TY - JOUR
T1 - Hospital based surveillance and molecular characterization of rotavirus in children less than 5 years of age with acute gastroenteritis in Nepal
AU - Sherchand, Jeevan B.
AU - Thakali, Ocean
AU - Sherchan, Jatan B.
AU - Bhandari, Dinesh
AU - Tandukar, Sarmila
AU - Paudel, Krishna Prasad
AU - Shrestha, Binod Man
AU - Rayamajhi, Ajit
AU - Rai, Ganesh K.
N1 - Funding Information:
The authors would like to acknowledge SEARO-WHO, WHO-IPD Nepal office and CDC, Atlanta, Georgia for supporting the surveillance in Nepal. We are very much grateful to Dr. Gagandeep Kang, Professor and Head, The Wellcome Trust Research Laboratory CMC Vellore WHO collaborating center for technical cooperation. In addition we would like to express our sincere gratitude to Dr. Jacqueline E Tate, Dr. Negar Aliabadi and Dr. Umesh Parashar from CDCfor their support. We would alsolike to thank Ms. Sony Shrestha and Ms. Kalpana Shrestha from Public Health Research Laboratory and Kanti Children Hospital for their co-operation during the study.
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/12/14
Y1 - 2018/12/14
N2 - Background: Rotavirus remains a significant causative agent of childhood acute gastroenteritis, particularly among children less than 5 years of age. Although precise data on childhood mortality associated with diarrheal disease in Nepal is not available, it is estimated that 22% of all rotavirus deaths globally occurs in neighboring country of India. In spite of the substantial burden of rotavirus gastroenteritis in the Indian subcontinent, rotavirus vaccine has not been introduced in Nepal. Continuous surveillance for monitoring rotavirus disease burden and molecular characterization is needed prior to rotavirus vaccine introduction in Nepal. Methods: A total of 3310 stool samples (2849 hospitalized cases and 461 non-hospitalized cases), were collected from patients <5 years of age from January 2013 to December 2016 and tested for rotavirus antigen by ELISA (ProSpecT, USA). A subset of ELISA positive stool samples was genotyped. Demographic data were collected. Results: During the four-year surveillance period, the overall burden of rotavirus infection was 24% among hospitalized children which was much higher than among non-hospitalized children (12%). The majority of children hospitalized with rotavirus gastroenteritis were less than 2 years of age (86%). Rotavirus-associated gastroenteritis hospitalizations occur year-round in Nepal, but a distinct peak in winter (up to 40% among hospitalized) was observed. Of 735 ELISA positive samples, 492 were genotyped by RT-PCR. The most prevalent genotype was G12P[6] (45.3%), followed byG2P[4](12.2%), G1P[8] (9.6%), G9P[4](7.3%), and G9P[8](4.5%). Mixed infection accounted for 4.4% of cases, 6.2% were partially typed and 10.5% of the samples were G and P untypable. Conclusions: A high burden of rotavirus gastroenteritis and a diversity of circulating rotavirus strains in Nepal were observed. Recommendation to introduce a rotavirus vaccine with known vaccine effectiveness would help in reducing the severity of Rotavirus diarrheal disease in children less than 5 years of age.
AB - Background: Rotavirus remains a significant causative agent of childhood acute gastroenteritis, particularly among children less than 5 years of age. Although precise data on childhood mortality associated with diarrheal disease in Nepal is not available, it is estimated that 22% of all rotavirus deaths globally occurs in neighboring country of India. In spite of the substantial burden of rotavirus gastroenteritis in the Indian subcontinent, rotavirus vaccine has not been introduced in Nepal. Continuous surveillance for monitoring rotavirus disease burden and molecular characterization is needed prior to rotavirus vaccine introduction in Nepal. Methods: A total of 3310 stool samples (2849 hospitalized cases and 461 non-hospitalized cases), were collected from patients <5 years of age from January 2013 to December 2016 and tested for rotavirus antigen by ELISA (ProSpecT, USA). A subset of ELISA positive stool samples was genotyped. Demographic data were collected. Results: During the four-year surveillance period, the overall burden of rotavirus infection was 24% among hospitalized children which was much higher than among non-hospitalized children (12%). The majority of children hospitalized with rotavirus gastroenteritis were less than 2 years of age (86%). Rotavirus-associated gastroenteritis hospitalizations occur year-round in Nepal, but a distinct peak in winter (up to 40% among hospitalized) was observed. Of 735 ELISA positive samples, 492 were genotyped by RT-PCR. The most prevalent genotype was G12P[6] (45.3%), followed byG2P[4](12.2%), G1P[8] (9.6%), G9P[4](7.3%), and G9P[8](4.5%). Mixed infection accounted for 4.4% of cases, 6.2% were partially typed and 10.5% of the samples were G and P untypable. Conclusions: A high burden of rotavirus gastroenteritis and a diversity of circulating rotavirus strains in Nepal were observed. Recommendation to introduce a rotavirus vaccine with known vaccine effectiveness would help in reducing the severity of Rotavirus diarrheal disease in children less than 5 years of age.
KW - Children
KW - Genotyping
KW - Hospital based
KW - Nepal
KW - Rotavirus surveillance
UR - http://www.scopus.com/inward/record.url?scp=85055521369&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2018.07.044
DO - 10.1016/j.vaccine.2018.07.044
M3 - Article
C2 - 30385057
AN - SCOPUS:85055521369
SN - 0264-410X
VL - 36
SP - 7841
EP - 7845
JO - Vaccine
JF - Vaccine
IS - 51
ER -
