and ROTASIIL® to inform future use. MethodsWe used a decision-support model to calculate the potential cost-effectiveness of vaccination with ROTARIX compared to no vaccination over a five-year period (2016–2020) and to compare the cost-effectiveness of ROTARIX, ROTAVAC, and ROTASIIL to no vaccination and to each other over a ten-year period (2021–2030). The primary outcome was the incremental cost per disability-adjusted life-year (DALY) averted from a government perspective. We assessed uncertainty through sensitivity analyses. ResultsFrom 2016 to 2020, we estimate the vaccine program with ROTARIX cost US$12.3 million, prevented 4,628 deaths, and averted US$3.1 million in healthcare costs. The cost per DALY averted was US$70. From 2021 to 2030, we estimate all three vaccines could prevent 9,000 deaths and avert US$7.8 million in healthcare costs. With Global Alliance for Vaccines and Immunization (Gavi) support, ROTARIX would have the lowest vaccine program cost (US$31 million) and 98 % probability of being cost-effective at a willingness-to-pay threshold of 0.5x GDP per capita. Without Gavi support, ROTASIIL would have the lowest vaccine program cost (US$75.8 million) and 30 % probability of being cost-effective at the same threshold. ConclusionROTARIX vaccination had a substantial public health impact in Mozambique between 2016 and 2020. ROTARIX is currently estimated to be the most cost-effective product, but the choice of vaccine should be re-evaluated as more evidence emerges on the price, incremental delivery cost, wastage, and impact associated with each of the different rotavirus vaccines.

Concordance of in vitro and in vivo measures of non-replicating rotavirus vaccine potency

Rotavirus infections remain a leading cause of morbidity and mortality among infants residing in low- and middle-income countries. To address the large need for protection from this vaccine-preventable disease we are developing a trivalent subunit rotavirus vaccine which is currently being evaluated in a multinational Phase 3 clinical trial for prevention of serious rotavirus gastroenteritis. Currently, there are no universally accepted in vivo or in vitro models that allow for correlation of field efficacy to an immune response against serious rotavirus gastroenteritis. As a new generation of non-replicating rotavirus vaccines are developed the lack of an established model for evaluating vaccine efficacy becomes a critical issue related to how vaccine potency and stability can be assessed. Our previous publication described the development of an in vitro ELISA to quantify individual vaccine antigens adsorbed to an aluminum hydroxide adjuvant to address the gap in vaccine potency methods for this non-replicating rotavirus vaccine candidate. In the present study, we report on concordance between ELISA readouts and in vivo immunogenicity in a guinea pig model as it relates to vaccine dosing levels and sensitivity to thermal stress. We found correlation between in vitro ELISA values and neutralizing antibody responses engendered after animal immunization. Furthermore, this in vitro assay could be used to demonstrate the effect of thermal stress on vaccine potency, and such results could be correlated with physicochemical analysis of the recombinant protein antigens. This work demonstrates the suitability of the in vitro ELISA to measure vaccine potency and the correlation of these measurements to an immunologic outcome.

ROTAVIRUS AND GASTROENTERITIS: CLINICAL AND EPIDEMIOLOGICAL TRAITS

There is a strong association between rotavirus and gastroenteritis. The gastroenteritis by rotavirus is one of the most important cause of child internation at hospital. The rotavirus belongs to the Reoviridae family, genus Rotavirus and it have been classified into seven groups (A to G), where the A group is the major cause of diarrhea in children, and the B group in adults. The symptoms of the rotavirus gastroenteritis are high fever, vomiting, and severe diarrhea, leading to dehydration. Subclinical and assymptomatic rotavirus infections are very common among adults. The detection of rotavirus is done by various methods. The treatment is the use of Oral Rehydration Salts, the control is made through epidemiological vigilance and the immunization is done by the use of vaccines (as RRV-TV, in the US market, and 89-12, still being tested).Was realized this bibliographic research using the international databanks SCIELO, BIREME, PUBMED and HIGHWIRE. The diarrhea caused by this virus is the most common severe infection in children younger than 5 years and it leads to approximately 440.000 deaths per year. By this way, efforts to discovery of vaccines more effective should be stimulated and the health workers must be prepared to detect these viruses to alert the epidemiological vigilance. Key words: rotavirus; gastroenteritis; diarrhea; children diarrhea; viruses.

