Prevalence of Rotavirus, Adenovirus, and Hepatitis A Virus in a Tertiary Care Hospital in Somalia

Abstract

Rotavirus, one of the viral infectious agents that is transmitted mainly through the fecal-oral route and spreads easily in regions with poor sanitation conditions, is the most common causative agent of acute gastroenteritis in children under five years of age worldwide, and enteric adenoviruses are other frequently encountered causative agents of gastroenteritis in childhood. Hepatitis A virus (HAV) is also transmitted in similar routes and is endemic in regions with poor sanitation conditions and limited access to clean water and is usually acquired in early childhood in these regions. In this study conducted in Mogadishu Somalia, rotavirus and adenovirus antigen test (immunochromatographic rapid test) results in patients admitted to a tertiary hospital in the 9-month period between February 2019 and October 2019 and ELISA based HAV antibody test results studied in 2018-2019 were retrospectively examined and it was aimed to determine the distribution of positivity rates of these viruses by age, gender, and year. During the study period, 1136 patients (mean age 6.33±12.36) were tested for rotavirus and adenovirus antigens, and 362 patients (mean age 21.26±18.45) were tested for anti-HAV IgM/IgG antibodies. The positivity rates of rotavirus and adenovirus were found as 17.8% and 5.1%, respectively. The positivity rates of anti-HAV IgM and IgG antibodies were 26.5% and 85.4%. The age group with the highest rotavirus test positivity was babies under one year old (27.3%), positivity rate was also high in children aged 1-2 years old (20.9%), and this distribution was similar for adenovirus. Although a small number of patients were tested in under five years of age, anti-HAV IgG seropositivity was 60% and above in all age groups. The highest anti-HAV IgM positivity rates were observed in children 2-<5 and 5-15 years of age, 52.9% and 44% respectively. Rotavirus antigen positivity was found at high levels in the three-month period covering June, July, and August 2019. In July (2019), it was observed that the number of rotavirus and adenovirus antigen test requests were increased, and also, at the same time the highest positivity rates for both viruses were observed; 31.2% and 9.5% for rotavirus and adenovirus. Rotavirus and enteric adenovirus co-infection was detected in 2.4% (27/1136) of the patients, and 23 (85.2%) of these were under five years of age children. Our study results show that children under the age of two are especially affected by rotavirus and adenovirus infections in Somalia and indicate that HAV infections are acquired at an early childhood. We can say that it may be useful to review vaccination programs as an important public health measure to reduce the burden of mortality and morbidity associated with HAV and rotavirus, which have a high prevalence and also have protective vaccines.