Prevalence of severe acute rotavirus gastroenteritis and intussusceptions in Ghanaian children under 5 years of age

Abstract

Introduction: Vaccination is the most effective preventive strategy against rotavirus disease. Regional differences in prevalent rotavirus genotypes may affect vaccine efficacy. Pre-vaccine surveillance for burden of rotavirus disease, prevalent rotavirus genotypes, and association between rotavirus disease and intussusceptions helps in monitoring the impact of vaccination. Methodology: A prospective study was conducted from January 2008 to December 2009 in children younger than five years hospitalized for longer than 24 hours with acute gastroenteritis. Data on confirmed cases of intussusception were collected retrospectively. Stools were tested by enzyme immunoassay, reverse-transcriptase polymerase chain reaction and nucleotide sequencing. Results: Acute gastroenteritis (AGE) caused 13.1% (2,147/16,348) of hospitalizations among children under five years. Stools were tested for 50.2% (1077/2147) of AGE cases. Of these, 49% (528/1077) were rotavirus positive. Rotavirus gastroenteritis, non-rotavirus gastroenteritis, and intussusceptions were most prevalent in children under 15 months [80.3%, 74% and 91% respectively]. Rotavirus was detected from more than 60% of acute gastroenteritis cases during peak months. The prevalence of intussusception showed no seasonal pattern. The peak ages of six to twelve months for acute gastroenteritis and five to eight months for intussusception overlapped. G1, G2 and mixed G/P genotypes were common in the isolated rotaviruses. Conclusion: Rotavirus gastroenteritis causes significant morbidity in children younger than five years of age in Ghana. Although the peak age of rotavirus gastroenteritis and intussusceptions overlapped, there was no seasonal correlation between them. The high prevalence of mixed G/P genotypes in Ghanaian children may affect the effectiveness of vaccination.

Association of Meteorological Factors with Pediatric Intussusception in Subtropical China: A 5-Year Analysis

“…However, Ho et al reported 952 intussusception cases in Taiwan from 1999 to 2001, and they concluded that there was no seasonal trend [12]. Enweronu-Laryea et al reported no intussusception seasonality in a 5-year study of Ghanaian children [13]. Khumju et al reported 72 intussusception cases over 3 years in Thailand finding that the peak of intussusception incidence for this sample was in the winter [14].…”

Surveillance for Rotavirus Gastroenteritis in Children Less Than 5 Years of Age in Togo

“…9,16,[19][20][21][22][23][24][25] In developed countries, in europe particularly, studies have shown that the prevalence varied between 41% and 46%. 2,6,7,10,26,27 the high prevalence of rotavirus gastroenteritis globally suggests that, unlike for other causes of gastroenteritis, improved sanitary conditions will probably not be enough to fight against rotavirus infection.…”

“…13,16,19,20,23,24 Current rotavirus vaccines were shown to provide broad heterotypic protection against a wide variety of circulating strains in clinical trials. 4,18,[36][37][38] Given the yearly changes in circulating genotypes and the enormous diversity observed, evaluating the performance and impact of rotavirus vaccines and monitoring circulating strains pre-and postrotavirus vaccine introduction would be important in countries like togo with great strain diversity.…”

“…4,5,18 In sub-Saharan Africa, genotypes of circulating rotavirus strains differ from 1 country to another. 13,16,19,20 In anticipation of the introduction of rotavirus vaccine into the routine immunization schedule in togo, this study highlights the importance of epidemiological data on this disease and knowledge of circulating strains before vaccine introduction.…”

The Accuracy of Elisa Versus Latex Agglutination Tests in Diagnosis of Rotavirus Acute Gastroenteritis and the Clinical Usefulness of C- Reactive Protein in Iraqi Children

“…The World Health Organization (WHO) has encouraged the introduction of a rotavirus vaccine into national immunisation programs, particularly in poorer countries [6]. Pre-vaccine surveillance to estimate the burden of rotavirus disease, prevalent rotavirus genotypes and the association between rotavirus disease and intussusceptions helps in monitoring the impact of vaccination [7].…”