Platelet indices as an acute phase reactant in infants admitted with acute febrile illness

Background: The most common causes of thrombocytosis are infectious illnesses; platelet count is unaffected by fever duration. Infectious disorders such rotavirus gastroenteritis, respiratory syncytial virus infection, hepatitis B and C virus infection, brucellosis, and pulmonary tuberculosis, and also medical and non-medical situations, might impact mean platelet volume (MPV) readings. C-reactive protein (CRP) plasma concentration changes during infection or inflammation as part of the innate immune response. Aim was to investigate in children with febrile illness the correlation between platelet indices and CRP.Methods: This hospital based descriptive study was conducted in post graduate Department of Paediatrics and Neonatology, an associated hospital of Government Medical College and Hospital, Srinagar, from December 2019 to November 2021. As per sample size calculation 3000 patients were included in the study. Patients of either sex, age from 1 month to 1 year of age with fever admitted in hospital were included in the study.Results: There was a significantly positive correlation between platelet count and CRP. The sensitivity was highest for platelets at 96.67 and lowest for MPV 32.97 while as specificity was highest for white blood cells (WBC) at 94.4 for MPV was 92.22 and lowest for platelet (PLT) 30.77. Spearman rank correlation between platelet indices and CRP value children with fever with high CRP had a significantly high PT and it has significant positive correlation with CRP.Conclusions: We found a strong link between CRP and platelet counts in patients. Platelet count, platelet distribution width (PDW), MPV, and plateletcrit (PCT) were all influenced.

First CD3/CD45RA depleted haploidentical transplant for severe combined immunodeficiency disease with Rotavirus gastroenteritis in Vietnam

Severe combined immunodeficiency includes inherited diseases with impairment of T cells development, often associated with profound defects of B and/or NK cells differentiation. Rotavirus infection is responsible for severe acute gastroenteritis and over 400,000 deaths a year in children aged &lt; 5 years, especially in low and middle-income countries. We report a nine-month-old girl presented with failure to thrive left axillary lymphadenitis post-BCG-vaccination, persistent, nonvaccine-associated rotavirus gastroenteritis. An immune evaluation revealed absent T lymphocytes, B lymphocytes, normal NK cells with genetic testing confirmed RAG2 severe combined immunodeficiency. Rotavirus gastroenteritis persisted despite the administration of oral immunoglobulin pre-transplantation. The patient was treated by a haploidentical transplant -from mother as a donor using CD3/CD45RA+ depletion kit, CliniMACs system (Miltenyi). The first transplant was performed without conditioning. One month post-transplant, rotavirus was cleared. The second transplant was performed three months later, with myeloablative conditioning (Bu-Flu-rATG). Neutrophils engrafted on day +10 post-transplant, platelet engrafted on day +45. Whole blood chimerism on day +28 post 2nd transplant was 100%. Serum IgG level has been normalized without IVIG infusion three months post 2nd transplant.

Wild and domestic animals variably display Neu5Ac and Neu5Gc sialic acids.

Sialic acids are used as a receptor by several viruses and variations in the linkage type or C-5 modifications affect the binding properties. A species barrier for multiple viruses is present due to α2,3- or α2,6-linked sialic acids. The C-5 position of the sialic acid can be modified to form N-acetylneuraminic acid (Neu5Ac) or N-glycolylneuraminic acid (Neu5Gc), which acts as a determinant for host susceptibility for pathogens such as influenza A virus, rotavirus, and transmissible gastroenteritis coronavirus. Neu5Gc is present in most mammals such as pigs and horses but is absent in humans, ferrets, and dogs. However, little is known about C-5 content in wildlife species or how many C-5 modified sialic acids are present on N-linked glycans or glycolipids. Using our previously developed tissue microarray system, we investigated how 2 different lectins specific for Neu5Gc can result in varying detection levels of Neu5Gc glycans. We used these lectins to map Neu5Gc content in wild Suidae, Cervidae, tigers, and European hedgehogs. We show that Neu5Gc content is highly variable among different species. Furthermore, the removal of N-linked glycans reduces the binding of both Neu5Gc lectins while retention of glycolipids by omitting methanol treatment of tissues increases lectin binding. These findings highlight the importance of using multiple Neu5Gc lectins as the rich variety in which Neu5Gc is displayed can hardly be detected by a single lectin.

