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Laker G, Nankunda J, Melvis BM, Kajoba D, Nduwimana M, Kimera J, Odong RJ, Edyedu I. Prevalence and factors associated with rotavirus diarrhea among children aged 3-24 months after the introduction of the vaccine at a referral hospital in Uganda: a cross-sectional study. BMC Pediatr 2024; 24:358. [PMID: 38778329 PMCID: PMC11112855 DOI: 10.1186/s12887-024-04842-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Rotavirus has a significant morbidity and mortality in children under two years. The burden of rotavirus diarrhea 4 years post introduction of rotavirus vaccine in Uganda is not well established. This study aimed to determine the prevalence, severity of dehydration and factors associated with rotavirus diarrhea among children aged 3 to 24 months after the introduction of the vaccine at Fort Portal Regional Referral hospital. METHODS This was a cross-sectional hospital-based study in which children with acute watery diarrhea were included. A rectal tube was used to collect a stool sample for those unable to provide samples. Stool was tested for rotavirus using rapid immunochromatographic assay. Data was analysed using SPSS version 22 with logistic regression done to determine the factors. RESULTS Out of 268 children with acute watery diarrhea, 133 (49.6%) were females. Rotavirus test was positive in 42 (15.7%), majority of whom had some dehydration 28(66.7%). The factors that were independently associated with rotavirus diarrhea were; age < 12 months (AOR = 8.87, P = 0.014), male gender (AOR = 0.08, P = 0.001), coming from a home with another person with diarrhea (AOR = 17.82, P = 0.001) or a home where the water source was a well (AOR = 50.17, P = 0.002). CONCLUSION The prevalence of rotavirus diarrhea was three times less in the post rotavirus vaccination period compared to pre-rota vaccination period. Majority of the participants with rotavirus diarrhea had some dehydration. There is need for provision of safe water sources to all homes. Surveillance to determine the cause of the non rota diarrhea should be done.
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Affiliation(s)
- Goretty Laker
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda.
| | - Jolly Nankunda
- Mulago specialised Women and Neonatal Hospital, Kampala, Uganda
| | - Bernis Maren Melvis
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
| | - Dickson Kajoba
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
| | - Martin Nduwimana
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
| | - Joel Kimera
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
| | - Richard Justine Odong
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
| | - Isaac Edyedu
- Department of Surgery, Kampala International University, Kampala, Uganda
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Miranda S, Tonin FS, Pinto-Sousa C, Fortes-Gabriel E, Brito M. Genetic Profile of Rotavirus Type A in Children under 5 Years Old in Africa: A Systematic Review of Prevalence. Viruses 2024; 16:243. [PMID: 38400019 PMCID: PMC10893345 DOI: 10.3390/v16020243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 02/25/2024] Open
Abstract
Human type A rotavirus (RV-A) is world-recognized as the major pathogen causing viral gastroenteritis in children under 5 years of age. The literature indicates a substantial increase in the diversity of rotavirus strains across continents, especially in Africa, which can pose significant challenges including an increase of disease burden and a reduction of vaccines' effectiveness. However, few studies have mapped the variety of circulating virus strains in different regions, which may hamper decisions on epidemiological surveillance and preventive public health measures. Thus, our aim was to compile the most updated available evidence on the genetic profile of RV-A among children in Africa and determine the prevalence of different genotypes according to the geographical regions by means of a broad systematic review. Systematic searches were performed in PubMed, Scopus, Web of Science, and Scielo without language, time limits, or geographical restrictions within the African continent. We selected full-text peer-reviewed articles assessing the genetic profile (i.e., genotyping) of RV-A in children up to 5 years old in Africa. Overall, 682 records were retrieved, resulting in 75 studies included for evidence synthesis. These studies were published between 1999 and 2022, were conducted in 28 countries from the five African regions, and 48% of the studies were carried out for 24 months or more. Most studies (n = 55; 73.3%) evaluated RV-A cases before the introduction of the vaccines, while around 20% of studies (n = 13) presented data after the vaccine approval in each country. Only seven (9.3%) studies compared evidence from both periods (pre- and post-vaccine introduction). Genotyping methods to assess RV-A varied between RT-PCR, nested or multiplex RT-PCR, testing only the most common P and G-types. We observed G1 and P[8] to be the most prevalent strains in Africa, with values around 31% and 43%, respectively. Yet if all the genotypes with the following highest prevalence were added ((G1 + G2, G3, G9) and (P[8] + P[6], P[4])), these figures would represent 80% and 99% of the total prevalence. The combination G1P[8] was the most reported in the studies (around 22%). This review study demonstrated an increased strain diversity in the past two decades, which could represent a challenge to the efficacy of the current vaccine.
