Molecular epidemiology of Rotavirus causing diarrhea among children less than five years of age visiting national level children hospitals, Nepal

Abstract

BackgroundRotaviruses are the major cause of diarrhea among the infants and young children all over the world causing over 500,000 deaths and 2.4 million hospitalizations each year. In Nepal Rotavirus infection positivity rates ranges from 17.0 to 39.0% among children less than 5 years. However, little is known about the molecular genotypes of Rotavirus prevailing. The objective of this study was to estimate the burden of Rotavirus gastroenteritis and determine the genotypes of Rotavirus among children less than 5 years.MethodsThe cross sectional study was conducted from January to November 2014 among children less than 5 years old visiting Kanti Children’s Hospital and Tribhuvan University Teaching Hospital.Rotavirus antigen detection was performed by Enzyme Linked Immunosorbent Assay (ELISA) using ProSpecT Rotavirus Microplate Assay. Among the Rotavirus antigen positive samples, 59 samples were used for Rotavirus RNA extraction. Multiplex PCR was performed to identify G type comprising G1-G4, G8-G10 and G12 and P type comprising P[4], P[6], P[8], P[9], P[10], and P[11].ResultsA total of 717 diarrheal stool samples were collected from patients ranging from 10 days to 59 months of age. Rotavirus antigen positive was found among (N = 164)22.9% of patients. The highest number of the diarrhea was seen in January. Molecular analysis of Rotavirus genotypes revealed that the predominant G-Type was G12 (36%) followed by G9 (31%), G1 (21%), G2 (8.6%). The predominant P- type was P6 (32.8%) followed by P8 (31%), P10 (14.8%), P4 (14.8%). A total of seven G/P type combinations were identified the most common being G12P [6] (35.8%), G1P [8] (15.1%), G9P [8] (15.1%).ConclusionRotavirus diarrhea is, mostly affecting children from 7 to 24 months in Nepal, mostly occurring in winter. The circulating genotypes in the country are found to be primarily unusual genotypes and predominance of G12P[6]. It is recommended to conduct genotyping of Rotavirus on large samples before starting vaccination in the country.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0858-0) contains supplementary material, which is available to authorized users.

Rotavirus: Genetics, pathogenesis and vaccine advances

“…42,43 Regionally, they are responsible for 14% of cases in Asia, 27% in Africa, 11% in South America, 5% in North America, 1.4% in Europe, and 0.1% in Australia. 44 A rare DS-1 like G1P [8] is recently reported in Thailand, Japan, and Vietnam showing reassortment between human and animal strains. 45 A rare G3P [9] genotype was first detected 46 in humans in Japan in 1982.…”

“…The unusual strains are associated with 4.9% of total RV infections all over the world . Regionally, they are responsible for 14% of cases in Asia, 27% in Africa, 11% in South America, 5% in North America, 1.4% in Europe, and 0.1% in Australia …”

“…By the support of Global Alliance for Vaccines and Immunisations (GAVI) Alliance and UNICEF, RV vaccination has been licensed in 86 countries including high‐income countries, upper‐middle‐income countries, and lower‐middle‐income countries . The global coverage is estimated to be 44% including 38 (52%) in low income GAVI support eligible countries …”

“…57 The global coverage is estimated to be 44% including 38 (52%) in low income GAVI support eligible countries. 44,115 12.2 | GAVI Alliance…”

Co-infection with Campylobacter and rotavirus in less than 5 year old children with acute gastroenteritis in Nepal during 2017-2018

“…Studies published on rotavirus infection in Nepal from 1999 to 2007 showed rotavirus positivity rates ranged from 17 to 39% among all hospitalized children less than 5 years (12)(13)(14)(15). Various published studies from 2008-2017 reported different prevalence rates of rotavirus infections in diarrhoeal children, ranging from 22-53% (16)(17)(18)(19).…”