Long-term surveillance of rotavirus vaccination after implementation of a national immunization program in Finland (2008–2018)

BackgroundRotavirus (RV) vaccination was included in the Finnish National immunization Program (NIP) in 2009. RotaTeq (RV5) has been used exclusively with a national average vaccination coverage rate (VCR) of > 90%. While previous studies have demonstrated that inpatient rotavirus gastroenteritis (RVGE) admissions declined by as much as 96% in Finnish children ≤ 5 years old following RV vaccination introduction, no study has evaluated long-term protection after vaccination in Finland. In this study, we analyze incidence of hospital outpatient visits and inpatient admissions of gastroenteritis in children up to 7 years of age. MethodsWe first describe the incidence of RVGE, viral gastroenteritis (VGE), and acute gastroenteritis (AGE) for all Finnish children born during 2008–2011. Children were stratified by the year of birth into not-eligible, partially eligible and rotavirus vaccine-eligible (born in 2008, 2009, 2010 and 2011, respectively). Hospital inpatient and outpatient data was collected from the National Care Register for all children from birth until December 31st, 2018. We also studied RVGE incidence during 2014–2017 for children<3 years of age in municipalities with VCRs of 90% and above and municipalities with VCRs below 90%. ResultsRVGE incidence decreased significantly soon after implementation of RV vaccination in the NIP. In vaccine-eligible cohorts, no clear peak incidence in the youngest age groups could be observed, and no RVGE cases were observed beyond 6 years after vaccination, in contrast to vaccine ineligible and partially eligible cohorts. Despite an overall high VCR in Finland, regions with high VCR had lower incidence of RVGE than regions with lower VCR. ConclusionIncidence of RVGE has remained low in all age groups during the 10 years following introduction of RV vaccine in the Finnish NIP. Differences in RVGE incidence were observed in regions with high as compared with lower VCR, highlighting the importance of maintaining high vaccination coverage.

Understanding Variation in Rotavirus Vaccine Effectiveness Estimates in the United States: The Role of Rotavirus Activity and Diagnostic Misclassification.

Estimates of rotavirus vaccine effectiveness (VE) in the United States appear higher in years with more rotavirus activity. We hypothesized rotavirus VE is constant over time but appears to vary as a function of temporal variation in local rotavirus cases and/or misclassified diagnoses. We analyzed 6 years of data from eight US surveillance sites on 8- to 59-month olds with acute gastroenteritis symptoms. Children's stool samples were tested via enzyme immunoassay (EIA); rotavirus-positive results were confirmed with molecular testing at the US Centers for Disease Control and Prevention. We defined rotavirus gastroenteritis cases by either positive on-site EIA results alone or positive EIA with Centers for Disease Control and Prevention confirmation. For each case definition, we estimated VE against any rotavirus gastroenteritis, moderate-to-severe disease, and hospitalization using two mixed-effect regression models: the first including year plus a year-vaccination interaction, and the second including the annual percent of rotavirus-positive tests plus a percent positive-vaccination interaction. We used multiple overimputation to bias-adjust for misclassification of cases defined by positive EIA alone. Estimates of annual rotavirus VE against all outcomes fluctuated temporally, particularly when we defined cases by on-site EIA alone and used a year-vaccination interaction. Use of confirmatory testing to define cases reduced, but did not eliminate, fluctuations. Temporal fluctuations in VE estimates further attenuated when we used a percent positive-vaccination interaction. Fluctuations persisted until bias-adjustment for diagnostic misclassification. Both controlling for time-varying rotavirus activity and bias-adjusting for diagnostic misclassification are critical for estimating the most valid annual rotavirus VE.