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Affiliation(s)
- Sandra Miranda
- Faculdade de Medicine, Universidade Agostinho Neto, Luanda, Angola; (S.M.); (C.P.-S.)
- CISA-Centro de Investigação em Saúde de Angola, Caxito, Bengo, Angola;
- Clínica Girassol, Luanda, Angola
| | - Fernanda S. Tonin
- ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal;
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, Brazil
| | - Carlos Pinto-Sousa
- Faculdade de Medicine, Universidade Agostinho Neto, Luanda, Angola; (S.M.); (C.P.-S.)
- UPRA-Universidade Privada de Angola, Luanda, Angola
| | - Elsa Fortes-Gabriel
- CISA-Centro de Investigação em Saúde de Angola, Caxito, Bengo, Angola;
- ISTM- Instituto Superior Técnico Militar, Luanda, Angola
| | - Miguel Brito
- CISA-Centro de Investigação em Saúde de Angola, Caxito, Bengo, Angola;
- ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal;
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Bwogi J, Karamagi C, Byarugaba DK, Tushabe P, Kiguli S, Namuwulya P, Malamba SS, Jere KC, Desselberger U, Iturriza-Gomara M. Co-Surveillance of Rotaviruses in Humans and Domestic Animals in Central Uganda Reveals Circulation of Wide Genotype Diversity in the Animals. Viruses 2023; 15:v15030738. [PMID: 36992447 PMCID: PMC10052166 DOI: 10.3390/v15030738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Rotavirus genotypes are species specific. However, interspecies transmission is reported to result in the emergence of new genotypes. A cross-sectional study of 242 households with 281 cattle, 418 goats, 438 pigs, and 258 humans in Uganda was undertaken between 2013 and 2014. The study aimed to determine the prevalence and genotypes of rotaviruses across co-habiting host species, as well as potential cross-species transmission. Rotavirus infection in humans and animals was determined using NSP3 targeted RT-PCR and ProSpecT Rotavirus ELISA tests, respectively. Genotyping of rotavirus-positive samples was by G- and P-genotype specific primers in nested RT-PCR assays while genotyping of VP4 and VP7 proteins for the non-typeable human positive sample was done by Sanger sequencing. Mixed effect logistic regression was used to determine the factors associated with rotavirus infection in animals. The prevalence of rotavirus was 4.1% (95% CI: 3.0–5.5%) among the domestic animals and 0.8% (95% CI: 0.4–1.5%) in humans. The genotypes in human samples were G9P[8] and P[4]. In animals, six G-genotypes, G3(2.5%), G8(10%), G9(10%), G11(26.8%), G10(35%), and G12(42.5%), and nine P-genotypes, P[1](2.4%), P[4](4.9%), P[5](7.3%), P[6](14.6%), P[7](7.3%), P[8](9.8%), P[9](9.8%), P[10](12.2%), and P[11](17.1%), were identified. Animals aged 2 to 18 months were less likely to have rotavirus infection in comparison with animals below 2 months of age. No inter-host species transmission was identified.
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Affiliation(s)
- Josephine Bwogi
- EPI Laboratory, Uganda Virus Research Institute, 51–59 Nakiwogo Road, Entebbe P.O. Box 49, Uganda
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
- Correspondence: or
| | - Charles Karamagi
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Denis Karuhize Byarugaba
- Department of Microbiology, College of Veterinary Medicine and Biosecurity, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Phionah Tushabe
- EPI Laboratory, Uganda Virus Research Institute, 51–59 Nakiwogo Road, Entebbe P.O. Box 49, Uganda
| | - Sarah Kiguli
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Prossy Namuwulya
- EPI Laboratory, Uganda Virus Research Institute, 51–59 Nakiwogo Road, Entebbe P.O. Box 49, Uganda
| | - Samuel S. Malamba
- Northern Uganda Program on Health Sciences, c/o Uganda Virus Research Institute, 51–59 Nakiwogo Road, Entebbe P.O. Box 49, Uganda
| | - Khuzwayo C. Jere
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
- Malawi Liverpool Wellcome Research Programme (MLW), Blantyre P.O. Box 30096, Malawi
- Department of Medical Laboratory Sciences, Faculty of Biomedical Sciences and Health Profession, Kamuzu University of Health Sciences, Blantyre P.O. Box 30184, Malawi
| | | | - Miren Iturriza-Gomara
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
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Mokoena F, Esona MD, Seheri LM, Nyaga MM, Magagula NB, Mukaratirwa A, Mulindwa A, Abebe A, Boula A, Tsolenyanu E, Simwaka J, Rakau KG, Peenze I, Mwenda JM, Mphahlele MJ, Steele AD. Whole Genome Analysis of African G12P[6] and G12P[8] Rotaviruses Provides Evidence of Porcine-Human Reassortment at NSP2, NSP3, and NSP4. Front Microbiol 2021; 11:604444. [PMID: 33510725 PMCID: PMC7835662 DOI: 10.3389/fmicb.2020.604444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/10/2020] [Indexed: 01/27/2023] Open
Abstract
