Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011–2016

Tagbo, Beckie Nnenna; Mwenda, Jason M.; Eke, Christopher Bismarck; Edelu, Benedict O; Chukwubuike, C.; Armah, George; Seheri, Mapaseka; Isiaka, Ayodeji; Namadi, L.; Okafor, HU; Ozumba, UC; Nnani, Roservelt Okechukwu; Okafor, Vina; Njoku, R.; Odume, C.; Benjamin-Pujah, Chioma; Azubuike, C.; Umezinne, N.; Ogude, N.; Osarogborun, V.O.; Okwesili, M. U.; Ezebilo, S.K.; Udemba, O.; Yusuf, Kabir; Mahmud, Zahid Hayat; Ticha, Johnson Muluh; Obidike, Egbuna; Mphahlele, M. Jeffrey

doi:10.1016/j.vaccine.2018.03.084

Cited by 16 publications

(19 citation statements)

References 21 publications

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“…Therefore, severe dehydration was more among rotavirus positive cases than adenovirus positive cases. This pattern of finding has been reported earlier [17] [19] [35].…”

Section: Discussionsupporting

confidence: 90%

“…However, this rotavirus positivity dropped in the other months of the year to about 1%. Other studies have identified peaks of rotavirus gastroenteritis during the same period of the year in other tropical countries [17] [34] [35]. We did not observe similar marked seasonal distribution of infection among adenovirus positive cases.…”

Section: Discussioncontrasting

confidence: 80%

“…This study also showed higher numbers of viral infection in males than in females, as seen by other researchers [6] [19] [27] [30] [31]. The reasons for observed higher prevalence among male gender is not quite clear [17]. Other studies have found that girls were more susceptible to rotavirus and adenoviruses gastroenteritis than boys [20] [32] [33], but these differences were however not significant (p > 0.05).…”

Section: Discussionsupporting

confidence: 68%

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Adenovirus and Rotavirus Associated Diarrhoea in under 5 Children from Enugu Rural Communities, South East Nigeria

Tagbo¹,

Chukwubike²,

Ezeugwu³

et al. 2019

WJV

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Globally, diarrhoea is the second commonest infectious cause of death in children less than 5 years old. It is estimated that more than one billion diarrhoea episodes occur every year causing up to 700,000 deaths among children younger than 5 years of age. Seventy-two percent of these deaths occur in children below two years and enteric viruses have been recognized as a major cause of childhood diarrhoea. This study was undertaken to determine the prevalence of enteric Adenoviruses and Rotaviruses in children with diarrhoea in rural Enugu communities of Enugu State South East Nigeria. Methods: Stool samples were collected from children less than 5 years with diarrhoea seen in any of the participating hospitals in Enugu State. Samples were collected between June 2015 and May 2017. Detection of rotavirus and enteric adenovirus antigens were performed using commercially available ELISA kit (Oxoid-ProspecT®). Demographic data of the children were also collected. Results: Of the 290 stool samples that had sufficient materials for adenovirus and rotavirus ELISA, 14 (4.8%) and 89 (30.7%) were positive for enteric adenovirus and rotavirus respectively. 3 (1%) were co-infected with adenovirus and rotavirus. Rotavirus positive cases were more among hospitalized patients while enteric adenovirus was more among outpatients. Marked peaks of rotavirus positivity were seen in January of each year but no peak was seen among adenovirus positive cases. Higher vomiting frequencies and severe dehydration were more among rotavirus positive cases compared to adenovirus positive cases (p = 0.030 and 0.001 respectively). Conclusion: Many diarrhoea cases among children aged <5 in the population studied were associated with enteric adenoviruses and rotavirus. This finding suggests that en

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“…Therefore, severe dehydration was more among rotavirus positive cases than adenovirus positive cases. This pattern of finding has been reported earlier [17] [19] [35].…”

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 80%

Section: Discussionsupporting

confidence: 68%

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Adenovirus and Rotavirus Associated Diarrhoea in under 5 Children from Enugu Rural Communities, South East Nigeria

Tagbo¹,

Chukwubike²,

Ezeugwu³

et al. 2019

WJV

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“…Rotavirus infections in 2016 occurred throughout the year, with the highest peak being in June, 52% (cool dry month), September and October (hot dry months) 57% and 52% respectively. These ndings are consistent with the ndings documented in a study conducted in Nigeria where they had a marked seasonal peak, with more than 90% of rotavirus infections occurring during December to March, their cool dry months [21]. Similar results were documented from a study conducted by Mwenda and colleagues who showed that rotavirus infections occurred throughout the year in other African countries (Uganda, Ghana, and Ethiopia), with a peak prevalence generally being recorded during the cool dry months of the year [22].…”

Section: Discussionsupporting

confidence: 91%

Rotavirus breakthrough infections responsible for gastroenteritis in vaccinated infants who presented with acute diarrhea at University Teaching Hospitals, Children's Hospital in 2016, in Lusaka Zambia

