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Dhalaria P, Kapur S, Singh AK, Verma A, Priyadarshini P, Taneja G. Potential impact of rotavirus vaccination on reduction of childhood diarrheal disease in India: An analysis of National Family Health Survey-5. Vaccine X 2023; 14:100319. [PMID: 37275272 PMCID: PMC10239013 DOI: 10.1016/j.jvacx.2023.100319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023] Open
Abstract
Rotavirus is one of the leading causes of diarrhea in infants and young children worldwide. In this study, we investigated the impact of rotavirus vaccination on the prevalence of diarrheal disease among children under five years of age in India. Research on the impact of the rotavirus vaccine on reducing diarrheal disease is therefore important in contributing to the growing body of evidence on the effectiveness of this intervention in improving child health outcomes. We adopted multivariate logistic regression and propensity score matching analysis to examine the association between diarrhea and the rotavirus vaccine. The bivariate analysis finding shows that the prevalence of diarrhea was remarkably higher (9.1%) among children who had not received rotavirus and the prevalence was 7.5%, 7.5%, and 7.2% among children who received one dose, two doses, and three rotavirus doses (all) respectively. The result of multivariate logistic regression shows that children who received all three doses of the rotavirus vaccine were 16% less likely to experience diarrhea compared to those who did not receive any rotavirus vaccine. Our analysis also found that the prevalence of diarrhea decreased significantly in the years following the introduction of the vaccine. The results of this study suggest that the rotavirus vaccine has a significant impact on reducing childhood diarrheal disease in India. These results have the potential to inform policy decisions and enable healthcare professionals to concert their efforts in reducing the diarrheal disease burden and its timely prevention in children. The study will also contribute to the existing literature on the impact of rotavirus vaccination in reducing the prevalence of diarrhea among children in India.
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Affiliation(s)
- Pritu Dhalaria
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India
| | | | - Ajeet Kumar Singh
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India
| | - Ajay Verma
- Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India
| | - Pretty Priyadarshini
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India
| | - Gunjan Taneja
- Bill & Melinda Gates Foundation, New Delhi 110067, India
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Stockdale SR, Blanchard AM, Nayak A, Husain A, Nashine R, Dudani H, McClure CP, Tarr AW, Nag A, Meena E, Sinha V, Shrivastava SK, Hill C, Singer AC, Gomes RL, Acheampong E, Chidambaram SB, Bhatnagar T, Vetrivel U, Arora S, Kashyap RS, Monaghan TM. RNA-Seq of untreated wastewater to assess COVID-19 and emerging and endemic viruses for public health surveillance. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 14:100205. [PMID: 37193348 PMCID: PMC10150210 DOI: 10.1016/j.lansea.2023.100205] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 05/18/2023]
Abstract
Background The COVID-19 pandemic showcased the power of genomic sequencing to tackle the emergence and spread of infectious diseases. However, metagenomic sequencing of total microbial RNAs in wastewater has the potential to assess multiple infectious diseases simultaneously and has yet to be explored. Methods A retrospective RNA-Seq epidemiological survey of 140 untreated composite wastewater samples was performed across urban (n = 112) and rural (n = 28) areas of Nagpur, Central India. Composite wastewater samples were prepared by pooling 422 individual grab samples collected prospectively from sewer lines of urban municipality zones and open drains of rural areas from 3rd February to 3rd April 2021, during the second COVID-19 wave in India. Samples were pre-processed and total RNA was extracted prior to genomic sequencing. Findings This is the first study that has utilised culture and/or probe-independent unbiased RNA-Seq to examine Indian wastewater samples. Our findings reveal the detection of zoonotic viruses including chikungunya, Jingmen tick and rabies viruses, which have not previously been reported in wastewater. SARS-CoV-2 was detectable in 83 locations (59%), with stark abundance variations observed between sampling sites. Hepatitis C virus was the most frequently detected infectious virus, identified in 113 locations and co-occurring 77 times with SARS-CoV-2; and both were more abundantly detected in rural areas than urban zones. Concurrent identification of segmented virus genomic fragments of influenza A virus, norovirus, and rotavirus was observed. Geographical differences were also observed for astrovirus, saffold virus, husavirus, and aichi virus that were more prevalent in urban samples, while the zoonotic viruses chikungunya and rabies, were more abundant in rural environments. Interpretation RNA-Seq can effectively detect multiple infectious diseases simultaneously, facilitating geographical and epidemiological surveys of endemic viruses that could help direct healthcare interventions against emergent and pre-existent infectious diseases as well as cost-effectively and qualitatively characterising the health status of the population over time. Funding UK Research and Innovation (UKRI) Global Challenges Research Fund (GCRF) grant number H54810, as supported by Research England.
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Affiliation(s)
| | - Adam M. Blanchard
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | - Amit Nayak
- Research Centre, Dr G.M. Taori Central India Institute of Medical Sciences (CIIMS), Nagpur, Maharashtra, India
| | - Aliabbas Husain
- Research Centre, Dr G.M. Taori Central India Institute of Medical Sciences (CIIMS), Nagpur, Maharashtra, India
| | - Rupam Nashine
- Research Centre, Dr G.M. Taori Central India Institute of Medical Sciences (CIIMS), Nagpur, Maharashtra, India
| | - Hemanshi Dudani
- Research Centre, Dr G.M. Taori Central India Institute of Medical Sciences (CIIMS), Nagpur, Maharashtra, India
| | - C. Patrick McClure
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
- Wolfson Centre for Global Virus Research, University of Nottingham, Nottingham, United Kingdom
| | - Alexander W. Tarr
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
- Wolfson Centre for Global Virus Research, University of Nottingham, Nottingham, United Kingdom
- Queen's Medical Centre, School of Life Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Aditi Nag
- Dr. B. Lal Institute of Biotechnology, 6-E, Malviya Industrial Area, Malviya Nagar, Jaipur, India
| | - Ekta Meena
- Dr. B. Lal Institute of Biotechnology, 6-E, Malviya Industrial Area, Malviya Nagar, Jaipur, India
| | - Vikky Sinha
- Dr. B. Lal Institute of Biotechnology, 6-E, Malviya Industrial Area, Malviya Nagar, Jaipur, India
| | - Sandeep K. Shrivastava
- Centre for Innovation, Research & Development, Dr. B. Lal Clinical Laboratory Pvt. Ltd., Malviya Industrial Area, Malviya Nagar, Jaipur, India
| | - Colin Hill
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
| | - Andrew C. Singer
- UK Centre for Ecology and Hydrology, Wallingford, United Kingdom
| | - Rachel L. Gomes
- Food Water Waste Research Group, Faculty of Engineering, University of Nottingham, United Kingdom
| | - Edward Acheampong
- Food Water Waste Research Group, Faculty of Engineering, University of Nottingham, United Kingdom
- Department of Statistics and Actuarial Science, University of Ghana, P.O. Box, LG 115, Legon, Ghana
| | - Saravana B. Chidambaram
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570015, KA, India
| | - Tarun Bhatnagar
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Umashankar Vetrivel
- National Institute of Traditional Medicine, Indian Council of Medical Research, Belagavi, 590010, India
- Virology and Biotechnology Division, ICMR-National Institute for Research in Tuberculosis, Chennai, 600031, India
| | - Sudipti Arora
- Dr. B. Lal Institute of Biotechnology, 6-E, Malviya Industrial Area, Malviya Nagar, Jaipur, India
| | - Rajpal Singh Kashyap
- Research Centre, Dr G.M. Taori Central India Institute of Medical Sciences (CIIMS), Nagpur, Maharashtra, India
| | - Tanya M. Monaghan
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Evaluating the Diagnostic Accuracy of Rapid Immuno-chromatographic Tests for Early Detection of Rotavirus in Fecal Samples from Children Less than Five Years with Acute Watery Diarrhea. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Acute diarrheal illness is a serious public health issue in developing and developed economies, with high morbidity and mortality rates. Children below five years are the most vulnerable, with one in every six dying from diarrhea. Diarrhea may be caused by various viruses, protozoa, and bacteria. Rotavirus, in particular, is often associated with diarrhea in children. Early detection of rotavirus infection reduces the need for medication and the spread of the virus and helps determine the optimal treatment strategies. In this study, we compared the efficacy of the rapid immunochromatography technique (ICT) with that of enzyme-linked immunosorbent assay (ELISA) to detect rotavirus antigens in stool samples. Overall, 361 stool samples were obtained from hospitalized children under five-years-old, with acute watery diarrhea symptoms and were tested by both rapid ICT and ELISA. Among these samples, 104 (28.81%) tested positive by ICT and 109 (30.19%) by ELISA. Furthermore, the specificity and sensitivity of ICT were assessed using ELISA, the gold standard test. ICT had a 95.41% sensitivity and a 100% specificity. Thus, during emergency testing, ICT may be utilized as an alternative test for quick diagnosis with high specificity and sensitivity in patients with rotavirus diarrhea.
