Prevalence of Rotavirus Genotypes in Children Younger than 5 Years of Age before the Introduction of a Universal Rotavirus Vaccination Program: Report of Rotavirus Surveillance in Turkey

Abstract

BackgroundGroup A rotaviruses are the most common causative agent of acute gastroenteritis among children less than 5 years of age throughout the world. This sentinel surveillance study was aimed to obtain baseline data on the rotavirus G and P genotypes across Turkey before the introduction of a universal rotavirus vaccination program.MethodsRotavirus antigen-positive samples were collected from 2102 children less than 5 years of age who attended hospitals participating in the Turkish Rotavirus Surveillance Network. Rotavirus antigen was detected in the laboratories of participating hospitals by commercial serological tests such as latex agglutination, immunochromatographic test or enzyme immunoassay. Rotavirus G and P genotypes were determined by reverse transcription polymerase chain reaction (RT-PCR) using consensus primers detecting the VP7 and VP4 genes, followed by semi-nested type-specific multiplex PCR.ResultsRT-PCR found rotavirus RNA in 1644 (78.2%) of the samples tested. The highest rate of rotavirus positivity (38.7%) was observed among children in the 13 to 24 month age group, followed by children in the age group of 25 to 36 months (28.3%). A total of eight different G types, six different P types, and 42 different G–P combinations were obtained. Four common G types (G1, G2, G3, and G9) and two common P types (P[8] and P[4]) accounted for 95.1% and 98.8% of the strains, respectively. G9P[8] was the most common G/P combination found in 40.5% of the strains followed by G1P[8] (21.6%), G2P[8] (9.3%), G2P[4] (6.5%), G3P[8] (3.5%), and finally, G4P[8] (3.4%). These six common genotypes included 83.7% of the strains tested in this study. The rate of uncommon genotypes was 14%.ConclusionThe majority of the strains analyzed belonged to the G1–G4 and G9 genotypes, suggesting high coverage of current rotavirus vaccines. This study also demonstrates a dramatic increase in G9 genotype across the country.

Epidemiology and genetic diversity of group A rotavirus in acute diarrhea patients in pre‐vaccination era in southwest China

“…G9P[8] (55.4%) was predominant G and P combination, and the total proportion of G9P[8], G3P[8], and G1P[8] was as high as 81.8% in all RVA strains in the study, similar conclusion was obtained from other study [Durmaz et al, ]. The result of G and P combinations in study was different from other study, which showed G3P[8] (32.1%) and G1P[8] (24.5%) were the two most common genotype in diarrhea children in China [Li et al, ], this phenomenon might be attributed that G9 became dominant prevalence since 2011, that is why the combination of G9 and P genotypes became mainly G and P combinations.…”

“…In the study, G9 was the most common genotype in diarrhea cases, this result was correspond with the molecular epidemiology feature of RVA in China [Liu et al, ]. The predominance of G genotype had fluctuation in different periods and regions [Durmaz et al, ], G1 was predominant strain in China before 2000 year, and then G3 was most common genotype since 2000–2010, and then G9 became preponderant prevalence genotype in some regions of China since 2011 year, G genotypes variation might be attributed to natural variability [Li et al, ; Liu et al, ]. In addition, the RVA variance also had selective pressure to G genotype fluctuation, for instance, in Belgium, when RVA variance was introduced, G1 and G4 decreased with the G9 increased sharply [Zeller et al, ]; in Denmark, G9 became predominant genotype since 2011 [Midgley et al, ].…”

“…The result of G and P combinations in study was different from other study, which showed G3P[8] (32.1%) and G1P[8] (24.5%) were the two most common genotype in diarrhea children in China [Li et al, ], this phenomenon might be attributed that G9 became dominant prevalence since 2011, that is why the combination of G9 and P genotypes became mainly G and P combinations. In Turkey, G9P[8] was also prominent genotype [Durmaz et al, ]; but some study showed that G1P[8] was prominent G and P combinations, followed by G3[P8] [Wu et al, ; Banyai et al, ].…”

Complications with rotavirus: A single center experiences

“…It might be related to the serotypes being responsible for more severe infections in our region. Although it is only a speculative reason due to lack of serotyping in our study, Durmaz et al recently reported a Rotavirus surveillance study in Turkey 21 . It was conducted in the same time period of our study and they found that G9P8 was the most common serotype.…”

The effects of nosocomial rotavirus gastroenteritis on the length of hospital stay and cost

“…It was reported that, in 2004, 527,000 children under the age of five died from rotavirus infection and more than 85% of these deaths occurred in Asian and Ssb-Saharan African countries [4]. Rotavirus positivity in children with gastroenteritis has been reported to be between 21% and 43.6% in Turkey [5].…”