Group A rotaviruses (RVA) represent the most common cause of pediatric gastroenteritis in children <5 years, worldwide. There has been an increase in global detection and reported cases of acute gastroenteritis caused by RVA genotype G12 strains, particularly in Africa. This study sought to characterize the genomic relationship between African G12 strains and determine the possible origin of these strains. Whole genome sequencing of 34 RVA G12P[6] and G12P[8] strains detected from the continent including southern (South Africa, Zambia, Zimbabwe), eastern (Ethiopia, Uganda), central (Cameroon), and western (Togo) African regions, were sequenced using the Ion Torrent PGM method. The majority of the strains possessed a Wa-like backbone with consensus genotype constellation of G12-P[6]/P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1, while a single strain from Ethiopia displayed a DS-1-like genetic constellation of G12-P[6]-I2-R2-C2-M2-A2-N2-T2-E2-H2. In addition, three Ethiopian and one South African strains exhibited a genotype 2 reassortment of the NSP3 gene, with genetic constellation of G12-P[8]-I1-R1-C1-M1-A1-N1-T2-E1-H1. Overall, 10 gene segments (VP1–VP4, VP6, and NSP1–NSP5) of African G12 strains were determined to be genetically related to cognate gene sequences from globally circulating human Wa-like G12, G9, and G1 strains with nucleotide (amino acid) identities in the range of 94.1–99.9% (96.5–100%), 88.5–98.5% (93–99.1%), and 89.8–99.0% (88.7–100%), respectively. Phylogenetic analysis showed that the Ethiopian G12P[6] possessing a DS-1-like backbone consistently clustered with G2P[4] strains from Senegal and G3P[6] from Ethiopia with the VP1, VP2, VP6, and NSP1–NSP4 genes. Notably, the NSP2, NSP3, and NSP4 of most of the study strains exhibited the closest relationship with porcine strains suggesting the occurrence of reassortment between human and porcine strains. Our results add to the understanding of potential roles that interspecies transmission play in generating human rotavirus diversity through reassortment events and provide insights into the evolutionary dynamics of G12 strains spreading across selected sub-Saharan Africa regions.
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Affiliation(s)
- Fortunate Mokoena
- Department of Biochemistry, Faculty of Natural and Agricultural Science, North West University, Mmabatho, South Africa.,Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Mathew Dioh Esona
- Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Luyanda Mapaseka Seheri
- Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Martin Munene Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Nonkululelo Bonakele Magagula
- Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Arnold Mukaratirwa
- Department of Medical Microbiology, University of Zimbabwe-College of Health Sciences, Harare, Zimbabwe
| | | | - Almaz Abebe
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Angeline Boula
- Mother and Child Center, Chantal Biya Foundation, Yaoundé, Cameroon
| | - Enyonam Tsolenyanu
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital of Lome, Lome, Togo
| | - Julia Simwaka
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Kebareng Giliking Rakau
- Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Ina Peenze
- Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Jason Mathiu Mwenda
- African Rotavirus Surveillance Network, Immunization, Vaccines and Development Cluster, WHO African Regional Office, Brazzaville, Congo
| | - Maphahlaganye Jeffrey Mphahlele
- Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Andrew Duncan Steele
- Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation, Seattle, WA, United States
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5
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Simwaka JC, Mpabalwani EM, Seheri M, Peenze I, Monze M, Matapo B, Parashar UD, Mufunda J, Mphahlele JM, Tate JE, Mwenda JM. Diversity of rotavirus strains circulating in children under five years of age who presented with acute gastroenteritis before and after rotavirus vaccine introduction, University Teaching Hospital, Lusaka, Zambia, 2008-2015. Vaccine 2018; 36:7243-7247. [PMID: 29907481 DOI: 10.1016/j.vaccine.2018.03.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 12/16/2017] [Accepted: 03/14/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Following the introduction of rotavirus vaccine into the routine immunization schedule, the burden of rotavirus disease has significantly reduced in Zambia. Although rotavirus vaccines appear to confer good cross-protection against both vaccine and non-vaccine strains, concerns about strain replacement following vaccine implementation remain. We describe the diversity of the circulating rotavirus strains before and after the Rotarix® vaccine was introduced in Lusaka from January 2012. METHODS Under five children were enrolled through active surveillance at University Teaching Hospital using a standardized WHO case investigation form. Stool samples were collected from children who presented with ≥3 loose stool in 24 h and were admitted to the hospital for acute gastroenteritis as a primary illness. Samples were tested for group A rotavirus antigen enzyme-linked immunosorbent assay. Randomly selected rotavirus positive samples were analysed by reverse transcription polymerase chain reaction for G and P genotyping and and Nucleotide sequencing was used to confirm some mixed infections. RESULTS A total of 4150 cases were enrolled and stool samples were collected from 4066 (98%) children between 2008 and 2011, before the vaccine was