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The Current Epidemiology of Rotavirus Infection in Children Less than 5 Years of Age after Introduction of RV Vaccine in India. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.1.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rotavirus is a major cause of severe acute gastroenteritis in infants and young children worldwide. It is responsible for 40% of childhood hospitalization. It has been estimated that about 23% of diarrhoeal death occurs due to the rotavirus infection in India. To study the epidemiology of rotavirus infection in children less than 5 years of age at a tertiary care teaching hospital. A total of 240 stool samples were collected from children <5 years of age suffering from acute diarrhea at a tertiary health care referral hospital in Western Uttar Pradesh, India. Rotavirus antigen was detected in stool by Enzyme immunoassay (EIA) which utilizes monoclonal antibodies directed against VP6 antigen. Molecular genotyping was done by nested multiplex PCR. The rotavirus antigen positivity rate was found to be 14.58% in this study. There was male preponderance and the male: female ratio was 1.5:1. Rotavirus diarrhoea was reported predominantly (42.85 %) in the age group of 13 to 24 months. The most common circulating G/P genotype strain was G9P[4] accounting for 36% of cases. Rotavirus remains a major cause of diarrhoea in children <5 years of age in Uttar Pradesh. However, the positivity rate has decreased after introduction of rotavirus vaccine into the Universal immunization program (UIP) in UP.
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Ali S, Khan S, Khan SN, Rauf M, Khan MF, Majid A, Dawar FU, Akbar NU, Ullah R, Bari A, Khan MY. Molecular detection and prevalence of Rotavirus with acute gastroenteritis among the children of rural and urban areas. BRAZ J BIOL 2021; 83:e244365. [PMID: 34932615 DOI: 10.1590/1519-6984.244365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
Rotavirus is the main infective agent of acute gastroenteritis (AGE) in children under the age of five years and causing significant morbidity as well as mortality throughout the world. The study was carried out to detect the prevalence rate, genotypes strain and risk factors of Rotavirus among the children of rural and urban areas of district Bannu Khyber Pakhtunkhwa Pakistan. A total of 180 stool samples were collected from children under the age of 5 years from two major hospitals of Bannu from January to December (2015). The samples were analyzed by Reverse-transcriptase Polymerase Chain Reaction (RT-PCR) for the detection of Rotavirus, positive samples were further processed for genotyping (G and P type) through specific PCR. Of the total, 41 (23%) samples were positive for Rotavirus. The most prevalent G genotypes found were: G3, G8, G9 (each 29%), followed by G10 (15%), and G11 (10%). Whereas the prevalent P genotypes were: P-8 (25%), P-4 and P-10 (each 20%), P-9 (15%), followed by P-6 and P-11 (each 10%). Moreover, Rotavirus infection was more prevalent in summer (23.73%) and winter (22.7%) than spring (20%) and autumn (21.4%). Rotavirus infection exhibited high frequency in June (14%), October (8%) and November (6%). It is concluded that Rotavirus is more prevalent in children and various genotypes (G and P) of Rotavirus are present in the study area. Lack of studies, awareness and rarer testing of Rotavirus are the principal reasons of virus prevalence in district Bannu, Pakistan.
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Affiliation(s)
- S Ali
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Khan
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S N Khan
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M Rauf
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M F Khan
- University of Hazara Dhodial, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - A Majid
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - F U Dawar
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - N Ul Akbar
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - R Ullah
- College of Pharmacy, Department of Pharmacognosy, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - A Bari
- King Saud University Riyadh, College of Pharmacy, Department of Pharmaceutical Chemistry, Riyadh, Saudi Arabia
| | - M Y Khan
- Lancaster University, Lancaster Environmental Centre, Lancaster, United Kingdon
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Rawal M, Raikwar P, Nair NP, Thiyagarajan V, Lingam R. Demographic Profile and Genotypic Distribution of Rotavirus Gastroenteritis from Rural Haryana, India. Indian J Pediatr 2021; 88:47-52. [PMID: 33420973 DOI: 10.1007/s12098-020-03612-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To know the prevalence of rotavirus among hospitalized <5 y children, their demographic profile and genotypic distribution of rotavirus strain from tertiary care center of rural Haryana. METHODS An observational 3-year study done from June 2016 to June 2019 where children under 5 y of age hospitalized for acute gastroenteritis were enrolled. Various demographic, environmental, and clinical parameters were assessed. Stool samples were collected and sent to CMC, Vellore for rotavirus screening by enzyme immune assay (EIA) and RV-positive samples were genotyped using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS Out of 444 stool sample screened, 107 were positive (24.1%) for rotavirus. RV positive cases seen mostly in 6-24 mo age group with moderate to severe dehydration at presentation and peaks in winter months (Dec - Feb). G3P[8] (35.24%) is the most prevalent genotype identified followed by G1P[8] (20.95%), G1P[6] (11.43%), G2P[4] (6.67%) and G12P[8] (2.86%). CONCLUSION Continuous surveillance is required to monitor the circulating genotypes in postvaccination phase and assess the effectiveness and impact of the vaccine.
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Affiliation(s)
- Manoj Rawal
- Department of Pediatrics, B P S Govt. Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Preeti Raikwar
- Department of Pediatrics, B P S Govt. Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India.
| | - Nayana P Nair
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Varunkumar Thiyagarajan
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ragavi Lingam
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
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Chaudhary P, Jain H, Nair NP, Thiyagarajan V. Rotavirus Diarrhea in Hospitalized Under-5 Children in Madhya Pradesh, India and the Prevalent Serotypes After Vaccine Introduction. Indian J Pediatr 2021; 88:78-83. [PMID: 33415553 DOI: 10.1007/s12098-020-03638-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report epidemiology of rotavirus gastroenteritis among under-five children hospitalized for acute diarrhea after the introduction of vaccine in Madhya Pradesh. METHODS Children hospitalized for diarrhea between August 2017 and December 2019 were recruited. Stool sample was collected and shipped to Christian Medical College (CMC), Vellore maintaining proper cold chain. Samples were then screened for rotavirus using enzyme immunoassay (EIA). The samples that were positive for rotavirus were further genotyped by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS Of the 794 stool samples collected, 150 (18.8%) samples were positive for rotavirus. Highest positivity was seen in winter months and in children less than 2 y of age. G3P[8] was found to be the most prevalent serotype. CONCLUSIONS The study highlights lowering prevalence of rotavirus gastroenteritis in the authors' region post vaccine introduction. It also highlights the change in prevalent serotypes.
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Affiliation(s)
- Prachi Chaudhary
- Department of Pediatrics, MGM Medical College, Indore, Madhya Pradesh, India.
| | - Hemant Jain
- Department of Pediatrics, MGM Medical College, Indore, Madhya Pradesh, India
| | - Nayana P Nair
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Varunkumar Thiyagarajan
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
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Vashishtha VM, Nair NP, Ahmad M, Vashishtha I, Thiyagarajan V. Rotavirus Gastroenteritis in Western Uttar Pradesh, India. Indian J Pediatr 2021; 88:59-65. [PMID: 33512672 DOI: 10.1007/s12098-020-03623-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To establish hospital-based surveillance to identify cases of rotavirus (RV) among children < 5 y of age hospitalized for acute gastroenteritis (AGE) and to determine the burden and profile of circulating RV genotypes in the region. METHODS This study was conducted at a tertiary level hospital in Bijnor district of western Uttar Pradesh, India from January 2018 to January 2020. The duly filled case reporting forms and specimens of all the enrolled children were transported in cold chain to the referral laboratory at Christian Medical College (CMC), Vellore on a monthly basis for testing and storage of stool samples as well as data entry and analysis. RESULTS A total of 1055 under-5 children admitted with AGE, were enrolled. Proper stool specimens were collected from 932 children. Rotavirus was found positive in 368 (39.5%) stool specimens. Marked seasonality was observed in RV-positive cases with the highest incidence was noticed during winter months. The 0-11 mo age group had the highest incidence of RV-GE followed by 12-23 mo. G1 (42.08%) was the most frequent G-type whereas G1P[8] (26.23%) was the commonest circulating genotype. CONCLUSION The study confirms a significant burden of RV among AGE cases in young children in western Uttar Pradesh. The findings of the study may serve as useful baseline information to the Government of India for assessing vaccine performance after its introduction in the national immunization programmes.