Simwaka

Mulundu

Mwenda³

et al. 2019

Preprint

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Background Rotavirus has continued to affect under five children despite the introduction of the vaccine. This study aimed at characterizing the rotavirus genotypes responsible for diarrhoea infections in vaccinated infants aged 2 to 12 months and determined the relationship between rotavirus strains and the severity of diarrhoea in 2016. Materials and Methods We tested stool for group A rotavirus P6 antigen using an ELISA kit (ProSpecT TM , Oxford, UK). All positive specimens with enough sample were genotyped using reverse transcriptase polymerase chain reaction (RT-PCR). A 20-point Vesikari clinical score was used to determine the severity of acute diarrhoea. Diarrhoea scores between 1-5 were considered as mild, 6-10 scores were considered as moderate and scores greater or equal to 11 considered as severe. Results 153/424 (36%, 95% CI 31.5% to 40.9%) were positive for VP6 rotavirus antigen. The age specific rotavirus infections decreased significantly (p = 0.041) from 2 - 4 months 32.0%,followed by a 38.8% infection rate in the 5-8 months category and subsequently dropped in the infants aged 9-12 months with a positivity rate of 27.2%. 12.3% received a single dose of rotarix vaccine, 77.8% received 2 doses, and 9.9% were not vaccinated. 38.5% of those who received a single dose, 34.5% of those who received a complete dose and 45.2% of the unvaccinated tested positive for rotavirus. Infants who tested positive differed significantly from those who tested negative in terms of fever (p = 0.010).The predominant rotavirus genotypes were, G2P[6] 36%, G1P[8] 32%, mixed infections 19%, G2P[4] 6%, G1P[6] 4% and G9P[6] 3%. Infants who were infected with G1P8 and G2P[6] had a median Vesikari score of 6, while those who were infected with G1P[6] and mixed infections had a median score of 7 and those with infections due to G2P[4] and G9P[6] had median scores of 4 and 8 respectively. Discussion and Conclusion The breakthrough infection of heterotypic strains (G2P[6] (36%), homotypic, G1P[8] (32%) and mixed infections (19%) raises concerns about the effects of the vaccination on the rotavirus diversity, considering the selective pressure that rotavirus vaccines could exert on viral populations.

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“…Fischer et al [43] found the majority of cases in Guinea-Bissau occur from January to April, with few to zero cases outside these months. Another study in Enugu, Nigeria also reported this observed strong seasonal transmission with more than 90% of cases occurring between December and March over the six-year study period [44]. Similarly, in Ouagadougou (the capital of Burkina Faso), approximately 72% of acute gastroenteritis cases among children aged <5 years were rotavirus-positive during the dry season (November to May) relative to 6% rotavirus-positive during the wet season (June to October) [45].…”

Section: Discussionmentioning

confidence: 92%

Modeling of rotavirus transmission dynamics and impact of vaccination in Ghana

Asare

Al-Mamun

Armah

et al. 2020

Preprint

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Background Rotavirus incidence remains relatively high in low-income countries (LICs) compared to high-income countries (HICs) after vaccine introduction. Ghana introduced monovalent rotavirus vaccine in April 2012 and despite the high coverage, vaccine performance has been modest compared to developed countries. The predictors of low vaccine effectiveness in LICs are poorly understood, and the drivers of subnational heterogeneity in rotavirus vaccine impact are unknown. Methods We used mathematical models to investigate variations in rotavirus incidence in children <5 years old in Ghana. We fit models to surveillance and case-control data from three different hospitals: Korle-Bu Teaching Hospital in Accra, Komfo Anokye Teaching Hospital in Kumasi, and War Memorial Hospital in Navrongo. The models were fitted to both pre- and post-vaccine data to estimate parameters describing the transmission rate, waning of maternal immunity, and vaccine response rate. Results The seasonal pattern and age distribution of rotavirus cases varied among the three study sites in Ghana. Our model was able to capture the spatio-temporal variations in rotavirus incidence across the three sites and showed good agreement with the age distribution of observed cases. The rotavirus transmission rate was highest in Accra and lowest in Navrongo, while the estimated duration of maternal immunity was longer (~5 months) in Accra and Kumasi and shorter (~3 months) in Navrongo. The proportion of infants who responded to the vaccine was estimated to be high in Accra and Kumasi and low in Navrongo. Conclusions Rotavirus vaccine impact varies within Ghana. A low vaccine response rate was estimated for Navrongo, where rotavirus is highly seasonal and incidence limited to a few months of the year. Our findings highlight the need to further explore the relationship between rotavirus seasonality, maternal immunity, and vaccine response rate to determine how they influence vaccine effectiveness and to develop strategies to improve vaccine impact. Keywords Ghana; Rotavirus; Vaccine impact; Vaccine response rate; Maternal immunity; Transmission rate

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Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011–2016

Cited by 16 publications

References 21 publications

Adenovirus and Rotavirus Associated Diarrhoea in under 5 Children from Enugu Rural Communities, South East Nigeria

Adenovirus and Rotavirus Associated Diarrhoea in under 5 Children from Enugu Rural Communities, South East Nigeria

Rotavirus breakthrough infections responsible for gastroenteritis in vaccinated infants who presented with acute diarrhea at University Teaching Hospitals, Children's Hospital in 2016, in Lusaka Zambia

Modeling of rotavirus transmission dynamics and impact of vaccination in Ghana

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Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011–2016

Cited by 16 publications

References 21 publications

Adenovirus and Rotavirus Associated Diarrhoea in under 5 Children from Enugu Rural Communities, South East Nigeria

Adenovirus and Rotavirus Associated Diarrhoea in under 5 Children from Enugu Rural Communities, South East Nigeria

Rotavirus breakthrough infections responsible for gastroenteritis in vaccinated infants who presented with acute diarrhea at University Teaching Hospitals, Children's Hospital in 2016, in Lusaka Zambia

Modeling of rotavirus transmission dynamics and impact of vaccination in Ghana

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Resources

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Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011–2016