introduced. Rotavirus antigen was detected in 1561/4066 (38%). After vaccine introduction (2012 to 2015), 3168 cases were enrolled, 3092 (98%) samples were collected, and 977/3092 (32%) were positive for rotavirus. The most common G and P genotype combinations before vaccine introduction were G1P[8] (49%) in 2008; G12P[6] (24%) and G9P[8] (22%) in 2009; mixed rotavirus infections (32%) and G9P[8] (20%) in 2010, and G1P[6] (46%), G9P[6] (16%) and mixed infections (20%) in 2011. The predominant strains after vaccine introduction were G1P[8] (25%), G2P[4] (28%) and G2P[6] (23%) in 2012; G2P[4] (36%) and G2P[6] (44%) in 2013; G1P[8] (43%), G2P[4] (9%), and G2P[6] (24%) in 2014, while G2P[4] (54%) and G2P[6] (20%) continued to circulate in 2015. CONCLUSION These continual changes in the predominant strains suggest natural secular variation in circulating rotavirus strains post-vaccine introduction. These findings highlight the need for ongoing surveillance to continue monitoring how vaccine use affects strain evolution over a longer period of time and assess any normal seasonal fluctuations of the rotavirus strains.
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Affiliation(s)
- J C Simwaka
- University Teaching Hospital, Department of Pathology & Microbiology, Virology Laboratory, Lusaka, Zambia.
| | - Evans M Mpabalwani
- University Teaching Hospital, Department of Pediatrics' and Child Health, Lusaka, Zambia
| | - Mapaseka Seheri
- Sefako Makgatho Health Sciences University, South African Medical Research Council Diarrhoeal Pathogens Research Unit and WHO AFRO Rotavirus Regional Reference Laboratory, Department of Virology, Medunsa, Pretoria, South Africa
| | - Ina Peenze
- Sefako Makgatho Health Sciences University, South African Medical Research Council Diarrhoeal Pathogens Research Unit and WHO AFRO Rotavirus Regional Reference Laboratory, Department of Virology, Medunsa, Pretoria, South Africa
| | - Mwaka Monze
- University Teaching Hospital, Department of Pathology & Microbiology, Virology Laboratory, Lusaka, Zambia
| | | | | | | | - Jeffrey M Mphahlele
- Sefako Makgatho Health Sciences University, South African Medical Research Council Diarrhoeal Pathogens Research Unit and WHO AFRO Rotavirus Regional Reference Laboratory, Department of Virology, Medunsa, Pretoria, South Africa
| | | | - Jason M Mwenda
- World Health Organization Regional office for Africa (WHO/AFRO), Brazzaville, Congo
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6
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Increasing predominance of G8P[8] species A rotaviruses in children admitted to hospital with acute gastroenteritis in Thailand, 2010-2013. Arch Virol 2018; 163:2165-2178. [DOI: 10.1007/s00705-018-3848-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 04/04/2018] [Indexed: 01/05/2023]
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7
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Ouermi D, Soubeiga D, Nadembega WMC, Sawadogo PM, Zohoncon TM, Obiri-Yeboah D, Djigma FW, Nordgren J, Simpore J. Molecular Epidemiology of Rotavirus in Children under Five in Africa (2006-2016): A Systematic Review. Pak J Biol Sci 2017; 20:59-69. [PMID: 29022996 DOI: 10.3923/pjbs.2017.59.69] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Group A human rotaviruses (RVA) are the most common causes of severe viral gastroenteritis in infants and young children worldwide. The available vaccines, while effective in Europe and North America have shown a reduced efficacy in Africa. One issue raised is the genetic variability of RVA. The objective of this study was to perform a literature review of molecular epidemiology to determine the prevalence of RVA genotypes circulating in Africa so as to establish a mapping of reliable data on these various genotypes. The search for articles was done from the National Institutes of Health (PUBMED) using three set of keywords. Articles were selected with inclusion criteria such as the date of publication, the age of the children, the sample size and the diagnostic techniques (standardized laboratory techniques). The data were imported into STATA SE version 11 software. Specific prevalence was estimated with Confidence Intervals (CI) of 95%. A total of 326 published studies were initially retrieved, out of which 27 studies were finally selected for the systematic review. The selected studies cover 20 African countries. The most encountered genotypes in Africa during this period were G1 (32.72%), followed by G2 (17.17%), G3 (9.88%), G9 (8.61%) and G12 (7.56%) among the G-types. The most common P-types were P[8] (48.71%) followed by P[6] (22.60%) and P[4] (11.58%) and the G1P[8] combination (22.64%) was the most encountered followed by G2P[4] (8.29%), G9P[8] (6.95%) and G2P[6] (5.00%). North Africa presented the highest prevalence of the P[8] genotype (65.70%). This review provides a comprehensive view of the current circulating rotavirus strains in Africa, which can be important in light of the new rotavirus vaccinations. Indeed, in Africa, the pursuit of national and continental studies for epidemiological surveillance of circulating rotavirus strains is vital for the promotion of future successful vaccines.