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Affiliation(s)
- Vipin M Vashishtha
- Department of Pediatrics, Mangla Hospital & Research Center, Shakti Chowk, Bijnor, Uttar Pradesh, 246701, India.
| | - Nayana P Nair
- Department of GI Sciences, The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mobeen Ahmad
- Department of Pediatrics, Mangla Hospital & Research Center, Shakti Chowk, Bijnor, Uttar Pradesh, 246701, India
| | - Ipsita Vashishtha
- Department of Pediatrics, Mangla Hospital & Research Center, Shakti Chowk, Bijnor, Uttar Pradesh, 246701, India
| | - Varunkumar Thiyagarajan
- Department of GI Sciences, The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
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Sharma P, Katewa S, Meel SK, Katewa V, Bishnoi A, Verma VK, Nair NP, Thiyagarajan V. Clinicoepidemiological Profile and Genetic Characterization of Circulating Rotavirus Strain among Children < 5 Years Hospitalized for Acute Gastroenteritis in Western Rajasthan, India. Indian J Pediatr 2021; 88:97-104. [PMID: 33555569 DOI: 10.1007/s12098-020-03628-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the clinical and epidemiological profile and circulating strains of rotavirus among children less than 5 y of age hospitalized for diarrhea in a tertiary care center of western Rajasthan. METHOD Children < 5 y of age admitted for acute gastroenteritis were recruited in this hospital-based surveillance study. Detailed clinical history and sociodemographic information was collected for all enrolled children. Severity of the gastroenteritis was assessed using the 20-point Vesikari Clinical Severity Scoring System. Rotavirus positivity was tested in the stool samples collected from children by commercially available techniques and further molecular characterization done as per defined protocol. RESULTS Out of 1055 enrolled children, overall positivity rate of typable rotavirus was 18.95% (169/892). Among children who were less than 24 mo of age, positivity due to rotavirus diarrhea was maximum (24.4%). Distinct seasonality was observed as maximum cases of rotavirus diarrhea were detected in the months of December to February. Commonest G type was G3 (54%) followed by G1 (19%) while predominant P type was P[8] (77%) followed by P[4] (11%). G3P[8] (51.83%) was the commonest genotype observed in the study region. CONCLUSION The current study found positivity of rotavirus to be 18.95% among children aged 0-59 mo admitted due to acute gastroenteritis is a tertiary care setting in northern part of India. Emergence of newer predominant strains emphasizes the need of continued surveillance to determine the changing trends.
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Affiliation(s)
- Pramod Sharma
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Suman Katewa
- Department of Obstetrics & Gynaecology, Dr S N Medical College, Jodhpur, Rajasthan, India
| | - Suresh Kumar Meel
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Vikash Katewa
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India.
| | - Alka Bishnoi
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Vijay Kumar Verma
- Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, 342003, India
| | - Nayana P Nair
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Varunkumar Thiyagarajan
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
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Abstract
OBJECTIVE To identify cases of rotavirus diarrhea in Uttar Pradesh among children less than 5 y of age presenting with acute gastroenteritis, to study the clinical profile of the cases and to identify the rotavirus genotypes. METHODS Any child who is 0-59 mo of age who is admitted to the study facility with diarrhea as the presenting complaint were enrolled into the surveillance after obtaining informed consent. Clinical history and sociodemographic information was recorded for all the patients. Patients with dehydration were treated as per standard protocol. Stool samples were collected for isolation of rotavirus and identification of its genotype. RESULTS Of the 418 stool specimens collected, rotavirus was isolated in 47 (11.33%) samples. Rotavirus gastroenteritis was most common below the age of two years. A significant difference in the clinical characteristics between children who were positive for rotavirus and those who tested negative were not observed in this study. But patients with rotavirus diarrhea had longer duration of hospital stay (OR 3.31; CI 1.24-8.87). The outcome was similar in the two groups (OR 2.64; CI 0.27-25.89). G3P[8] was the most common type genotype isolated in 13 (28.89%) patients followed by G2P[4] in 7 (15.56%) patients. Thirteen patients (28.89%) had mixed genotype. CONCLUSION Rotavirus diarrhea was most common below two years of age. G3P[8] was the most common genotype identified.
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Girish Kumar CP, Giri S, Chawla-Sarkar M, Gopalkrishna V, Chitambar SD, Ray P, Venkatasubramanian S, Borkakoty B, Roy S, Bhat J, Dwibedi B, Paluru V, Das P, Arora R, Kang G, Mehendale SM. Epidemiology of rotavirus diarrhea among children less than 5 years hospitalized with acute gastroenteritis prior to rotavirus vaccine introduction in India. Vaccine 2020; 38:8154-8160. [PMID: 33168345 PMCID: PMC7694878 DOI: 10.1016/j.vaccine.2020.10.084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/23/2020] [Accepted: 10/26/2020] [Indexed: 11/23/2022]
Abstract
Background Rotavirus is an important cause of severe diarrhea requiring hospitalization, accounting for approximately 78,000 deaths annually in Indian children below 5 years of age. We present epidemiological data on severe rotavirus disease collected during hospital-based surveillance in India before the introduction of the oral rotavirus vaccine into the national immunization schedule. Methods The National Rotavirus Surveillance Network was created involving 28 hospital sites and 11 laboratories across the four geographical regions of India. From September 2012 to August 2016 children less than 5 years of age hospitalized for diarrhea for at least 6 h, were enrolled. After recording clinical details, a stool sample was collected from each enrolled child, which was tested for rotavirus antigen using enzyme immunoassay (EIA). Nearly 2/3rd of EIA positive samples were genotyped using reverse transcription polymerase chain reaction to identify the G and P types. Results Of the 21,421 children enrolled during the 4 years surveillance, 36.3% were positive for rotavirus. The eastern region had the highest proportion of rotavirus associated diarrhea (39.8%), while the southern region had the lowest (33.8%). Rotavirus detection rates were the highest in children aged 6–23 months (41.8%), and 24.7% in children aged < 6 months. Although rotavirus associated diarrhea was seen throughout the year, the highest positivity was documented between December and February across all the regions. The most common rotavirus genotype was G1P[8] (52.9%), followed by G9P4 (8.7%) and G2P4 (8.4%). Conclusions There is high burden of rotavirus gastroenteritis among Indian children below 5 years of age hospitalized for acute diarrhea thereby highlighting the need for introduction of rotavirus vaccine into the national immunization program and also for monitoring circulating genotypes.
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Affiliation(s)
- C P Girish Kumar
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Sidhartha Giri
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mamta Chawla-Sarkar
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | | | | | | | | | | | - Subarna Roy
- ICMR-National Institute of Traditional Medicine, Belgaum, Karnataka, India
| | - Jyothi Bhat
- ICMR-National Institute for Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Vijayachari Paluru
- ICMR-Regional Medical Research Centre, Port Blair, Andaman & Nicobar Islands, India
| | - Pradeep Das
- ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Rashmi Arora
- Indian Council of Medical Research (ICMR), New Delhi, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sanjay M Mehendale
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India; Indian Council of Medical Research (ICMR), New Delhi, India.
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Giri S, Kumar CPG, Khakha SA, Chawla-Sarkar M, Gopalkrishna V, Chitambar SD, Ray P, Venkatasubramanian S, Borkakoty BJ, Roy S, Bhat J, Dwibedi B, Das P, Paluru V, Ramani S, Babji S, Arora R, Mehendale SM, Gupte MD, Kang G. Diversity of rotavirus genotypes circulating in children < 5 years of age hospitalized for acute gastroenteritis in India from 2005 to 2016: analysis of temporal and regional genotype variation. BMC Infect Dis 2020; 20:740. [PMID: 33036575 PMCID: PMC7547507 DOI: 10.1186/s12879-020-05448-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 09/23/2020] [Indexed: 11/13/2022] Open
Abstract
Background From 2016, the Government of India introduced the oral rotavirus vaccine into the national immunization schedule. Currently, two indigenously developed vaccines (ROTAVAC, Bharat Biotech; ROTASIIL, Serum Institute of India) are included in the Indian immunization program. We report the rotavirus disease burden and the diversity of rotavirus genotypes from 2005 to 2016 in a multi-centric surveillance study before the introduction of vaccines. Methods A total of 29,561 stool samples collected from 2005 to 2016 (7 sites during 2005–2009, 3 sites from 2009 to 2012, and 28 sites during 2012–2016) were included in the analysis. Stools were tested for rotavirus antigen using enzyme immunoassay (EIA). Genotyping was performed on 65.8% of the EIA positive samples using reverse transcription- polymerase chain reaction (RT-PCR) to identify the G (VP7) and P (VP4) types. Multinomial logistic regression was used to quantify the odds of detecting genotypes across the surveillance period and in particular age groups. Results Of the 29,561 samples tested, 10,959 (37.1%) were positive for rotavirus. There was a peak in rotavirus positivity during December to February across all sites. Of the 7215 genotyped samples, G1P[8] (38.7%) was the most common, followed by G2P[4] (12.3%), G9P[4] (5.8%), G12P[6] (4.2%), G9P[8] (4%), and G12P[8] (2.4%). Globally, G9P[4] and G12P[6] are less common genotypes, although these genotypes have been reported from India and few other countries. There was a variation in the geographic and temporal distribution of genotypes, and the emergence or re-emergence of new genotypes such as G3P[8] was seen. Over the surveillance period, there was a decline in the proportion of G2P[4], and an increase in the proportion of G9P[4]. A higher proportion of mixed and partially typed/untyped samples was also seen more in the age group 0–11 months. Conclusions This 11 years surveillance highlights the high burden of severe rotavirus gastroenteritis in Indian children < 5 years of age before inclusion of rotavirus vaccines in the national programme. Regional variations in rotavirus epidemiology were seen, including the emergence of G3P[8] in the latter part of the surveillance. Having pre-introduction data is important to track changing epidemiology of rotaviruses, particularly following vaccine introduction.
