Rotavirus Gastroenteritis in Children in 4 Regions in Brazil: A Hospital‐Based Surveillance Study

Abstract

The prevalence, seasonality, and genotype distribution of rotavirus infection varied in different regions in Brazil. With immunization programs, continuous monitoring of rotavirus types is important to detect novel and emerging strains.

Projecting the effectiveness of RotaTeq® against rotavirus-related hospitalisations in Brazil

“…Knowing that rotavirus serotypes can vary from region to region, these effectiveness projections used the most recent rotavirus surveillance data from four regions of Brazil to obtain each region's weighted serotype-specific effectiveness (Munford et al 2009). The sensitivity analysis also accounted for variations in the effectiveness against mixed and non-typeable serotypes that may also affect overall vaccine effectiveness.…”

“…Serotype data used in this model included published hospital rotavirus surveillance data collected in four cities from different regions in Brazil -Goiânia, Porto Alegre, Salvador and São Paulo -from [2005][2006], providing the proportions of rotavirus attributable to serotypes G1, G2, G3, G4 and G9 (Table I) (Munford et al 2009). The model inputs for baseline serotype-specific vaccine efficacy were derived from the large-scale RV5 clinical trial, REST, that demonstrated the efficacy against RGE-related hospitalisations and emergency department (ED) visits for serotypes G1 [95%; 95% confidence interval (CI) 91.6-97.1], G2 (88%; 95% CI < 0-98.5), G3 (93%; 95% CI 49.4-99.1), G4 (89%; 95% CI 52.0-97.5) and G9 (100%; 95% CI 67.4-100.0) check the efficacy among infants from 11 countries (United States, Finland, Germany, Belgium, Sweden, Italy, Jamaica, Costa Rica, Mexico, Puerto Rico and Guatemala) (Vesikari et al 2006, Munford et al 2009). …”

“…International health agencies have determined that the development of rotavirus vaccines is the best means of preventing morbidity and mortality due to rotavirus infection (Bressee et al 2005, Guarino et al 2008 (Gentsch et al 1996, Santos & Hoshino 2005, Matthijnssens et al 2008. A recent surveillance study of cities in different regions in Brazil (Goiânia, Midwest Region, Porto Alegre, South Region, Salvador, Northeast Region, and São Paulo, Southeast Region) from 2005-2006 identified G9 as the predominant rotavirus serotype, followed by G2 and G1 (Munford et al 2009). In another surveillance study in the state of Minas Gerais, Brazil, from 2005-2007, 80% of rotavirus-positive stool samples were G1 (Nunes et al 2010).…”

Molecular characterization of group A rotavirus before and after the introduction of vaccines in Brazil

“…Positive samples were molecularly analyzed. Results: RVA positivity was 16.9%, with a predominance of G2P [4]. Periods: pre-vaccination: predominance of IId (G1), IId (G2) lineages, and I1 and E1 genotypes; post-vaccination: predominance of Ib (G1), IIa, and IIc (G2) lineages and I2 and E2 genotypes.…”

“…No statistical signifi cances were observed between the positivity rates and gender (p = 0.7418), age (p = 0.5895), symptoms (p = 0.2416), or vaccination status (p = 0.6793), although a higher detection rate was detected among unvaccinated children (23.1%) compared to vaccinated children (15.4%). Of the 11 positive samples, 4 were characterized as G2P [4], 6 were G2PNT (not genotyped), and 1 was GNTP [9][11]. Table 1 shows that of the 6 archived samples obtained before the introduction of the vaccine in Brazil, 5 were characterized as G1P [8] and 1 was G2PNT.…”