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Affiliation(s)
- D Ouermi
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - D Soubeiga
- Institut de Formation et de Recherche Interdisciplinaires en Santé (IFRIS), Ouagadougou, Burkina Faso
| | - W M C Nadembega
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - P M Sawadogo
- Institut de Formation et de Recherche Interdisciplinaires en Santé (IFRIS), Ouagadougou, Burkina Faso
| | - T M Zohoncon
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - D Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Ghana
| | - F W Djigma
- Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA)/LABIOGENE, Université Ouaga I Professeur Joseph KI-ZERBO, 01 B.P. 364, 01 Ouagadougou, Ouagadougou, Burkina Faso, West Africa
| | - J Nordgren
- Division of Molecular Virology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - J Simpore
- University Saint Thomas d'Aquin, USTA, Ouagadougou, Burkina Faso
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8
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O'Brien E, Nakyazze J, Wu H, Kiwanuka N, Cunningham W, Kaneene JB, Xagoraraki I. Viral diversity and abundance in polluted waters in Kampala, Uganda. WATER RESEARCH 2017; 127:41-49. [PMID: 29031798 DOI: 10.1016/j.watres.2017.09.063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/29/2017] [Accepted: 09/30/2017] [Indexed: 05/02/2023]
Abstract
Waterborne viruses are a significant cause of human disease, especially in developing countries such as Uganda. A total of 15 virus-selective samples were collected at five sites (Bugolobi Wastewater Treatment Plant (WWTP) influent and effluent, Nakivubo Channel upstream and downstream of the WWTP, and Nakivubo Swamp) in July and August 2016. Quantitative PCR and quantitative RT-PCR was performed to determine the concentrations of four human viruses (adenovirus, enterovirus, rotavirus, and hepatitis A virus) in the samples. Adenovirus (1.53*105-1.98*107 copies/L) and enterovirus (3.17*105-8.13*107 copies/L) were found to have the highest concentrations in the samples compared to rotavirus (5.79*101-3.77*103 copies/L) and hepatitis A virus (9.93*102-1.11*104 copies/L). In addition, next-generation sequencing and metagenomic analyses were performed to assess viral diversity, and several human and vertebrate viruses were detected, including Herpesvirales, Iridoviridae, Poxviridae, Circoviridae, Parvoviridae, Bunyaviridae and others. Effluent from the wastewater treatment plant appears to impact surface water, as samples taken from surface water downstream of the treatment plant had higher viral concentrations than samples taken upstream. Temporal fluctuations in viral abundance and diversity were also observed. Continuous monitoring of wastewater may contribute to assessing viral disease patterns at a population level and provide early warning of potential outbreaks using wastewater-based epidemiology methods.
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Affiliation(s)
- Evan O'Brien
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Joyce Nakyazze
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Huiyun Wu
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Noah Kiwanuka
- Department of Epidemiology and Biostatistics, College of Health Sciences, Makerere University, Kampala, Uganda
| | - William Cunningham
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - John B Kaneene
- Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - Irene Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA.
