Epidemiology and pre-vaccine burden of rotavirus diarrhea in Democratic Republic of Congo (DRC): Results of sentinel surveillance, 2009–2019

Rotavirus and adenovirus infections in children with acute gastroenteritis after introducing the Rotasiil® vaccine in Kisangani, Democratic Republic of the Congo

“…We observed that the prevalence of rotavirus infection in Kisangani after the introduction of the rotavirus vaccine is low compared with that for the DRC as a whole, estimated at 60% at sentinel rotavirus infection surveillance sites [ 11 ]; it remains almost identical to that found by Heylen before the introduction of the rotavirus vaccine in its study including two health facities included in this study ( Hôpital Général de Référence de Makiso and Centre de Santé Nouveau Village de Pédiatrie) [ 14 ]. This could be explained by the fact that a high number of unusual genotypes and gene segments of animal origin, as demonstrated by Heylen’s study in symptomatic children, were not part of the Rotasiil ® vaccine antigens.…”

“…The Democratic Republic of the Congo (DRC) is one of four countries, including India, Nigeria, and Pakistan, that account for almost half of all rotavirus-related deaths [ 7 ]. In this country, the rate of rotavirus infection was 60% in children under five years of age admitted with acute gastroenteritis before the vaccine’s introduction in 2019 [ 10 , 11 ]. To the best of our knowledge, empirical findings on the epidemiology and clinic of rotavirus are scarce, apart from a few results from sentinel rotavirus post-vaccination surveillance sites in the DRC.…”

Clinical profile of children under 5 years of age with rotavirus diarrhoea in a hospital setting in Kisangani, DRC, after the introduction of the rotavirus vaccine, a cross-sectional study

“…Prior to the introduction of vaccination, Heylen E and Bibi found a prevalence ranging from 18.8 to 37.1% with an average of 29% in children under 5 years of age [ 17 ]. However, in Lubumbashi, Sangaji found a high prevalence of 53.9% in children under 5 years of age suffering from acute diarrhoea [ 18 ], while in sentinel sites, the prevalence of acute rotavirus diarrhoea in children under 5 years of age was 60% [ 6 ]. We believe that the high proportion of unvaccinated children could explain this prevalence.…”

“…Regardless of where they live, almost all children are infected with rotavirus at least once before the age of 5 years, despite efforts to improve immunisation, hygiene and access to safe water in many parts of the world [ 4 , 5 ]. In the Democratic Republic of the Congo, rotavirus infection is a real public health problem and before the introduction of the rotavirus vaccine, the rotavirus mortality rate was estimated to be around 7% of the global under-five mortality rate in DRC [ 3 , 6 ]. The clinical manifestations of rotavirus infection vary greatly with age and previous exposure to the virus, ranging from asymptomatic infection to severe manifestations of diarrhoea, vomiting and dehydration [ 5 , 7 ].…”

“…Presented as the best way to protect children against rotavirus in several countries [ 11 , 12 ]; it is since 2019, the DRC, with the support of the World Health Organisation (WHO), has introduced the Rotasiil vaccine into the routine vaccination of children, following the example of other countries in Africa and this vaccine was recommended for all children in the DRC within the framework of the National Expanded Programme on Immunisation [ 13 , 14 ]. This vaccine, manufactured by the Serum Institute of India, includes five genotypes G1, G2, G3, G4 and G9 that are frequently involved in acute diarrhoea in children in Africa [ 6 , 15 ]. Although data on the impact of vaccination on the epidemiological and clinical changes of rotavirus infection in children under 5 years of age are available globally and in some SSA countries [ 7 , 10 ], there are still few data available for the DRC, especially the city of Kisangani.…”