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Magzoub MA, Bilal NE, Bilal JA, Alzohairy MA, Elamin BK, Gasim GI. Detection and sequencing of rotavirus among sudanese children. Pan Afr Med J 2017; 28:87. [PMID: 29255557 PMCID: PMC5724952 DOI: 10.11604/pamj.2017.28.87.11008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 08/16/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Diarrheal diseases are a big public health problem worldwide, particularly among developing countries. The current study was conducted to detect and characterize group A rotavirus among admitted children with gastroenteritis to the pediatric hospitals, Sudan. METHODS A total of 755 stool samples were collected from Sudanese children with less than 5 years of age presenting with acute gastroenteritis during the period from April to September 2010. Enzyme-linked immunosorbent assay (ELISA) was used to Detection of Rotavirus antigens. Ribonucleic acid (RNAs) were extracted from rotavirus-positive stool samples using (QIAamp® Viral RNA Mini Kit). (Omniscript® Reverse Transcription kit) was used to convert RNA to complementary Deoxyribonucleic acid (cDNA). The cDNAs were used as template for detection of VP4-P (P for Protease-sensitive) and VP7-G (G for Glycoprotein) genotyping of Rotavirus using nested PCR and sequencing. RESULTS Out of the 755 stool samples from children with acute gastroenteritis, 121 were positive for rotavirus A. Among 24 samples that were sequenced; the VP7 predominant G type was G1 (83.3%), followed by G9 (16.7%). Out of these samples, only one VP4 P[8] genotype was detected. CONCLUSION As a conclusion the VP7 predominant G type was G1, followed by G9 whereas only one VP4 genotype was detected and showed similarity to P[8] GenBank strain. It appears that the recently approved rotavirus vaccines in Sudan are well matched to the rotavirus genotypes identified in this study, though more studies are needed.
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Affiliation(s)
- Magzoub Abbas Magzoub
- National Public Health Laboratory, Ministry of Health, Khartoum, Sudan
- Faculty of Medical Laboratory Sciences, Khartoum University, Khartoum, Sudan
- College of Applied Medical Science, Qassim University, Buraydah, Saudi Arabia
| | - Naser Eldin Bilal
- Faculty of Medical Laboratory Sciences, Khartoum University, Khartoum, Sudan
| | - Jalal Ali Bilal
- College of Medicine, Qassim University, Qassim, Saudi Arabia
| | | | - Bahaeldin Khalid Elamin
- Faculty of Medical Laboratory Sciences, Khartoum University, Khartoum, Sudan
- College of Medicine, Bisha University, Bisha, Saudi Arabia
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Impact of self-financed rotavirus vaccines on hospital stays and costs in Spain after a 3-year introductory period. Epidemiol Infect 2017; 145:1773-1785. [PMID: 28367780 DOI: 10.1017/s0950268817000620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vaccination has reduced rotavirus hospitalizations by 25% in European regions with low-moderate vaccine availability. We aimed to quantify the reduction in hospital costs after the longest period in which Rotarix® and Rotateq® were simultaneously commercially available in Spain. Cases, length of stay (LOS), and diagnosis-related groups (DRGs) were retrieved from the Minimum Basic Data Set. Healthcare expenditure was estimated through the cost accounting system Gescot®. DRGs were clustered: I, non-bacterial gastroenteritis with complications; II, without complications; III, requiring surgical/other procedures or neonatal cases (highest DRG weights). Comparisons between pre (2003-2005)- and post-vaccine (2007-2009) hospital stays and costs by DRG group were made. Rotaviruses were the most common agents of specific-coded gastroenteritis (N = 1657/5012). LOS and extended LOS of rotaviruses fell significantly in 2007-2009 (β-coefficient = -0·43, 95% confidence intervals (95% CI) -0·68 to -0·17; and odds ratio 0·62, 95% CI 0·50-0·76, respectively). Overall, costs attributable to rotavirus hospitalizations fell approximately €244 per patient (95% CI -365 to -123); the decrease in DRG group III was €2269 per patient (95% CI -4098 to -380). We concluded modest savings in hospital costs, largely attributable to cases with higher DRG weights, and a faster recovery. A universal rotavirus vaccination program deserves being re-evaluated, regarding its potential high impact on both at-risk children and societal costs.