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9
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Weldegebriel G, Mwenda JM, Chakauya J, Daniel F, Masresha B, Parashar UD, Tate JE. Impact of rotavirus vaccine on rotavirus diarrhoea in countries of East and Southern Africa. Vaccine 2017; 36:7124-7130. [PMID: 29102168 DOI: 10.1016/j.vaccine.2017.10.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/17/2017] [Accepted: 10/16/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Established in 2006 with four countries conducting hospital-based rotavirus surveillance, the African rotavirus surveillance network has expanded over subsequent years. By 2015, 14 countries in the World Health Organization (WHO) East and Southern Africa sub-region (Eritrea, Ethiopia, Kenya, Lesotho, Madagascar, Mauritius, Namibia, Rwanda, Seychelles, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe) were participating in the rotavirus surveillance network coordinated by WHO. We monitored the proportion of rotavirus diarrhoea among children under five years of age who were hospitalized for diarrhoea in the sentinel hospitals from 2010 to 2015 among countries that introduced rotavirus vaccine during or before 2013 (Rwanda, Tanzania, Zambia and Ethiopia) and compared with the other countries in the network. METHODS Children under the age of five years hospitalized due to acute diarrhoea were enrolled into the sentinel surveillance system and had stool samples collected and tested for rotavirus antigens by enzyme immunoassay. We described trends in rotavirus positivity among tested stool samples before and after rotavirus vaccine introduction. RESULTS In countries that introduced rotavirus vaccine by 2013 (Rwanda, Tanzania, Zambia and Ethiopia), average rotavirus vaccine coverage from 2010 to 2015 improved from 0% in 2010 and 2011, 13% in 2012, 46% in 2013, 83% in 2014 to 90% in 2015. Annual average rotavirus positivity from 2010 to 2015 was 35%, 33%, 38%, 28%, 27%, and 19%, respectively. In countries that introduced rotavirus vaccine after 2013 or had not introduced by 2015, average rotavirus vaccine coverage was 0% in 2010-2013, 13% in 2014 and 51% in 2015. In these countries, rotavirus positivity was 44% in 2010, 32% in 2011, 33% in 2012, 41% in 2013, 40% in 2014 and 25% in 2015. CONCLUSION Countries that introduced rotavirus vaccine by 2013 had a lower proportion of rotavirus positive hospitalizations in 2013-2015 as compared to those that had not introduced rotavirus vaccine by 2013. The decrease in rotavirus positivity was inversely related to increase in rotavirus vaccine coverage showing impact of rotavirus vaccines.
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Affiliation(s)
| | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | | | - Balcha Masresha
- World Health Organization Regional Office for Africa, Brazzaville, Congo
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10
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Maphalala G, Phungwayo N, Masona G, Lukhele N, Tsegaye G, Dube N, Sindisiwe D, Khumalo L, Daniel F, Katsande R, Tate JE, Mwenda JM, Weldegebriel G. Early impact of rotavirus vaccine in under 5year old children hospitalized due to diarrhea, Swaziland. Vaccine 2017; 36:7210-7214. [PMID: 28778615 DOI: 10.1016/j.vaccine.2017.07.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/15/2017] [Accepted: 07/21/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Swaziland introduced rotavirus vaccine in the National Immunization Program, in May 2015, with the objective of reducing the burden of rotavirus diarrheal disease. We monitored the early impact of the vaccine in reducing rotavirus diarrhea. METHODS We conducted sentinel rotavirus surveillance from January 2013 to December 2016 in children under five years of age admitted due to diarrhea attending Mbabane Government Referral Hospital in the Hhohho Region and Raleigh Fitkin Memorial Hospital in the Manzini Region. All cases had stool samples collected and tested for rotavirus antigen by enzyme immunoassay. RESULTS Between 2013 and 2016, 596 samples were collected and tested. Rotavirus positivity reduced from average of 50.8% (172/338) (in 2013-2014 (pre vaccine period)) to 29% (24/82) in 2016, post-vaccine introduction. The median age of children with rotavirus infection increased from average of 10months in 2013-2014 to 13.7months in 2016. The peak season for all-cause diarrhea and rotavirus-specific hospitalizations among children under five years of age was June-August in all years with a blunting of the peak season in 2016. Rotavirus positivity among children 0-11months reduced from an average of 49% in 2013-2014 (116/236) to 33% (15/45) in 2016, a 33% reduction following rotavirus vaccine introduction. CONCLUSION There has been a rapid reduction of all-cause diarrhea and rotavirus hospitalizations in Swaziland, particularly in young children and during the rotavirus season, after the introduction rotavirus vaccine. Continued surveillance is needed to monitor the long-term impact of rotavirus vaccine introduction.