Effect of Rotavirus Infection on Serum Micronutrients and Atopy in Children

AbstractObjective Rotavirus is a highly infectious and prevalent ribonucleic acid (RNA) virus that causes fatal gastroenteritis in children. Despite vitamin D deficiency is associated with susceptibility to infections, the relationship between ferritin and vitamin B12 levels is not known. This study aimed to investigate and compare the effect of rotavirus on micronutrient levels, atopy, and the frequency of allergic diseases in children with rotavirus.Methods There were rotavirus gastroenteritis (RVG) (N = 92) and non-rotavirus (control) groups (N = 95). Serum micronutrient levels (B12, ferritin, and 25-hydroxyvitamin D [25-OH-D3]) were checked during the first control after gastroenteritis healed. Patients were also examined for allergic diseases on an average of 17 (14–32) months following rotavirus infection. Serum immunoglobulin E (IgE), eosinophil count, and percentage were analyzed. Skin tests and respiratory function tests were also performed on patients with allergic disease and asthma symptoms.Results Mean ferritin, B12, and 25-OH-D3 levels were lower in the RVG group compared with the control group. Allergic diseases in the RVG group were more frequent than in the control group. The prevalence of the allergic disease in the RVG group was 16.3%, as opposed to 5.2% in the control group (p = 0.014). The IgE level was significantly higher in the RVG group.Conclusion Children with rotavirus infection should be followed closely in terms of allergic diseases and micronutrient deficiency. Furthermore, rotavirus infection should be prevented in the society and early treatment should be made available via tests detecting micronutrient deficiency.

Molecular assay for rotavirus NP4 protein gene in infected children under five years in Hilla City

Rotavirus gastroenteritis is one of the most common causes of severe diarrhea in children under the age of five worldwide, with the majority of mortality in lower-income countries. A total of 150 children under the age of five year were involved. (100 child suffering from rotavirus diarrhea were enrolled at Babylon Maternity and Children's Hospital –Al Noor Children's Hospital and 50 child healthy as control), for RT-PCR and RNA extraction the cDNA for DNA sequencing method was carried out to identification genetic variation (substation Mutations) analysis in non-structural protein NSP4 (NSP4) gene of local Human Rotavirus A isolates (IQH1 - IQH.5) and NCBI-Blast related Human Rotavirus A isolates. The phylogenetic tree genetic relationship analysis was showed that local Human Rotavirus A isolates (IQH.1 - IQH.4) were showed closed related to NCBI-BLAST Human Rotavirus A strain RV1326 , the local Human Rotavirus A isolates (IQH.5) were showed closed related to NCBI-BLAST Human Rotavirus A strain G1P at total genetic changes (0.0080-0.0020%).The homology sequence identity between local Human Rotavirus A isolates (IQH1 - IQH.4) and NCBI BLAST related Human Rotavirus A strain RV1326 were showed genetic homology sequence identity ranged from (99.37-99.84%).

Determination and Genotype Distribution of Rotavirus Gastroenteritis in Pediatric Patients Admitted to a Tertiary Care Hospital