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Hospital admissions for seizure in Italy: a decennial retrospective analysis with a special focus on the burden in the pediatric age. Neurol Sci 2015; 36:1667-73. [DOI: 10.1007/s10072-015-2230-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/20/2015] [Indexed: 11/26/2022]
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Magzoub MA, Bilal NE, Bilal JA, Osman OF. Rotavirus infection among Sudanese children younger than 5 years of age: a cross sectional hospital-based study. Pan Afr Med J 2013; 16:88. [PMID: 24711878 PMCID: PMC3976662 DOI: 10.11604/pamj.2013.16.88.2519] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 11/04/2013] [Indexed: 02/05/2023] Open
Abstract
Introduction In Sudan, rotavirus has been one of the important causative agents of diarrhea among children. Rotavirus A is well known as the leading cause of diarrhea in young children worldwide. It was estimated to account for 41% of hospitalized cases of acute gastroenteritis among children in Sub-Saharan Africa. This study aimed to determine the prevalence and the common clinical presentations of rotavirus A infection among Sudanese children with gastroenteritis seeking management in hospitals. Methods 755 Sudanese children less than 5 years of age suffering from acute gastroenteritis in hospital settings were included. The positive stool specimens for rotavirus A was used for extract Ribonucleic acid (RNA) and the RNA product was loaded on formaldehyde agarose gel and visualized under UV illumination. Results Of the 755 children, 430(57%) were males while 325(43%) were female. The age of children ranged from 1 to 60 months. There were 631 (84%) children who were less than 24 months of age. Out of the 755 stool samples, 121(16%) were positive for rotavirus. Of the 121 infected children with rotavirus, 79(65.3%) were male and 42(34.7%) were female and the highest infection rate was seen among 91(75.2%) of children up to 12 months of age. Children of illiterate parents were more infected with rotavirus than children of educated parents. Severe dehydration present among 70% of infected children with rotavirus. Conclusion Since this study is hospital-based, the 16% prevalence rate may not reflect the true prevalence among Sudanese children, thus a community-based surveillance is needed.
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Affiliation(s)
| | - Naser Eldin Bilal
- Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Khartoum University P.O. Box 11081, Khartoum, Sudan
| | - Jalal Ali Bilal
- Pediatric Department, college of Medicine, Qassim University, P.O. Box 6699 Buraydah 51452, Saudi Arabia
| | - Omran Fadl Osman
- Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Khartoum University P.O. Box 11081, Khartoum, Sudan
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Zlamy M, Kofler S, Orth D, Würzner R, Heinz-Erian P, Streng A, Prelog M. The impact of Rotavirus mass vaccination on hospitalization rates, nosocomial Rotavirus gastroenteritis and secondary blood stream infections. BMC Infect Dis 2013; 13:112. [PMID: 23452879 PMCID: PMC3599253 DOI: 10.1186/1471-2334-13-112] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 02/27/2013] [Indexed: 11/12/2022] Open
Abstract
Background The aim of the study was to evaluate the effects of universal mass vaccination (UMV) against rotavirus (RV) on the hospitalization rates, nosocomial RV infections and RV-gastroenteritis (GE)-associated secondary blood stream infections (BSI). Methods The retrospective evaluation (2002–2009) by chart analysis included all clinically diagnosed and microbiologically confirmed RV-GE cases in a large tertiary care hospital in Austria. The pre-vaccination period (2002–2005) was compared with the recommended and early funded (2006–2007) and the funded (2008–2009) vaccination periods. Primary outcomes were RV-GE-associated hospitalizations, secondary outcomes nosocomial RV disease, secondary BSI and direct hospitalization costs for children and their accompanying persons. Results In 1,532 children with RV-GE, a significant reduction by 73.9% of hospitalized RV-GE cases per year could be observed between the pre-vaccination and the funded vaccination period, which was most pronounced in the age groups 0–11 months (by 87.8%), 6–10 years (by 84.2%) and 11–18 years (88.9%). In the funded vaccination period, a reduction by 71.9% of nosocomial RV-GE cases per year was found compared to the pre-vaccination period. Fatalities due to nosocomial RV-GE were only observed in the pre-vaccination period (3 cases). Direct costs of hospitalized, community-acquired RV-GE cases per year were reduced by 72.7% in the funded vaccination period. The reduction of direct costs for patients (by 86.9%) and accompanying persons (86.2%) was most pronounced in the age group 0–11 months. Conclusions UMV may have contributed to the significant decrease of RV-GE-associated hospitalizations, to a reduction in nosocomial RV infections and RV-associated morbidity due to secondary BSI and reduced direct hospitalization costs. The reduction in nosocomial cases is an important aspect considering severe disease courses in hospitalized patients with co-morbidities and death due to nosocomial RV-GE.