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Affiliation(s)
- Gugu Maphalala
- National Reference Laboratory, Surveillance Laboratory, Swaziland.
| | | | | | | | | | - Nomsa Dube
- Ministry of Health, Expanded Programme for Immunization, Swaziland
| | | | | | | | | | | | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Congo
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11
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Agutu MT, Ongus J, Kombich J, Kamenwa R, Nyangao J, Kagira J, Ogutu AA, Bitek A. Prevalence and genetic diversity of rotavirus infection in children with acute gastroenteritis in a hospital setting, Nairobi Kenya in post vaccination era: a cross-sectional study. Pan Afr Med J 2017; 26:38. [PMID: 28451016 PMCID: PMC5398238 DOI: 10.11604/pamj.2017.26.38.10312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 12/19/2016] [Indexed: 12/02/2022] Open
Abstract
Introduction Rotavirus is the leading cause of severe diarrhoea among infants and young children. Each year more than 611 000 children die from rotavirus gastroenteritis, and two million are hospitalized, worldwide. In Kenya, the impact of recent rotavirus vaccinations on morbidities has not been estimated. The study aimed at determining the prevalence and identity of rotavirus strains isolated from rotavirus-associated diarrhoea in vaccinated children presenting with acute gastroenteritis. Methods Two hundred and ninety eight specimen from children presented at Gertrude Childrens’ Hospital from January to June 2012 were tested by EIA (Enzyme-linked Immunosorbent Assay) for rotavirus antigens. Molecular characterization was conducted on rotavirus-positive specimens. Extracted viral RNA was separated by polyacrylamide gel electrophoresis (PAGE) and the specific rotavirus VP4 (P-types) and VP7 (G-types) determined. Results The prevalence rate of rotavirus was 31.5% (94/298). Of the rotavirus dsRNA, 57 (60.1%) gave visible RNA profiles, 38 (40.4%) assigned long electropherotypes while 19 (20.2%) were short electropherotypes. The strains among the vaccinated were G3P [4], G12P [6], G3P [6], G9P [4], G mixed G9/3P [4] and G1/3P [4]. Specifically, the G genotypes were G9/3 (5.3%), G9 (4.3%), G3 (4.3%), G12 (2.1%) and mixed G1/3 (1.1%). The P genotypes detected were P [4] (5.3%) and P [6] (5.3%). Conclusion The present study demonstrates diversity in circulating genotypes with emergence of genotypes G3, G9, G12 and mixed genotypes G9/3 and recommends that vaccines should be formulated with a broad range of strains to include G9 and G12.
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Affiliation(s)
- Mary-Theresa Agutu
- Institute of Tropical Medicine and Infectious Diseases, Kenya.,Jomo Kenyatta University of Agriculture and Technology, Kenya
| | - Julliette Ongus
- Jomo Kenyatta University of Agriculture and Technology, Kenya
| | | | | | | | - John Kagira
- Jomo Kenyatta University of Agriculture and Technology, Kenya
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12
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Genetic diversity of rotavirus strains in children with diarrhea in Lagos, Nigeria. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2016. [DOI: 10.1016/s2222-1808(16)61080-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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13
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Bwogi J, Malamba S, Kigozi B, Namuwulya P, Tushabe P, Kiguli S, Byarugaba DK, Desselberger U, Iturriza-Gomara M, Karamagi C. The epidemiology of rotavirus disease in under-five-year-old children hospitalized with acute diarrhea in central Uganda, 2012-2013. Arch Virol 2016; 161:999-1003. [PMID: 26724820 PMCID: PMC4819735 DOI: 10.1007/s00705-015-2742-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 12/21/2015] [Indexed: 12/13/2022]
Abstract
A cross-sectional study was undertaken during 2012-2013 to determine the prevalence, strains and factors associated with rotavirus infection among under-5-year-old children hospitalized with acute diarrhea in Uganda. Rotaviruses were detected in 37 % (263/712) of the children. The most prevalent strains were G9P[8] (27 %, 55/204) and G12P[4] (18.6 %, 38/204). Mixed infections were detected in 22.5 % (46/204) of the children. The study suggests that consumption of raw vegetables (OR = 1.45, 95 % CI = 1.03-2.03) and family ownership of dogs (OR = 1.9, 95 % CI = 1.04-3.75) increases the risk of rotavirus infection. The study findings will be used to assess the impact of RV vaccination in Uganda.