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Affiliation(s)
- Sidhartha Giri
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.,Indian Council of Medical Research, New Delhi, India
| | | | - Shainey Alokit Khakha
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mamta Chawla-Sarkar
- National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | | | | | | | | | | | - Subarna Roy
- National Institute of Traditional Medicine, Belgaum, Karnataka, India
| | - Jyothi Bhat
- National Institute for Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Vijayachari Paluru
- Regional Medical Research Centre, Port Blair, Andaman & Nicobar Islands, India
| | - Sasirekha Ramani
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.,Baylor College of Medicine, Houston, TX, USA
| | - Sudhir Babji
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rashmi Arora
- Indian Council of Medical Research, New Delhi, India.,Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, India
| | | | - Mohan D Gupte
- Indian Council of Medical Research, New Delhi, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India. .,Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, India.
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13
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Aetiology and outcome of acute diarrhoea in children with severe acute malnutrition: a comparative study. Public Health Nutr 2020; 23:1563-1568. [PMID: 31699164 DOI: 10.1017/s1368980019003069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the microbiological profile, clinical course and outcome of acute diarrhoea in children aged <5 years having severe acute malnutrition (SAM) with those of children having normal nutritional status. DESIGN Cross-sectional comparative study. SETTING Tertiary-care hospital catering mainly to the urban poor of East Delhi, India. PARTICIPANTS Children aged <5 years (n 140; seventy with SAM (cases) and seventy with normal anthropometry (controls)) with acute diarrhoea (duration < 14 d). Stool samples were collected for conventional culture, microscopy, acid-fast staining, rotavirus and Cryptosporidium antigen detection, and subtyping of diarrhoeagenic Escherichia coli (DEC). We followed-up these children for persistent diarrhoea and subsequent diarrhoeal episode in the next 3 months. RESULTS Rotavirus was detected in six (9 %) cases and in fifteen (21 %) controls (P = 0·03; OR = 0·34; 95 % CI 0·12, 0·94). DEC was isolated significantly more in cases compared with controls (93 v. 64 %; P < 0·001; OR = 7·25; 95 % CI 2·57, 20·4). Cryptosporidium was detected in seven (10 %) cases and five (7 %) controls. Total duration of diarrhoea and percentage change in weight after resolution of diarrhoea were comparable between cases and controls. At 3-month follow-up, number of subsequent episodes of diarrhoea and persistent diarrhoea were comparable between the two groups. CONCLUSIONS Rotavirus was found significantly less frequently, whereas DEC was detected more frequently in children with SAM in comparison to non-malnourished children. To further reduce diarrhoea-related mortality, preventive and therapeutic interventions need to be designed against organisms causing diarrhoea in children with SAM.
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Ramanathan M, Vijayan B. Covariates of diarrhoea among under-five children in India: Are they level dependent? PLoS One 2019; 14:e0221200. [PMID: 31433822 PMCID: PMC6703849 DOI: 10.1371/journal.pone.0221200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/01/2019] [Indexed: 11/19/2022] Open
Abstract
Program interventions like access to improved water supply, sanitation and hygiene do not have a systematic response to the aggregate health outcomes. Therefore, this is an attempt at recognising the concept of level sensitivity while verifying the association between prevalence of diarrhoea in under-five children in a district and its corresponding coverage of improved water supply and sanitation and hygiene. Information obtained in the DLHS—4 including 275 districts from 19 states and 2 union territories of India forms the database for this analysis. Universal access to safe drinking water, improving coverage of sanitation in a district beyond 71 percent across the country and beyond 78 percent among the non-south DLHS districts, has the potential to realise reductions in the prevalence of diarrhoea in under-five children in a district. The effect of improved sanitation seems to work synergistically with these indicators only at better levels of prevalence of diarrhoea in under-five children in a district. This offers lessons for the Clean India Mission in terms of universalising access to safe water and coverage up to three-fourths of households with sanitation in a district for the positive externalities to manifest in reduced prevalence of diarrhoea in under-five children.
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Affiliation(s)
- Mala Ramanathan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
- * E-mail:
| | - Bevin Vijayan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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15
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Giri S, Nair NP, Mathew A, Manohar B, Simon A, Singh T, Suresh Kumar S, Mathew MA, Babji S, Arora R, Girish Kumar CP, Venkatasubramanian S, Mehendale S, Gupte MD, Kang G. Rotavirus gastroenteritis in Indian children < 5 years hospitalized for diarrhoea, 2012 to 2016. BMC Public Health 2019; 19:69. [PMID: 30646867 PMCID: PMC6334384 DOI: 10.1186/s12889-019-6406-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/07/2019] [Indexed: 02/08/2023] Open
Abstract
Background In 2016, the Government of India introduced the oral rotavirus vaccine (ROTAVAC, Bharat Biotech, India) in 4 states of India as part of the Universal Immunization Programme, and expanded to 5 more states in 2017. We report four years of data on rotavirus gastroenteritis in hospitalized children < 5 years of age prior to vaccine introduction. Methods Children from 7 sites in southern and northern India hospitalized for diarrhoea were recruited between July 2012 and June 2016. Stool samples were screened for rotavirus using enzyme immunoassay (EIA). The EIA positive samples were genotyped by reverse-transcription polymerase chain reaction. Results Of the 5834 samples from the 7 sites, 2069 (35.5%) were positive for rotavirus by EIA. Genotyping was performed for 2010 (97.1%) samples. G1P[8](56.3%), G2P[4](9.1%), G9P[4](7.6%), G9P[8](4.2%), and G12P[6](3.7%) were the common genotypes in southern India and G1P[8](36%), G9P[4](11.4%), G2P[4](11.2%), G12P[6](8.4%), and G3P[8](5.9%) in northern India. Conclusions The study highlights the high prevalence of rotavirus gastroenteritis in India and the diversity of rotavirus genotypes across different geographical regions. Pre- vaccine surveillance data is necessary to evaluate the potential change in admission rates for gastroenteritis and circulating rotavirus genotypes after vaccine introduction, thus assessing impact. Electronic supplementary material The online version of this article (10.1186/s12889-019-6406-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sidhartha Giri
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nayana P Nair
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ann Mathew
- Department of Paediatrics, St. Stephen's Hospital, Tis Hazari, New Delhi, India
| | - B Manohar
- Department of Paediatrics, SV Medical College, Tirupati, Andhra Pradesh, India
| | - Anna Simon
- Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tejinder Singh
- Department of Paediatrics, Christian Medical College, Ludhiana, Punjab, India
| | - S Suresh Kumar
- Punjagutta, Pragna Hospital, Hyderabad, Telangana, India
| | - M A Mathew
- Department of Paediatrics, Malankara Orthodox Syrian Church Medical College, Kolenchery, Kerala, India
| | - Sudhir Babji
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rashmi Arora
- Indian Council of Medical Research, New Delhi, India.,Present address: Translational Health Science and Technology Institute (THSTI), Faridabad, India
| | | | | | | | - Mohan D Gupte
- Indian Council of Medical Research, New Delhi, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India. .,Present address: Translational Health Science and Technology Institute (THSTI), Faridabad, India.
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Rotavirus infection among hospitalized children under five years of age with acute watery diarrhea in Sri Lanka. Vaccine 2018; 36:7846-7850. [PMID: 29945833 DOI: 10.1016/j.vaccine.2018.03.062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/24/2018] [Accepted: 03/22/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Rotavirus is the leading cause of acute watery diarrhoea among children and is vaccine preventable. The aim of this hospital-based sentinel surveillance was to study the prevalence, demographic and clinical characteristics of rotavirus infections and to describe rotavirus genotype distribution patterns among children under five years of age hospitalized for acute watery diarrhea during the period of 2009-2016. METHODS Prospective, sentinel hospital-based surveillance was conducted in Lady Ridgeway Hospital (LRH) from 2009 to 2016. Stool samples of children admitted with acute watery diarrhea were tested by rotavirus antigen detection 'ProSpecT' Enzyme Immunoassay (EIA) at Department of Virology, Medical Research Institute, Colombo. Specimens that tested positive for rotavirus were further analyzed at the Regional Reference Laboratory (RRL) participating in the World Health Organization (WHO)-coordinated Global Rotavirus Surveillance Network (GRSN) to determine the genotype of strains by reverse-transcriptase polymerase chain reaction. RESULTS Of the 6090 children with diarrhea admitted, 1801 (29.5%) had stools taken and tested. In years with at least 11 months of data (2010 and 2013) rotavirus was detected in 36.5% (228/624) of specimens. Genotype G1P[8] was the most common genotype detected throughout the surveillance period (30.1%; 123/408) with G2P [8], G9P[8] and G3P[8] also detected. CONCLUSIONS Rotavirus is a common cause of pediatric diarrhea hospitalizations in Sri Lanka. National introduction of rotavirus vaccine could reduce the burden of pediatric diarrhea.
