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Claudine U, Kim JY, Kim EM, Yong TS. Association between Sociodemographic Factors and Diarrhea in Children Under 5 Years in Rwanda. Korean J Parasitol 2021; 59:61-65. [PMID: 33684988 PMCID: PMC7939958 DOI: 10.3347/kjp.2021.59.1.61] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/18/2021] [Indexed: 11/23/2022]
Abstract
Diarrheal disease is the second leading cause of mortality and morbidity in children under 5 years old worldwide, and is the most common cause of malnutrition in sub-Saharan Africa. In Rwanda, diarrhea is the third leading cause of death in children under 5 years old. This study examined the association between sociodemographic factors and diarrhea in children under 5 years using the data of 7,474 households in the 2014-2015 Rwanda Demographic and Health Survey. Overall prevalence of diarrhea in this study was 12.7% in children. An increased risk for diarrhea was found for children aged 12-23 months (odds ratio (OR)=4.514), those with a low economic status (OR=1.64), those from the Western province (OR=1.439), those with poorly-educated mothers (OR=5.163), and those with families engaged in agricultural activities (OR=1.624). In conclusion, sociodemographic factors significantly affect the risk of developing diarrhea in children under 5 years in Rwanda. Designing and implementing health education promoting awareness of early interventions and rotavirus vaccination are essential to reduce diarrheal diseases for the Rwandan community.
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Affiliation(s)
- Umuhoza Claudine
- Department of Environmental Medical Biology, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722, Korea
- Department of Global Health Security, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
| | - Ju Yeong Kim
- Department of Environmental Medical Biology, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Eun-Min Kim
- Department of Environmental Medical Biology, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Tai-Soon Yong
- Department of Environmental Medical Biology, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722, Korea
- Department of Global Health Security, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
- Corresponding author ()
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202
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Halasa N, Piya B, Stewart LS, Rahman H, Payne DC, Woron A, Thomas L, Constantine-Renna L, Garman K, McHenry R, Chappell J, Spieker AJ, Fonnesbeck C, Batarseh E, Hamdan L, Wikswo ME, Parashar U, Bowen MD, Vinjé J, Hall AJ, Dunn JR. The Changing Landscape of Pediatric Viral Enteropathogens in the Post- Rotavirus Vaccine Era. Clin Infect Dis 2021; 72:576-585. [PMID: 32009161 PMCID: PMC7884803 DOI: 10.1093/cid/ciaa100] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/31/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Acute gastroenteritis (AGE) is a common reason for children to receive medical care. However, the viral etiology of AGE illness is not well described in the post-rotavirus vaccine era, particularly in the outpatient (OP) setting. METHODS Between 2012 and 2015, children 15 days through 17 years old presenting to Vanderbilt Children's Hospital, Nashville, Tennessee, with AGE were enrolled prospectively from the inpatient, emergency department, and OP settings, and stool specimens were collected. Healthy controls (HCs) were enrolled and frequency matched for period, age group, race, and ethnicity. Stool specimens were tested by means of reverse-transcription real-time quantitative polymerase chain reaction for norovirus, sapovirus, and astrovirus RNA and by Rotaclone enzyme immunoassay for rotavirus antigen, followed by polymerase chain reaction verification of antigen detection. RESULTS A total of 3705 AGE case patients and 1563 HCs were enrolled, among whom 2885 case patients (78%) and 1110 HCs (71%) provided stool specimens that were tested. All 4 viruses were more frequently detected in AGE case patients than in HCs (norovirus, 22% vs 8%, respectively; rotavirus, 10% vs 1%; sapovirus, 10% vs 5%; and astrovirus, 5% vs 2%; P < .001 for each virus). In the OP setting, rates of AGE due to norovirus were higher than rate for the other 3 viruses. Children <5 years old had higher OP AGE rates than older children for all viruses. CONCLUSIONS Norovirus remains the most common virus detected in all settings, occurring nearly twice as frequently as the next most common pathogens, sapovirus and rotavirus. Combined, norovirus, sapovirus, rotavirus, and astrovirus were associated with almost half of all AGE visits and therefore are an important reason for children to receive medical care.
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Affiliation(s)
- Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Bhinnata Piya
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura S Stewart
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Herdi Rahman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Daniel C Payne
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amy Woron
- Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, Tennessee, USA
| | - Linda Thomas
- Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, Tennessee, USA
| | - Lisha Constantine-Renna
- Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, Tennessee, USA
| | - Katie Garman
- Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, Tennessee, USA
| | - Rendie McHenry
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher Fonnesbeck
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Einas Batarseh
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lubna Hamdan
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mary E Wikswo
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Umesh Parashar
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael D Bowen
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aron J Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John R Dunn
- Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, Tennessee, USA
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203
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Kumar P, Pullagurla SR, Patel A, Shukla RS, Bird C, Kumru OS, Hamidi A, Hoeksema F, Yallop C, Bines JE, Joshi SB, Volkin DB. Effect of Formulation Variables on the Stability of a Live, Rotavirus (RV3-BB) Vaccine Candidate using in vitro Gastric Digestion Models to Mimic Oral Delivery. J Pharm Sci 2021; 110:760-770. [PMID: 33035539 PMCID: PMC7815322 DOI: 10.1016/j.xphs.2020.09.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/23/2020] [Accepted: 09/29/2020] [Indexed: 12/20/2022]
Abstract
In this work, two different in vitro gastric digestion models were used to evaluate the stability of a live attenuated rotavirus vaccine candidate (RV3-BB) under conditions designed to mimic oral delivery in infants. First, a forced-degradation model was established at low pH to assess the buffering capacity of formulation excipients and to screen for RV3-BB stabilizers. Second, a sequential-addition model was implemented to examine RV3-BB stability under conditions more representative of oral administration to infants. RV3-BB rapidly inactivated at < pH 5.0 (37 °C, 1 h) as measured by an infectivity RT-qPCR assay. Pre-neutralization with varying volumes of infant formula (Enfamil®) or antacid (Mylanta®) conferred partial to full protection of RV3-BB. Excipients with sufficient buffering capacity to minimize acidic pH inactivation of RV3-BB were identified (e.g., succinate, acetate, adipate), however, they concomitantly destabilized RV3-BB in accelerated storage stability studies. Both effects were concentration dependent, thus excipient optimization was required to design candidate RV3-BB formulations which minimize acid-induced viral inactivation during oral delivery while not destabilizing the vaccine during long-term 2-8 °C storage. Finally, a statistical Design -of-Experiments (DOE) study examining RV3-BB stability in the in vitro sequential-addition model identified key formulation parameters likely affecting RV3-BB stability during in vivo oral delivery.