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Affiliation(s)
- Manuela Zlamy
- Department of Pediatrics, Pediatrics I, Innsbruck Medical University, Anichstr, 35, 6020, Innsbruck, Austria
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Ogilvie I, Khoury H, Goetghebeur MM, El Khoury AC, Giaquinto C. Burden of community-acquired and nosocomial rotavirus gastroenteritis in the pediatric population of Western Europe: a scoping review. BMC Infect Dis 2012; 12:62. [PMID: 22429601 PMCID: PMC3342230 DOI: 10.1186/1471-2334-12-62] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 03/19/2012] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Rotavirus affects 95% of children worldwide by age 5 years and is the leading cause of severe dehydrating diarrhea. The objective of this review was to estimate the burden of rotavirus gastroenteritis (RVGE) in the Western European pediatric population. METHODS A comprehensive literature search (1999-2010) was conducted in PubMed and other sources (CDC; WHO, others). Data on the epidemiology and burden of RVGE among children < 5 years-old in Western Europe --including hospital-acquired disease--were extracted. RESULTS 76 studies from 16 countries were identified. The mean percentage of acute gastroenteritis (AGE) cases caused by rotavirus ranged from 25.3%-63.5% in children < 5 years of age, peaking during winter. Incidence rates of RVGE ranged from 1.33-4.96 cases/100 person- years. Hospitalization rates for RVGE ranged from 7% to 81% among infected children, depending on the country. Nosocomial RVGE accounted for 47%-69% of all hospital-acquired AGE and prolonged hospital stays by 4-12 days. Each year, RVGE incurred $0.54- $53.6 million in direct medical costs and $1.7-$22.4 million in indirect costs in the 16 countries studied. Full serotyping data was available for 8 countries. G1P[8], G2P[4], G9P[8], and G3P[8] were the most prevalent serotypes (cumulative frequency: 57.2%- 98.7%). Serotype distribution in nosocomial RVGE was similar. CONCLUSIONS This review confirms that RVGE is a common disease associated with significant morbidity and costs across Western Europe. A vaccine protecting against multiple serotypes may decrease the epidemiological and cost burden of RVGE in Western Europe.
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Affiliation(s)
- Isla Ogilvie
- BioMedCom Consultants Inc., 1405 TransCanada Highway, Suite 310, Montreal, QC, H9P 2V9, Canada
| | - Hanane Khoury
- BioMedCom Consultants Inc., 1405 TransCanada Highway, Suite 310, Montreal, QC, H9P 2V9, Canada
| | - Mireille M Goetghebeur
- BioMedCom Consultants Inc., 1405 TransCanada Highway, Suite 310, Montreal, QC, H9P 2V9, Canada
| | | | - Carlo Giaquinto
- Department of Paediatrics, University of Padua, Padua, Italy
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Abbott C, Tiede B, Armah G, Mahmoud A. Evaluation of cost-effectiveness of live oral pentavalent reassortant rotavirus vaccine introduction in Ghana. Vaccine 2012; 30:2582-7. [DOI: 10.1016/j.vaccine.2012.01.076] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 01/18/2012] [Accepted: 01/24/2012] [Indexed: 11/24/2022]
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G2 as an emerging rotavirus strain in pediatric gastroenteritis in southern Italy. Infection 2011; 39:113-9. [PMID: 21437737 DOI: 10.1007/s15010-011-0102-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 02/14/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND Human rotaviruses (HRVs) represent a major cause of acute gastroenteritis in children worldwide. It is estimated that they are responsible for a large number of diarrhea-associated hospitalizations in childhood each year. In Italy, limited data are available on the patterns of distribution of HRV G and P types. We report here the results of 2 years of rotavirus strain surveillance among children with severe gastroenteritis diagnosed in the town of Portici, Campania, southern Italy. METHODS A total of 421 stool specimens from children between 6 months and 5 years of age and presenting acute diarrhea were collected and tested by routine diagnostic tests for HRV, adenovirus, astrovirus, norovirus, and common bacterial pathogens. RESULTS The laboratory results showed that 110 of the 225 (26.1%) virus-positive samples contained HRVs. The different G and P rotavirus genotypes were analyzed by polymerase chain reaction (PCR). Among the VP7 genotypes identified, G1 and G2 were predominant, with percentages of 48.2 and 30.9%, respectively. G4, G9, and G10 were detected in a minority of cases. Among the VP4 genotypes, P[8] occurred the most frequently (56.4%), followed by P[4] (31.8%), and only a few P[10] and P[11] at percentages of 1.8 and 0.9%, respectively. CONCLUSION Our epidemiological data of HRV strains will contribute to assessing the magnitude of the problem of HRV in the south of Italy.