Acute infectious gastroenteritis is a prevalent disease worldwide, and most of the cases are caused by viral pathogens. Many different viruses, including Rotavirus (RV), Norovirus, Adenovirus, and Astroviruses, are responsible for most acute viral gastroenteritis cases. According to the Centers for Disease Control and Prevention (CDC), viral gastroenteritis infections cause more than 200 000 child mortalities each year worldwide. One of the best strategies to reduce the global burden of RV gastroenteritis is the development and administration of effective vaccines. However, since there are differences in the coverage of the vaccines, the choice of appropriate vaccine for localized genotypes based on regions is important. The aim of this study was to detect the RV infections in our region and to perform genotyping using real time polymerase chain reaction (Rt-PCR) and high resolution melting (HRM) analysis. A total of 341 stool samples collected from pediatric patients were tested. Lateral flow immunochromatographic assay principle based assay was used for antigen detection. RT-PCR and HRM were applied for genotype analysis. Similar to the data from our country and Eastern Mediterranean region, RV positivity in stool samples was 23.1%. The majority of the patients (51%) were aged 0-2 years and the vast majority of the patients, with a rate of 77%, were between the ages of 0-5. Most of the cases were detected in the winter months, especially in February. The distribution of 40 samples, whose G genotype could be detected, was as follows: G2, 21 (52.5%); G1, 11 (27.5%); G9, 5 (12.5%); G3, 2 (5%); G4, 1 (2.5%). The distribution of 53 samples, whose P genotype could be detected, was as follows: P4, 44 (83.0%); P9, 8 (15.1%); P10, 1 (1.9%). Among those whose genotype could be detected, the most prevalent genotypes were G2 with 52.5% and P4 with 83%. When the distribution of 25 samples was evaluated, in which RV G and P genotypes were detected simultaneously, G1P [4] 11 (44%), G2P[9] 5 (20%), G9P[4] 5 (20%), G2P[4] 2 (8%), G3P[10] 1 (4%), and G4P[4] 1 (4%) genotypes were determined, respectively. The most commonly observed genotype was G1P[4]. In the HRM analysis, it was observed that the melting curve peaks were at different temperatures in nine of the G2 genotype samples and 16 of the P4 and P9 genotype samples. Thus, genotyping with HRM analysis could not be fully finalized, especially for G2 and P. Of the Rota Teq® and RotarixTM vaccines administered on demand in our country, Rota Teq® is considered the vaccine that has the widest coverage for the genotypes observed in our country and region. ROTASIIL® vaccine, which covers all the genotypes in our region (G1, G2, G3, G4, G9) is not available in our country. The emergence of the strains with the potential to increase the current burden of RV disease should be continuously monitored, as different results are obtained by region and year, even within the same country. Thus, the emergence of vaccine-resistant strains can be followed up, especially in countries with higher viral diversity.

Regional hospitalisation and seasonal variations of Pediatric rotavirus gastroenteritis pre- and post-RV vaccination: a prospective and retrospective study.

Rotavirus is the primary cause of gastroenteritis in children worldwide and is a leading cause of gastroenteritis in children, with a significant burden. Rotavirus vaccine became available in Ireland in 2016. This study aimed to investigate hospital admissions and seasonal characteristics of rotavirus gastroenteritis in a pre- and post-vaccination period in a single district general hospital. In the post-vaccination year, from November 18th 2016 to November 18th 2017, all children up to 3years of age who presented to Mayo University Hospital with vomiting and diarrhea, were recruited and had their stool tested for rotavirus. Retrospective analysis of hospital data of children of the same age during pre-vaccination years (2014-2016) were used for comparison. Compared with the pre-vaccination years (2014-2016), the median percentages of reduction of rotavirus positive stool requests and hospital admissions were high, 48.5% and 73%, respectively. In the post-vaccination year, the median percentage of reduction of emergency department presentation (stool requests) with gastroenteritis was 9%. No delay in the onset of RV season or reduction of the peak of RV infection was noted in the post-vaccination year. The duration of rotavirus season in 2016/2017 was short. Compared with 3 pre-vaccination years, the total number of gastroenteritis presentations, gastroenteritis hospital admissions, and rotavirus positive gastroenteritis cases were all reduced, and the duration of the rotavirus season was shorter.