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Shetty RS, Kamath VG, Nayak DM, Hegde A, Saluja T. Rotavirus associated acute gastroenteritis among under-five children admitted in two secondary care hospitals in southern Karnataka, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2017. [DOI: 10.1016/j.cegh.2016.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Moussa A, Fredj MBH, BenHamida-Rebaï M, Fodha I, Boujaafar N, Trabelsi A. Phylogenetic analysis of partial VP7 gene of the emerging human group A rotavirus G12 strains circulating in Tunisia. J Med Microbiol 2017; 66:112-118. [DOI: 10.1099/jmm.0.000420] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Amal Moussa
- Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Mouna Ben Hadj Fredj
- Faculty of Sciences and Techniques, University of Kairouan, 9100 Kairouan, Tunisia
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Meriam BenHamida-Rebaï
- Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Imene Fodha
- Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Noureddine Boujaafar
- Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia
- Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia
| | - Abdelhalim Trabelsi
- Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia
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Tacharoenmuang R, Komoto S, Guntapong R, Ide T, Sinchai P, Upachai S, Yoshikawa T, Tharmaphornpilas P, Sangkitporn S, Taniguchi K. Full Genome Characterization of Novel DS-1-Like G8P[8] Rotavirus Strains that Have Emerged in Thailand: Reassortment of Bovine and Human Rotavirus Gene Segments in Emerging DS-1-Like Intergenogroup Reassortant Strains. PLoS One 2016; 11:e0165826. [PMID: 27802339 PMCID: PMC5089778 DOI: 10.1371/journal.pone.0165826] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/18/2016] [Indexed: 12/15/2022] Open
Abstract
The emergence and rapid spread of unusual DS-1-like intergenogroup reassortant rotavirus strains have been recently reported in Asia, Australia, and Europe. During rotavirus surveillance in Thailand in 2013-2014, novel DS-1-like intergenogroup reassortant strains having G8P[8] genotypes (i.e., strains KKL-17, PCB-79, PCB-84, PCB-85, PCB-103, SKT-107, SWL-12, NP-130, PCB-656, SKT-457, SSKT-269, and SSL-55) were identified in stool samples from hospitalized children with severe diarrhea. In this study, we determined and characterized the complete genomes of these 12 strains (seven strains, KKL-17, PCB-79, PCB-84, PCB-85, PCB-103, SKT-107, and SWL-12, found in 2013 (2013 strains), and five, NP-130, PCB-656, SKT-457, SSKT-269, and SSL-55, in 2014 (2014 strains)). On full genomic analysis, all 12 strains showed a unique genotype constellation comprising a mixture of genogroup 1 and 2 genes: G8-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2. With the exception of the G genotype, the unique genotype constellation of the 12 strains (P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2) was found to be shared with DS-1-like intergenogroup reassortant strains. On phylogenetic analysis, six of the 11 genes of the 2013 strains (VP4, VP2, VP3, NSP1, NSP3, and NSP5) appeared to have originated from DS-1-like intergenogroup reassortant strains, while the remaining four (VP7, VP6, VP1, and NSP2) and one (NSP4) gene appeared to be of bovine and human origin, respectively. Thus, the 2013 strains appeared to be reassortant strains as to DS-1-like intergenogroup reassortant, bovine, bovine-like human, and/or human rotaviruses. On the other hand, five of the 11 genes of the 2014 strains (VP4, VP2, VP3, NSP1, and NSP3) appeared to have originated from DS-1-like intergenogroup reassortant strains, while three (VP7, VP1, and NSP2) and one (NSP4) were assumed to be of bovine and human origin, respectively. Notably, the remaining two genes, VP6 and NSP5, of the 2014 strains appeared to have originated from locally circulating DS-1-like G2P[4] human rotaviruses. Thus, the 2014 strains were assumed to be multiple reassortment strains as to DS-1-like intergenogroup reassortant, bovine, bovine-like human, human, and/or locally circulating DS-1-like G2P[4] human rotaviruses. Overall, the great genomic diversity among the DS-1-like intergenogroup reassortant strains seemed to have been generated through additional reassortment events involving animal and human strains. Moreover, all the 11 genes of three of the 2014 strains, NP-130, PCB-656, and SSL-55, were very closely related to those of Vietnamese DS-1-like G8P[8] strains that emerged in 2014-2015, indicating the derivation of these DS-1-like G8P[8] strains from a common ancestor. To our knowledge, this is the first report on full genome-based characterization of DS-1-like G8P[8] strains that have emerged in Thailand. Our observations will add to our growing understanding of the evolutionary patterns of emerging DS-1-like intergenogroup reassortant strains.
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Affiliation(s)
| | - Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Ratigorn Guntapong
- National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand
| | - Tomihiko Ide
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Phakapun Sinchai
- National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand
| | - Sompong Upachai
- National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | | | - Somchai Sangkitporn
- National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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20
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Rotavirus diarrhea in children presenting to an urban hospital in Western Uttar Pradesh, India. Indian Pediatr 2016; 53:627-9. [DOI: 10.1007/s13312-016-0899-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Komoto S, Tacharoenmuang R, Guntapong R, Ide T, Tsuji T, Yoshikawa T, Tharmaphornpilas P, Sangkitporn S, Taniguchi K. Reassortment of Human and Animal Rotavirus Gene Segments in Emerging DS-1-Like G1P[8] Rotavirus Strains. PLoS One 2016; 11:e0148416. [PMID: 26845439 PMCID: PMC4742054 DOI: 10.1371/journal.pone.0148416] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 01/17/2016] [Indexed: 12/02/2022] Open
Abstract
The emergence and rapid spread of novel DS-1-like G1P[8] human rotaviruses in Japan were recently reported. More recently, such intergenogroup reassortant strains were identified in Thailand, implying the ongoing spread of unusual rotavirus strains in Asia. During rotavirus surveillance in Thailand, three DS-1-like intergenogroup reassortant strains having G3P[8] (RVA/Human-wt/THA/SKT-281/2013/G3P[8] and RVA/Human-wt/THA/SKT-289/2013/G3P[8]) and G2P[8] (RVA/Human-wt/THA/LS-04/2013/G2P[8]) genotypes were identified in fecal samples from hospitalized children with acute gastroenteritis. In this study, we sequenced and characterized the complete genomes of strains SKT-281, SKT-289, and LS-04. On whole genomic analysis, all three strains exhibited unique genotype constellations including both genogroup 1 and 2 genes: G3-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2 for strains SKT-281 and SKT-289, and G2-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2 for strain LS-04. Except for the G genotype, the unique genotype constellation of the three strains (P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2) is commonly shared with DS-1-like G1P[8] strains. On phylogenetic analysis, nine of the 11 genes of strains SKT-281 and SKT-289 (VP4, VP6, VP1-3, NSP1-3, and NSP5) appeared to have originated from DS-1-like G1P[8] strains, while the remaining VP7 and NSP4 genes appeared to be of equine and bovine origin, respectively. Thus, strains SKT-281 and SKT-289 appeared to be reassortant strains as to DS-1-like G1P[8], animal-derived human, and/or animal rotaviruses. On the other hand, seven of the 11 genes of strain LS-04 (VP7, VP6, VP1, VP3, and NSP3-5) appeared to have originated from locally circulating DS-1-like G2P[4] human rotaviruses, while three genes (VP4, VP2, and NSP1) were assumed to be derived from DS-1-like G1P[8] strains. Notably, the remaining NSP2 gene of strain LS-04 appeared to be of bovine origin. Thus, strain LS-04 was assumed to be a multiple reassortment strain as to DS-1-like G1P[8], locally circulating DS-1-like G2P[4], bovine-like human, and/or bovine rotaviruses. Overall, the great genomic diversity among the DS-1-like G1P[8] strains seemed to have been generated through reassortment involving human and animal strains. To our knowledge, this is the first report on whole genome-based characterization of DS-1-like intergenogroup reassortant strains having G3P[8] and G2P[8] genotypes that have emerged in Thailand. Our observations will provide important insights into the evolutionary dynamics of emerging DS-1-like G1P[8] strains and related reassortant ones.