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Panatto D, Amicizia D, Giacchino R, Tacchella A, Natalizia AR, Melioli G, Bandettini R, Pietro P, Diana MC, Gasparini R. Burden of rotavirus infections in Liguria, northern Italy: hospitalisations and potential savings by vaccination. Eur J Clin Microbiol Infect Dis 2011; 30:957-64. [DOI: 10.1007/s10096-011-1180-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 01/14/2011] [Indexed: 11/28/2022]
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Lou JT, Xu XJ, Wu YD, Tao R, Tong MQ. Epidemiology and burden of rotavirus infection among children in Hangzhou, China. J Clin Virol 2011; 50:84-7. [DOI: 10.1016/j.jcv.2010.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 06/02/2010] [Accepted: 10/04/2010] [Indexed: 10/18/2022]
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Berry SA, Johns B, Shih C, Berry AA, Walker DG. The cost-effectiveness of rotavirus vaccination in Malawi. J Infect Dis 2010; 202 Suppl:S108-15. [PMID: 20684689 DOI: 10.1086/653578] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Rotarix (GlaxoSmithKline), a newly licensed rotavirus vaccine requiring 2 doses, may have the potential to save hundreds of thousands of lives in Africa. Nations such as Malawi, where Rotarix is currently under phase III investigation, may nevertheless face difficult economic choices in considering vaccine adoption. METHODS The cost-effectiveness of implementing a Rotarix vaccine program in Malawi was estimated using published estimates of rotavirus burden, vaccine efficacy, and health care utilization and costs. RESULTS With 49.5% vaccine efficacy, a Rotarix program could avert 2582 deaths annually. With GAVI Alliance cofinancing, adoption of Rotarix would be associated with a cost of $5.07 per disability-adjusted life-year averted. With market pricing, Rotarix would be associated with a base case cost of $74.73 per disability-adjusted life-year averted. Key variables influencing results were vaccine efficacy, under-2 rotavirus mortality, and program cost of administering each dose. CONCLUSIONS Adopting Rotarix would likely be highly cost-effective for Malawi, particularly with GAVI support. This finding holds true across uncertainty ranges for key variables, including efficacy, for which data are becoming available.
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Affiliation(s)
- Stephen A Berry
- Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
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Festini F, Cocchi P, Mambretti D, Tagliabue B, Carotti M, Ciofi D, Biermann KP, Schiatti R, Ruggeri FM, De Benedictis FM, Plebani A, Guarino A, de Martino M. Nosocomial Rotavirus Gastroenteritis in pediatric patients: a multi-center prospective cohort study. BMC Infect Dis 2010; 10:235. [PMID: 20696065 PMCID: PMC2928776 DOI: 10.1186/1471-2334-10-235] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Accepted: 08/09/2010] [Indexed: 11/30/2022] Open
Abstract
Background Few data are available on the incidence of nosocomial Rotavirus infections (NRVI) in pediatric hospitals and on their economic impact. The goals of this study were: to evaluate the incidence of NRVI in various Italian pediatric wards during the course of two peak RV seasons; to investigate possible risk factors for NRVI; to estimate the costs caused by NRVI. Methods prospective cohort study. Population: all the children under 30 months of age who were admitted without any symptom or diagnosis of gastroenteritis in the pediatric hospitals of Florence, Naples, Brescia and Ancona, Italy, during the winter-spring periods 2006-2007 and 2007-2008. Serial RV rapid tests and clinical monitoring were carried out on the cohort. Telephone interviews were performed from 3 to 5 days after discharge. Results 520 out of 608 children completed the study (85.6%). The overall incidence of NRVI was 5.3% (CI95% 3.6-7.5), (7.9 per 1,000 days of hospital stay, CI 95% 5.3-11.3). The average duration of hospital stay was significantly longer for children who had NRVI (8.1 days, SD 5.4) than for non-infected children (6.4 days, SD 5.8, difference 1.7 days, p = 0.004). The risk of contracting NRVI increased significantly if the child stayed in hospital more than 5 days, RR = 2.8 (CI95% 1.3-6), p = 0.006. In Italy the costs caused by NRVI can be estimated at 8,019,155.44 Euro per year. 2.7% of the children hospitalized with no gastroenteritis symptoms tested positive for RV. Conclusions Our study showed a relevant incidence of NRVI, which can increase the length of the children's stay in hospital. Limiting the number of nosocomial RV infections is important to improve patients' safety as well as to avoid additional health costs.
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Affiliation(s)
- Filippo Festini
- Department of Pediatrics, University of Florence, Florence, Italy.
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Gallelli L, Colosimo M, Tolotta GA, Falcone D, Luberto L, Curto LS, Rende P, Mazzei F, Marigliano NM, De Sarro G, Cucchiara S. Prospective randomized double-blind trial of racecadotril compared with loperamide in elderly people with gastroenteritis living in nursing homes. Eur J Clin Pharmacol 2009; 66:137-44. [PMID: 19902197 DOI: 10.1007/s00228-009-0751-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 10/18/2009] [Indexed: 11/24/2022]
Affiliation(s)
- Luca Gallelli
- School of Medicine and Surgery, Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Mater Domini University Hospital, Catanzaro, Italy.
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