Role of routine laboratory markers in the diagnosis of rotavirus and adenovirus gastroenteritis

Purpose: The present study aimed to evaluate and estimate the additional and auxiliary diagnostic value of routine laboratory parameters in patients with acute diarrhea caused by rotavirus and adenovirus. Methods/ patients: A total of 6784 patients diagnosed with acute gastroenteritis were evaluated. Rotavirus and adenovirus infection was diagnosed via a Qualitative immunochromatographic combo rapid cassette antigen test. Complete blood count and biochemical blood tests were performed in all the patients and were compared between the groups according to the positivity or negativity of the virus. Results: Rotavirus diarrhea was diagnosed in 16.8% and adenovirus diarrhea in 3.2% of patients. Hemoglobin, hematocrit, and mean cell volume (MCV) levels were lower, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly higher in rotavirus positive cases. Neutrophil to lymphocyte ratio was significantly higher, and lymphocyte to monocyte ratio was significantly lower in positive rotavirus cases than negative ones 2.96 and 2.56, respectively (p&lt;0.001). Conclusions: Hematological and biochemical parameters may assist in diagnosing and distinguishing rotaviral and adenoviral gastroenteritis, especially in low-resource environments. Keywords: adenovirus; children; diarrhea; laboratory markers; rotavirus

Effectiveness of Monovalent Rotavirus Vaccine in Mozambique, a Country with a High Burden of Chronic Malnutrition.

Mozambique introduced monovalent rotavirus vaccine (Rotarix®) in September 2015. We evaluated the effectiveness of Rotarix® under conditions of routine use in Mozambican children hospitalized with acute gastroenteritis (AGE). A test negative case-control analysis was performed on data collected during 2017–2019 from children <5 years old, admitted with AGE in seven sentinel hospital sites in Mozambique. Adjusted VE was calculated for ≥1 dose of vaccine vs. zero doses using unconditional logistic regression, where VE = (1 − aOR) × 100%. VE estimates were stratified by age group, AGE severity, malnutrition, and genotype. Among 689 children eligible for analysis, 23.7% were rotavirus positive (cases) and 76.3% were negative (controls). The adjusted VE of ≥1 dose in children aged 6–11 months was 52.0% (95% CI, −11, 79), and −24.0% (95% CI, −459, 62) among children aged 12–23 months. Estimated VE was lower in stunted than non-stunted children (14% (95% CI, −138, 66) vs. 59% (95% CI, −125, 91)). Rotavirus vaccination appeared moderately effective against rotavirus gastroenteritis hospitalization in young Mozambican children. VE point estimates were lower in older and stunted children, although confidence intervals were wide and overlapped across strata. These findings provide additional evidence for other high-mortality countries considering rotavirus vaccine introduction.

Polynesian medicine used to treat diarrhea and ciguatera: An ethnobotanical survey in six islands from French Polynesia

Ethnopharmacological relevanceIn French Polynesia, many pathologies common or endemic to the territory cause diarrhea. This is the case for rotavirus gastroenteritis, salmonella food poisoning, ingestion of water contaminated by bacteria, and ciguatera. To treat these ailments, the population may employ traditional medicine for cultural reasons, geographical isolation, and poor health coverage. Polynesian remedies are often used without medical consultation and there is no data on their benefit-risk balance. A few ethnobotanical studies have been carried out in order to identify the traditional remedies used for various ailments, but few studies have focused on gastrointestinal pathologies. In this context, an ethnobotanical survey was carried out to identify treatments used for diarrhea and ciguatera, inventory the plants used, better understand the local representation of these remedies, and provide efficacy and safety data on these uses. Materials and methodsFrom February to April 2021, a semi-structured survey was conducted on six islands in French Polynesia, including one island in the Windward Islands archipelago (Tahiti), three islands in the Marquesas archipelago (Hiva Oa, Nuku Hiva, Tahuata), and two islands in the Leeward Islands archipelago (Raiatea, Tahaa). A total of 133 people was interviewed including 34 specialists (of which 29 experts in herbalism). ResultsThese people mentioned the use of 27 plants for the treatment of diarrhea, and 24 for the treatment of ciguatera. Citrus aurantiifolia, Psidium guajava and Cordyline fruticosa were the three most cited plant species used for treating diarrhea, while Cocos nucifera, Punica granatum and Barringtonia asiatica were the most cited for ciguatera. A large majority of plants are widespread and introduced plants, which is congruent with the history of Polynesian people. While some plants are well known for similar uses (e.g. Psidium guajava for diarrhea, Heliotropium arboreum for ciguatera), others are less well known and may present toxicity risks (e.g. Barringtonia asiatica for ciguatera). ConclusionTraditional Polynesian medicine is an integral part of the local culture so important to be preserved and valued. However, more pharmacological and toxicological studies are still needed to determine the benefit-risk balance of some of these remedies and to allow their official integration into the Polynesian health system.