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Affiliation(s)
- Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- * E-mail:
| | | | - Ratigorn Guntapong
- Department of Medical Sciences, National Institute of Health, Nonthaburi, Thailand
| | - Tomihiko Ide
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takao Tsuji
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | | | - Somchai Sangkitporn
- Department of Medical Sciences, National Institute of Health, Nonthaburi, Thailand
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Tacharoenmuang R, Komoto S, Guntapong R, Ide T, Haga K, Katayama K, Kato T, Ouchi Y, Kurahashi H, Tsuji T, Sangkitporn S, Taniguchi K. Whole Genomic Analysis of an Unusual Human G6P[14] Rotavirus Strain Isolated from a Child with Diarrhea in Thailand: Evidence for Bovine-To-Human Interspecies Transmission and Reassortment Events. PLoS One 2015; 10:e0139381. [PMID: 26421718 PMCID: PMC4589232 DOI: 10.1371/journal.pone.0139381] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/11/2015] [Indexed: 11/19/2022] Open
Abstract
An unusual rotavirus strain, SKT-27, with the G6P[14] genotypes (RVA/Human-wt/THA/SKT-27/2012/G6P[14]), was identified in a stool specimen from a hospitalized child aged eight months with severe diarrhea. In this study, we sequenced and characterized the complete genome of strain SKT-27. On whole genomic analysis, strain SKT-27 was found to have a unique genotype constellation: G6-P[14]-I2-R2-C2-M2-A3-N2-T6-E2-H3. The non-G/P genotype constellation of this strain (I2-R2-C2-M2-A3-N2-T6-E2-H3) is commonly shared with rotavirus strains from artiodactyls such as cattle. Phylogenetic analysis indicated that nine of the 11 genes of strain SKT-27 (VP7, VP4, VP6, VP2-3, NSP1, NSP3-5) appeared to be of artiodactyl (likely bovine) origin, while the remaining VP1 and NSP2 genes were assumed to be of human origin. Thus, strain SKT-27 was found to have a bovine rotavirus genetic backbone, and thus is likely to be of bovine origin. Furthermore, strain SKT-27 appeared to be derived through interspecies transmission and reassortment events involving bovine and human rotavirus strains. Of note is that the VP7 gene of strain SKT-27 was located in G6 lineage-5 together with those of bovine rotavirus strains, away from the clusters comprising other G6P[14] strains in G6 lineages-2/6, suggesting the occurrence of independent bovine-to-human interspecies transmission events. To our knowledge, this is the first report on full genome-based characterization of human G6P[14] strains that have emerged in Southeast Asia. Our observations will provide important insights into the origin of G6P[14] strains, and into dynamic interactions between human and bovine rotavirus strains.
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Affiliation(s)
| | - Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- * E-mail:
| | - Ratigorn Guntapong
- Department of Medical Sciences, National Institute of Health, Nonthaburi, Thailand
| | - Tomihiko Ide
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kei Haga
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Kazuhiko Katayama
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Takema Kato
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Aichi, Japan
| | - Yuya Ouchi
- Genome and Transcriptome Analysis Center, Fujita Health University, Toyoake, Aichi, Japan
| | - Hiroki Kurahashi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Aichi, Japan
- Genome and Transcriptome Analysis Center, Fujita Health University, Toyoake, Aichi, Japan
| | - Takao Tsuji
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Somchai Sangkitporn
- Department of Medical Sciences, National Institute of Health, Nonthaburi, Thailand
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Ide T, Komoto S, Higo-Moriguchi K, Htun KW, Myint YY, Myat TW, Thant KZ, Thu HM, Win MM, Oo HN, Htut T, Wakuda M, Dennis FE, Haga K, Fujii Y, Katayama K, Rahman S, Nguyen SV, Umeda K, Oguma K, Tsuji T, Taniguchi K. Whole Genomic Analysis of Human G12P[6] and G12P[8] Rotavirus Strains that Have Emerged in Myanmar. PLoS One 2015; 10:e0124965. [PMID: 25938434 PMCID: PMC4418666 DOI: 10.1371/journal.pone.0124965] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/20/2015] [Indexed: 11/18/2022] Open
Abstract
G12 rotaviruses are emerging rotavirus strains causing severe diarrhea in infants and young children worldwide. However, the whole genomes of only a few G12 strains have been fully sequenced and analyzed. In this study, we sequenced and characterized the complete genomes of six G12 strains (RVA/Human-tc/MMR/A14/2011/G12P[8], RVA/Human-tc/MMR/A23/2011/G12P[6], RVA/Human-tc/MMR/A25/2011/G12P[8], RVA/Human-tc/MMR/P02/2011/G12P[8], RVA/Human-tc/MMR/P39/2011/G12P[8], and RVA/Human-tc/MMR/P43/2011/G12P[8]) detected in six stool samples from children with acute gastroenteritis in Myanmar. On whole genomic analysis, all six Myanmarese G12 strains were found to have a Wa-like genetic backbone: G12-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1 for strains A14, A25, P02, P39, and P43, and G12-P[6]-I1-R1-C1-M1-A1-N1-T1-E1-H1 for strain A23. Phylogenetic analysis showed that most genes of the six strains examined in this study were genetically related to globally circulating human G1, G3, G9, and G12 strains. Of note is that the NSP4 gene of strain A23 exhibited the closest relationship with the cognate genes of human-like bovine strains as well as human strains, suggesting the occurrence of reassortment between human and bovine strains. Furthermore, strains A14, A25, P02, P39, and P43 were very closely related to one another in all the 11 gene segments, indicating derivation of the five strains from a common origin. On the other hand, strain A23 consistently formed distinct clusters as to all the 11 gene segments, indicating a distinct origin of strain A23 from that of strains A14, A25, P02, P39, and P43. To our knowledge, this is the first report on whole genome-based characterization of G12 strains that have emerged in Myanmar. Our observations will provide important insights into the evolutionary dynamics of spreading G12 rotaviruses in Asia.
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Affiliation(s)
- Tomihiko Ide
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- * E-mail:
| | - Kyoko Higo-Moriguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Khaing Win Htun
- Nay Pyi Taw General Hospital (Central Myanmar), Nay Pyi Taw, Myanmar
| | - Yi Yi Myint
- Department of Medical Research (Upper Myanmar), Pyin Oo Lwin, Myanmar
| | | | - Kyaw Zin Thant
- Department of Medical Research (Lower Myanmar), Yangon, Myanmar
| | - Hlaing Myat Thu
- Department of Medical Research (Lower Myanmar), Yangon, Myanmar
| | - Mo Mo Win
- Department of Medical Research (Lower Myanmar), Yangon, Myanmar
| | - Htun Naing Oo
- Department of Traditional Medicine (Central Myanmar), Nay Pyi Taw, Myanmar
| | - Than Htut
- Ministry of Health (Central Myanmar), Nay Pyi Taw, Myanmar
| | - Mitsutaka Wakuda
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Francis Ekow Dennis
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Kei Haga
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Yoshiki Fujii
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Kazuhiko Katayama
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Shofiqur Rahman
- Immunology Research Institute in Gifu, EW Nutrition Japan, Gifu, Japan
| | - Sa Van Nguyen
- Immunology Research Institute in Gifu, EW Nutrition Japan, Gifu, Japan
| | - Kouji Umeda
- Immunology Research Institute in Gifu, EW Nutrition Japan, Gifu, Japan
| | - Keiji Oguma
- Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Takao Tsuji
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Bhandari N, Rongsen-Chandola T, Bavdekar A, John J, Antony K, Taneja S, Goyal N, Kawade A, Kang G, Rathore SS, Juvekar S, Muliyil J, Arya A, Shaikh H, Abraham V, Vrati S, Proschan M, Kohberger R, Thiry G, Glass R, Greenberg HB, Curlin G, Mohan K, Harshavardhan GVJA, Prasad S, Rao TS, Boslego J, Bhan MK. Efficacy of a monovalent human-bovine (116E) rotavirus vaccine in Indian children in the second year of life. Vaccine 2015; 32 Suppl 1:A110-6. [PMID: 25091663 DOI: 10.1016/j.vaccine.2014.04.079] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED Rotavirus gastroenteritis is one of the leading causes of diarrhea in Indian children less than 2 years of age. The 116E rotavirus strain was developed as part of the Indo-US Vaccine Action Program and has undergone efficacy trials. This paper reports the efficacy and additional safety data in children up to 2 years of age. In a double-blind placebo controlled multicenter trial, 6799 infants aged 6-7 weeks were randomized to receive three doses of an oral human-bovine natural reassortant vaccine (116E) or placebo at ages 6, 10, and 14 weeks. The primary outcome was severe (≥11 on the Vesikari scale) rotavirus gastroenteritis. Efficacy outcomes and adverse events were ascertained through active surveillance. We randomly assigned 4532 and 2267 subjects to receive vaccine and placebo, respectively, with over 96% subjects receiving all three doses of the vaccine or placebo. The per protocol analyses included 4354 subjects in the vaccine and 2187 subjects in the placebo group. The overall incidence of severe RVGE per 100 person years was 1.3 in the vaccine group and 2.9 in the placebo recipients. Vaccine efficacy against severe rotavirus gastroenteritis in children up to 2 years of age was 55.1% (95% CI 39.9 to 66.4; p<0.0001); vaccine efficacy in the second year of life of 48.9% (95% CI 17.4 to 68.4; p=0.0056) was only marginally less than in the first year of life [56.3% (95% CI 36.7 to 69.9; p<0.0001)]. The number of infants needed to be immunized to prevent one episode of severe RVGE in the first 2 years of life was 40 (95% CI 28.0 to 63.0) and for RVGE of any severity, it was 21 (95% CI 16.0 to 32.0). Serious adverse events were observed at the same rates in the two groups. None of the eight intussusception events occurred within 30 days of a vaccine dose and all were reported only after the third dose. The sustained efficacy of the 116E in the second year of life is reassuring. CLINICAL TRIAL REGISTRY The trial is registered with Clinical Trial Registry-India (# CTRI/2010/091/000102) and Clinicaltrials.gov (# NCT01305109).