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Affiliation(s)
- Josephine Bwogi
- Uganda Virus Research Institute, 51-59 Nakiwogo Road, P.O. BOX 49, Entebbe, Uganda. .,Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. BOX 7072, Kampala, Uganda.
| | - Samuel Malamba
- Uganda Virus Research Institute, 51-59 Nakiwogo Road, P.O. BOX 49, Entebbe, Uganda
| | - Brian Kigozi
- Uganda Virus Research Institute, 51-59 Nakiwogo Road, P.O. BOX 49, Entebbe, Uganda
| | - Prossy Namuwulya
- Uganda Virus Research Institute, 51-59 Nakiwogo Road, P.O. BOX 49, Entebbe, Uganda
| | - Phionah Tushabe
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. BOX 7072, Kampala, Uganda
| | - Sarah Kiguli
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. BOX 7072, Kampala, Uganda
| | - Denis Karuhize Byarugaba
- Department of Microbiology, College of Veterinary Medicine and Biosecurity, Makerere University, P.O. BOX 7072, Kampala, Uganda
| | | | - Miren Iturriza-Gomara
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Ronald Ross Building, West Derby Street, Liverpool, L69 7BE, UK
| | - Charles Karamagi
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. BOX 7072, Kampala, Uganda
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Nyaga MM, Jere KC, Esona MD, Seheri ML, Stucker KM, Halpin RA, Akopov A, Stockwell TB, Peenze I, Diop A, Ndiaye K, Boula A, Maphalala G, Berejena C, Mwenda JM, Steele AD, Wentworth DE, Mphahlele MJ. Whole genome detection of rotavirus mixed infections in human, porcine and bovine samples co-infected with various rotavirus strains collected from sub-Saharan Africa. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2015; 31:321-34. [PMID: 25701122 PMCID: PMC4361293 DOI: 10.1016/j.meegid.2015.02.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/27/2015] [Accepted: 02/10/2015] [Indexed: 01/13/2023]
Abstract
Group A rotaviruses (RVA) are among the main global causes of severe diarrhea in children under the age of 5years. Strain diversity, mixed infections and untypeable RVA strains are frequently reported in Africa. We analysed rotavirus-positive human stool samples (n=13) obtained from hospitalised children under the age of 5years who presented with acute gastroenteritis at sentinel hospital sites in six African countries, as well as bovine and porcine stool samples (n=1 each), to gain insights into rotavirus diversity and evolution. Polyacrylamide gel electrophoresis (PAGE) analysis and genotyping with G-(VP7) and P-specific (VP4) typing primers suggested that 13 of the 15 samples contained more than 11 segments and/or mixed G/P genotypes. Full-length amplicons for each segment were generated using RVA-specific primers and sequenced using the Ion Torrent and/or Illumina MiSeq next-generation sequencing platforms. Sequencing detected at least one segment in each sample for which duplicate sequences, often having distinct genotypes, existed. This supported and extended the PAGE and RT-PCR genotyping findings that suggested these samples were collected from individuals that had mixed rotavirus infections. The study reports the first porcine (MRC-DPRU1567) and bovine (MRC-DPRU3010) mixed infections. We also report a unique genome segment 9 (VP7), whose G9 genotype belongs to lineage VI and clusters with porcine reference strains. Previously, African G9 strains have all been in lineage III. Furthermore, additional RVA segments isolated from humans have a clear evolutionary relationship with porcine, bovine and ovine rotavirus sequences, indicating relatively recent interspecies transmission and reassortment. Thus, multiple RVA strains from sub-Saharan Africa are infecting mammalian hosts with unpredictable variations in their gene segment combinations. Whole-genome sequence analyses of mixed RVA strains underscore the considerable diversity of rotavirus sequences and genome segment combinations that result from a complex evolutionary history involving multiple host species.
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Affiliation(s)
- Martin M Nyaga
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
| | - Khuzwayo C Jere
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa; Institute of Infection and Global Health, Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, United Kingdom.
| | - Mathew D Esona
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa; Gastroenteritis and Respiratory Viruses Laboratory Branch, Division of Viral Diseases, NCIRD, CDC, Atlanta, GA, USA.
| | - Mapaseka L Seheri
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
| | | | | | | | | | - Ina Peenze
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
| | - Amadou Diop
- Albert Royer National Paediatric Hospital Laboratory, Dakar, Senegal.
| | - Kader Ndiaye
- Unite de Virologie Medicale Institut Pasteur, Dakar, Senegal.
| | - Angeline Boula
- Mother and Child Center, Chantal Biya Foundation, Yaoundé, Cameroon.
| | - Gugu Maphalala
- The National Clinical Laboratory Service, Mbabane, Swaziland.
| | - Chipo Berejena
- University of Zimbabwe, Department of Medical Microbiology, Virology Section, Harare, Zimbabwe.
| | - Jason M Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville, People's Republic of Congo.
| | - A Duncan Steele
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa; Enteric and Diarrhoeal Diseases Programme, Global Health Program, Bill and Melinda Gates Foundation, Seattle, WA, USA.
| | | | - M Jeffrey Mphahlele
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
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