Experience with the use of the drug cycloferon in the treatment of rotaviral infection in children

Introduction. Rotavirus infection is the leading cause of acute gastroenteritis in young children. Due to the lack of etiotropic treatment of viral gastroenteritis, the interest of scientists and practitioners in the use of antiviral drugs is increasing. Studies of domestic authors have proven that the low molecular weight interferon inductor – meglumine acridonacetate has antiviral, immunoregulatory and anti-inflammatory activity.Aim. Evaluation of the efficacy and safety of the antiviral drug meglumine acridonacenate in the treatment of acute gastroenteritis of rotavirus etiology in children aged 4–7 years in a hospital setting.Materials and methods. A prospective analysis of cases of treatment with meglumine acridonacetate for moderately severe rotavirus gastroenteritis in preschool children (n = 29, group I) was carried out. The comparison group consisted of patients receiving standard therapy (n = 31, group II). The presence of rotavirus infection was confirmed by the detection of the pathogen antigen in the feces. Meglumine acridonacetate was prescribed according to the scheme, parenterally, every other day.Results and discussion. The effectiveness of therapy with an antiviral drug on the 3rd day of treatment of moderately severe rotavirus gastroenteritis was 79.3% (p &lt; 0.05). The elimination of the main clinical symptoms of the disease was noted on days 2–3: a decrease in the symptoms of intoxication, fever, a significant decrease in the duration of vomiting and diarrhea (p &lt; 0.05), a reduction in the pathogen elimination period by 2.67 days (p &lt; 0.01), meglumine acridonacetate was well tolerated, no side effects of the drug were detected.Conclusions. Meglumine acridonacetate can be recommended for the complex treatment of moderate rotavirus infection from the first days of the disease.

Pathogen-specific response of infectious gastroenteritis to ambient temperature: National surveillance data in the Republic of Korea, 2015-2019.

The objective of this study was to investigate the relationship between ambient temperature and common viral and bacterial gastroenteritis in the Republic of Korea, which has a high-income and temperate climate, considering the different lagged effects of each causative pathogen. We obtained the number of weekly reported cases of infectious gastroenteritis caused by norovirus, group A rotavirus, enteric adenovirus, Clostridium perfringens, non-typhoidal Salmonella, and Campylobacter between 2015 and 2019 from the Korean Infectious Diseases Sentinel Surveillance System. We obtained weather data from the Korea Meteorological Administration for the same period. Generalized linear models with quasi-Poisson distributions and distributed lag non-linear models were utilized after adjusting for relative humidity, precipitation, long-term trends, and seasonality. We investigated the associations between weekly mean temperature and the weekly number of reported cases of each type of infectious gastroenteritis by applying different maximum lags for each type. Compared with the 50th percentile temperature, the lag-cumulative relative risks (RRs) with 95% confidence intervals (CIs) at the 5th percentile temperature for norovirus gastroenteritis, rotavirus gastroenteritis, adenovirus gastroenteritis were 11.0 (4.7-25.7), 2.7 (1.4-5.2), and 4.7 (1.4-15.8) by applying the maximum lag of 6, 4, and 3 weeks, respectively. Compared with the 50th percentile temperature, the lag-cumulative RRs with 95% CIs at the 95th percentile temperature for C. perfringens gastroenteritis, Salmonella gastroenteritis, and Campylobacter gastroenteritis were 1.2 (0.8-1.9), 3.0 (1.5-6.2), and 2.0 (1.1-3.6), by applying the maximum lag of 2, 3, and 2 weeks, respectively. Cold temperature increased the risk of viral gastroenteritis and showed relatively long lagged effects. Hot temperature increased the risk of bacterial gastroenteritis and showed relatively short lagged effects.