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Affiliation(s)
- Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | | | - Jacob John
- Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nidhi Goyal
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Anand Kawade
- KEM Hospital Research Centre, Pune, Maharashtra, India
| | | | - Sudeep Singh Rathore
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | | | - Alok Arya
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Hanif Shaikh
- KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Vinod Abraham
- Christian Medical College, Vellore, Tamil Nadu, India
| | - Sudhanshu Vrati
- Translational Health Science and Technology Institute, Gurgaon, Haryana, India; National Institute of Immunology, New Delhi, India
| | | | | | - Georges Thiry
- Advancing Rotavirus Vaccines Development Project, PATH, France
| | - Roger Glass
- National Institutes of Health, Bethesda, MD, USA
| | | | | | - Krishna Mohan
- Bharat Biotech International Limited, Genome Valley, Andhra Pradesh, India
| | | | - Sai Prasad
- Bharat Biotech International Limited, Genome Valley, Andhra Pradesh, India
| | - T S Rao
- Department of Biotechnology, Ministry of Science and Technology, Government of India, India
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25
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Rao TS, Arora R, Khera A, Tate JE, Parashar U, Kang G. Insights from global data for use of rotavirus vaccines in India. Vaccine 2015; 32 Suppl 1:A171-8. [PMID: 25091672 DOI: 10.1016/j.vaccine.2014.03.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Rotavirus vaccines are being introduced in several low- and middle-income countries across the world with and without support from the GAVI Alliance. India has the highest disease burden of rotavirus based on morbidity and mortality estimates and several indigenous vaccine manufacturers are developing rotavirus vaccines. One candidate has undergone phase III testing and others have completed evaluation in phase II. Global data on licensed vaccine performance in terms of impact on disease, strain diversity, safety and cost-effectiveness has been reviewed to provide a framework for decision making in India.
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Affiliation(s)
- T S Rao
- Department of Biotechnology, Ministry of Science and Technology, Government of India, CGO Complex, New Delhi, India
| | - Rashmi Arora
- Division of Epidemiology and Communicable Diseases, Indian Council for Medical Research, Ansari Nagar, New Delhi, India
| | - Ajay Khera
- Child Health and Immunization, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, India
| | - Jacqueline E Tate
- Viral Gastroenteritis Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Umesh Parashar
- Viral Gastroenteritis Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, Tamil Nadu, India.
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26
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Babji S, Arumugam R, Sarvanabhavan A, Moses PD, Simon A, Aggarwal I, Mathew A, Sr Anita, Kang G. Multi-center surveillance of rotavirus diarrhea in hospitalized children <5 years of age in India, 2009-2012. Vaccine 2015; 32 Suppl 1:A10-2. [PMID: 25091661 DOI: 10.1016/j.vaccine.2014.03.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Diarrheal disease due to Group A rotaviruses continues to be an important cause of morbidity in the developing world and India contributes significantly to the disease burden. Surveillance carried out between July 2009 and June 2012 at two medical centers in south India and one center in north India estimated 39% of all diarrheal admissions to be due to rotavirus. The most prevalent genotype isolated was G1P[8](33%) followed by G2P[4](17%). G9P[4] has also emerged as a significant cause of rotavirus diarrhea. No seasonal variation was noticed from the centers in south India, whereas we observed increased rotavirus diarrhea in the center in north India during March and April.
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Affiliation(s)
- Sudhir Babji
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Rajesh Arumugam
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - Prabhakar D Moses
- Department of Child Health, Christian Medical College, Vellore, India
| | - Anna Simon
- Department of Child Health, Christian Medical College, Vellore, India
| | - Indira Aggarwal
- Department of Child Health, Christian Medical College, Vellore, India
| | - Ann Mathew
- Department of Pediatrics, St. Stephen's Hospital, Delhi, India
| | - Sr Anita
- Child Jesus Hospital, Trichy, India
| | - Gagandeep Kang
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
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27
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Paul S, Sahoo J. Four new vaccines for routine immunization in India: what about hemophilus influenza B and pneumococcal vaccine? J Family Med Prim Care 2015; 4:9-12. [PMID: 25810981 PMCID: PMC4367014 DOI: 10.4103/2249-4863.152238] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. The Expanded Program on Immunization (EPI) was flagged off in India in 1978. According to the recommendation of National technical advisory group of India (NATGI), Government of India is going to include four new vaccines in the UIP for whole India. The four new vaccines are Inactivated Poliomyelitis Vaccine (IPV) for polio, rota viral vaccine, vaccine against rubella, and Japanese encephalitis vaccine (179 districts in India). Here, authors have tried to show a comparative descriptive analysis of the hemophilus influenza and pneumococcal pneumonia with rota virus, so that in near future Government of India can also consider their inclusion in the national UIP. In India, 39.2% of all diarrheal death are due to rota virus, whereas 0.72 million deaths are due to hemophilus influenza B and 1.3 million are due to pneumococcal pneumonia in <5 years age-group. India's indigenous developed rota viral vaccine's (Rotavac) efficacy is 56% in 1(st) year compared to H influenza B (Hib) efficacy 95% and PCV13 vaccine "3 + 1" dose efficacy 100% (South Africa). Rotarix incremental cost-effectiveness ratio is US $21.4 to US $34 per disability-adjusted life years (DALYs) compared to Hib US $ 819 per DALYs in India. In case of pneumococcal vaccine, India needs more trails on the serotype specificity, efficacy, and cost-effectiveness but there is enough evidence that hemophilus influenza burden is high in India and the present Hib vaccine is safe and highly effective. In future with the help of donor agencies, India should include the hemophilus influenza B and pneumococcal pneumonia vaccine in national UIP which will save millions of poor children's life.
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Affiliation(s)
- Sourabh Paul
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jyotiranjan Sahoo
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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28
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Changing trends in circulating rotavirus strains in Pune, western India in 2009–2012: Emergence of a rare G9P[4] rotavirus strain. Vaccine 2014; 32 Suppl 1:A29-32. [DOI: 10.1016/j.vaccine.2014.03.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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29
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Poppitt SD, McGregor RA, Wiessing KR, Goyal VK, Chitkara AJ, Gupta S, Palmano K, Kuhn-Sherlock B, McConnell MA. Bovine complex milk lipid containing gangliosides for prevention of rotavirus infection and diarrhoea in northern Indian infants. J Pediatr Gastroenterol Nutr 2014; 59:167-71. [PMID: 25023444 DOI: 10.1097/mpg.0000000000000398] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Rotavirus (RV) is a leading cause of morbidity and mortality in children younger than 5 years of age, presenting commonly with diarrhoeal symptoms. In a prospective 12-week double-blind randomised controlled trial we assessed acceptability and efficacy of a high-ganglioside complex milk lipid (CML) for prevention of RV infection in 450 infants, ages 8 to 24 months, at 3 sites in northern India. Prevalence of diarrhoea and RV was unseasonably low at baseline (all-cause diarrhoea [ACD], n = 16; RV diarrhoea [RVD], n = 2; RV infection, RV positive [RV+], n = 20) and throughout the trial, with only 110 total episodes of ACD for 12 weeks (CML, n = 62; control, n = 48) of which 10 were RVD (CML, n = 4; control, n = 6). Mean duration that RVD persisted was lower in the CML group (2.3 ± 0.5 days) than that in the control group (3.8 ± 1.3 days, P = 0.03), but only 3 of 450 end of trial stool samples were identified as RV+ (<1%; CML, n = 2; control, n = 1). This hampered the assessment of efficacy of CML, despite the large a priori determined sample size. During the trial similar numbers of infants reported adverse events (AEs: CML 41%, control 46%), with the majority of events classified as mild and not related to the intervention. In conclusion, further clinical trials against a higher background of seasonal prevalence are necessary to assess efficacy of this nutritional intervention to prevent RVD. More important, however, high-ganglioside CML was acceptable for long-term consumption in infants ages 8 to 24 months.
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Affiliation(s)
- Sally D Poppitt
- *Human Nutrition Unit, School of Biological Sciences, University of Auckland, New Zealand †Panchsheel Hospital, Yamuna Vihar ‡Sarvodaya Child Care, Pitampura, New Delhi §M.V. Hospital & Research Centre, Lucknow, India
- Research and Development Centre, Palmerston North ¶University of Otago, Dunedin, New Zealand
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30
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Synthesizing evidences for policy translation: A public health discourse on rotavirus vaccine in India. Vaccine 2014; 32 Suppl 1:A162-70. [DOI: 10.1016/j.vaccine.2014.03.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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31
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Absence of genetic differences among G10P[11] rotaviruses associated with asymptomatic and symptomatic neonatal infections in Vellore, India. J Virol 2014; 88:9060-71. [PMID: 24899175 DOI: 10.1128/jvi.01417-14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Rotaviruses (RVs) are leading causes of severe diarrhea and vomiting in infants and young children. RVs with G10P[11] genotype specificity have been associated with symptomatic and asymptomatic neonatal infections in Vellore, India. To identify possible viral genetic determinants responsible for differences in symptomology, the genome sequences of G10P[11] RVs in stool samples of 19 neonates with symptomatic infections and 20 neonates with asymptomatic infections were determined by Sanger and next-generation sequencing. The data showed that all 39 viruses had identical genotype constellations (G10-P[11]-I2-R2-C2-M2-A1-N1-T1-E2-H3), the same as those of the previously characterized symptomatic N155 Vellore isolate. The data also showed that the RNA and deduced protein sequences of all the Vellore G10P[11] viruses were nearly identical; no nucleotide or amino acid differences were found that correlated with symptomatic versus asymptomatic infection. Next-generation sequencing data revealed that some stool samples, both from neonates with symptomatic infections and from neonates with asymptomatic infections, also contained one or more positive-strand RNA viruses (Aichi virus, astrovirus, or salivirus/klassevirus) suspected of being potential causes of pediatric gastroenteritis. However, none of the positive-strand RNA viruses could be causally associated with the development of symptoms. These results indicate that the diversity of clinical symptoms in Vellore neonates does not result from genetic differences among G10P[11] RVs; instead, other undefined factors appear to influence whether neonates develop gastrointestinal disease symptoms. IMPORTANCE Rotavirus (RV) strains have been identified that preferentially replicate in neonates, in some cases, without causing gastrointestinal disease. Surveillance studies have established that G10P[11] RVs are a major cause of neonatal infection in Vellore, India, with half of infected neonates exhibiting symptoms. We used Sanger and next-generation sequencing technologies to contrast G10P[11] RVs recovered from symptomatic and asymptomatic neonates. Remarkably, the data showed that the RNA genomes of the viruses were virtually indistinguishable and lacked any differences that could explain the diversity of clinical outcomes among infected Vellore neonates. The sequencing results also indicated that some symptomatic and some asymptomatic Vellore neonates were infected with other enteric viruses (Aichi virus, astrovirus, salvirus/klassevirus); however, none could be correlated with the presence of symptoms in neonates. Together, our findings suggest that other poorly defined factors, not connected to the genetic makeup of the Vellore G10P[11] viruses, influence whether neonates develop gastrointestinal disease symptoms.
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32
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John BM, Devgan A, Mitra B. Prevalence of rotavirus infection in children below two years presenting with diarrhea. Med J Armed Forces India 2014; 70:116-9. [PMID: 24843198 DOI: 10.1016/j.mjafi.2014.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 02/22/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Rotavirus is a common cause of diarrhea in children. There is a need for data on prevalence of rotavirus diarrhea especially in our setting. This study was carried out to determine the prevalence of rotavirus infection in children upto two years presenting with diarrhea and to ascertain factors associated with rotavirus infection in them. METHODS A cross sectional observational study was carried out to determine the prevalence of rotavirus infection amongst children less than 2 years presenting with diarrhea. The clinical profile of the children was analyzed along with detection of rotavirus antigen in stool. RESULTS A total of 250 children with diarrhea were included in the study. The Male: Female ratio was 0.97:1. We found 24% children presenting with diarrhea to be positive for rotavirus antigen. 78.3% of children with rotaviral diarrhea were in the age group of 6-15 months. There was a significant association between type of feeding and rotavirus diarrhea with reduced prevalence while on exclusive breast-feeding. Though only 10.4% of children with rotavirus diarrhea had severe dehydration, 61.5% of children with severe dehydration were positive for rotavirus. CONCLUSION Rotavirus diarrhea caused substantial morbidity in our study population. The rotavirus positivity in these children was 24% and there was a significant association of rotavirus infection with type of feeding and severity of dehydration.
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Affiliation(s)
- B M John
- Classified Specialist (Pediatrics), Command Hospital (Air Force), Bangalore, India
| | - Amit Devgan
- Associate Professor, Department of Pediatrics, Armed Forces Medical College, Pune 411040, India
| | - Barnali Mitra
- Graded Specialist (Pediatrics), 5 Air Force Hospital, C/o 99 APO, India
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33
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Prevalence of rotavirus diarrhea among hospitalized under-five children. Indian Pediatr 2013; 51:27-31. [PMID: 24277960 DOI: 10.1007/s13312-014-0329-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 08/22/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To estimate the prevalence of rotavirus diarrhea among hospitalized children less than 5 years of age in Kerala State and to determine the circulating strains of rotavirus in Kerala. DESIGN Multicenter, cross-sectional study. SETTING Eight representative hospitals in Kunnathunadu Thaluk, Ernakulam district, Kerala. PARTICIPANTS Children in the age group under 5 years. METHODS Hospitalized children admitted with acute diarrhea were examined and standardized case report form was used to collect demographic, clinical and health outcome. Stool specimens were collected and ELISA testing was done. ELISA rotavirus positive samples were tested by reverse transcription PCR for G and P typing (CMC Vellore). RESULTS Among the 1827 children, 648 (35.9%) were positive for rotavirus by the Rotaclone ELISA test. The prevalence of rotavirus diarrhea in infants less than 6 months of age was 24.7%; 6- 11 months 31.9%; 12- 23 months 41.9%; 24- 35 months 46.9%; and 33.3% in 36- 59 months. Rotavirus infections were most common during the dry months from January through May. G1P[8] (49.7%) was the most common strain identified followed by G9P[8] (26.4%), G2P[4] (5.5%), G9P[4] (2.6%) and G12P[6] (1.3%). CONCLUSIONS The prevalence of rotavirus diarrhea among hospitalized children less than 5 years is high in Ernakulam district, Kerala State.
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Sarkar R, Kang G, Naumova EN. Rotavirus seasonality and age effects in a birth cohort study of southern India. PLoS One 2013; 8:e71616. [PMID: 23977089 PMCID: PMC3745434 DOI: 10.1371/journal.pone.0071616] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 06/30/2013] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Understanding the temporal patterns in disease occurrence is valuable for formulating effective disease preventive programs. Cohort studies present a unique opportunity to explore complex interactions associated with emergence of seasonal patterns of infectious diseases. METHODS We used data from 452 children participating in a birth cohort study to assess the seasonal patterns of rotavirus diarrhea by creating a weekly time series of rotavirus incidence and fitting a Poisson harmonic regression with biannual peaks. Age and cohort effects were adjusted for by including the weekly counts of number of children in the study and the median age of cohort in a given week. Weekly average temperature, humidity and an interaction term to reflect the joint effect of temperature and humidity were included to consider the effects of meteorological variables. RESULTS In the overall rotavirus time series, two significant peaks within a single year were observed--one in winter and the other in summer. The effect of age was found to be the most significant contributor for rotavirus incidence, showing a strong negative association. Seasonality remained a significant factor, even after adjusting for meteorological parameters, and the age and cohort effects. CONCLUSIONS The methodology for assessing seasonality in cohort studies is not yet developed. This is the first attempt to explore seasonal patterns in a cohort study with a dynamic denominator and rapidly changing immune response on individual and group levels, and provides a highly promising approach for a better understanding of the seasonal patterns of infectious diseases, tracking emergence of pathogenic strains and evaluating the efficacy of intervention programs.
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Affiliation(s)
- Rajiv Sarkar
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, India
| | - Gagandeep Kang
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, India
| | - Elena N. Naumova
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, India
- Department of Civil and Environmental Engineering Tufts University School of Engineering, Boston, Massachusetts, United States of America
- * E-mail:
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Verguet S, Murphy S, Anderson B, Johansson KA, Glass R, Rheingans R. Public finance of rotavirus vaccination in India and Ethiopia: an extended cost-effectiveness analysis. Vaccine 2013; 31:4902-10. [PMID: 23871824 DOI: 10.1016/j.vaccine.2013.07.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 07/02/2013] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantially decrease child mortality and also reduce rotavirus-related hospitalizations, prevent health-related impoverishment and bring significant cost savings to households. METHODS We use a methodology of 'extended cost-effectiveness analysis' (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. We measure program impact along four dimensions: 1) rotavirus deaths averted; 2) household expenditures averted; 3) financial risk protection afforded; 4) distributional consequences across the wealth strata of the country populations. RESULTS In India and Ethiopia, the program would lead to a substantial decrease in rotavirus deaths, mainly among the poorer; it would reduce household expenditures across all income groups and it would effectively provide financial risk protection, mostly concentrated among the poorest. Potential indirect benefits of vaccination (herd immunity) would increase program benefits among all income groups, whereas potentially decreased vaccine efficacy among poorer households would reduce the equity benefits of the program. CONCLUSIONS Our approach incorporates financial risk protection and distributional consequences into the systematic economic evaluation of vaccine policy, illustrated here with the case study of public finance for rotavirus vaccination. This enables selection of vaccine packages based on the quantitative inclusion of information on equity and on how much financial risk protection is being bought per dollar expenditure on vaccine policy, in addition to how much health is being bought.
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Affiliation(s)
- Stéphane Verguet
- Department of Global Health, University of Washington, Seattle, WA, United States.
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