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Affiliation(s)
- Prashant Kumar
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA
| | - Swathi R Pullagurla
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA
| | - Ashaben Patel
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA
| | - Ravi S Shukla
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA
| | - Christopher Bird
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA
| | - Ozan S Kumru
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA
| | - Ahd Hamidi
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333 CL Leiden, the Netherlands
| | - Femke Hoeksema
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333 CL Leiden, the Netherlands
| | - Christopher Yallop
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333 CL Leiden, the Netherlands
| | - Julie E Bines
- Murdoch Children's Research Institute, Department of Paediatrics University of Melbourne, Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia 3052
| | - Sangeeta B Joshi
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA.
| | - David B Volkin
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, 66047, USA.
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Shi D, Ma H, Miao J, Liu W, Yang D, Qiu Z, Shen Z, Yin J, Yang Z, Wang H, Li H, Chen Z, Li J, Jin M. Levels of human Rotaviruses and Noroviruses GII in urban rivers running through the city mirror their infection prevalence in populations. Sci Total Environ 2021; 754:142203. [PMID: 32920413 PMCID: PMC7470703 DOI: 10.1016/j.scitotenv.2020.142203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
Enteric viruses exposed to water pose a huge threat to global public health and can lead to waterborne disease outbreaks. A sudden increase in enteric viruses in some water matrices also underpins the prevalence of corresponding waterborne diseases in communities over the same time period. However, few efforts have been focused on water matrices whose viral pollution may best reflect the clinical prevalence in communities. Here, a one-year surveillance of human enteric viruses including Enteroviruses (EnVs), Rotaviruses (HRVs), Astroviruses (AstVs), Noroviruses GII (HuNoVsGII) and Mastadenoviruses (HAdVs) in four representative water matrices: an urban river (UR) running through city, effluent from Wastewater Treatment Plant (EW), raw water for Urban Water Treatment Plant (RW), and tap water (TW) were performed by qPCR. The relationship between the virus detection frequency at each site and their prevalence in clinical PCR assay was further analyzed. We found that the detection frequencies of HRVs, HuNoVsGII, and AstVs in stools peaked in winter, while EnVs peaked in autumn. No EnVs occurred in EW, RW, or TW, but HuNoVsGII and AstVs occurred intensively in winter. For UR, all types of enteric viruses could be detected and the levels of acute gastroenteritis viruses (HRVs, HuNoVsGII, AstVs, and HAdVs) were highest in autumn or winter, whereas EnVs peaked in summer. In terms of correlation analyses, only HRVs and HuNoVsGII levels in UR showed a strong positive correlation with their prevalence in clinical stool samples. This study indicated that HRVs and HuNoVsGII levels in URs may mirror the local virus prevalence, thereby implying the possibility of revealing their local epidemiology by monitoring them in the URs.
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Affiliation(s)
- Danyang Shi
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Hui Ma
- Department of Clinical Laboratory, Tianjin Children's Hospital, No. 238, Longyan Road, Tianjin 300134, China
| | - Jing Miao
- Department of Public Health, Shanxi University of Chinese Medicine, Xianyang 712046, China
| | - Weili Liu
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Dong Yang
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Zhigang Qiu
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Zhiqiang Shen
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Jing Yin
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Zhongwei Yang
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Huaran Wang
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Haibei Li
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Zhengshan Chen
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China
| | - Junwen Li
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China.
| | - Min Jin
- Key Laboratory of Risk Assessment and Control for Environment & Food Safety, Tianjin Institute of Environmental & Operational Medicine, No.1, Dali Road, Tianjin 300050, China.
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205
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Vorobiova N, Usachova E. INFLUENCE OF CARBOHYDRATE MALABSORPTION SYNDROME ON THE CLINICAL COURSE OF ROTAVIRUS INFECTION IN CHILDREN AT AN EARLY AGE. Georgian Med News 2021:120-125. [PMID: 33814404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of the work - to determine the pathogenetic role of carbohydrate malabsorption syndrome in severity and duration of rotavirus infection symptoms in early aged children. The study included 60 breastfed children aged 1-24 months with rotavirus infection. The severity and duration of the main symptoms of rotavirus gastroenteritis were analyzed depending on the dynamic changes in laboratory parameters of carbohydrate malabsorption syndrome: the total amount of reducing carbohydrates in feces, lactose and glucose in feces, which were determined on II-III, V, VII and X days of the disease. To determine the total amount of reducing sugars in the coprofiltrates, the Benedict's test was used, the lactose in the feces was determined using the Malfatti's test, and the glucose was determined by the Glucophane test systems (Erba Lachema). It was found that the syndrome of carbohydrate malabsorption had the maximum pathogenetic effect on the severity of rotavirus diarrhea after the fifth day of the disease mainly due to lactase deficiency. Starting from the seventh day of rotavirus infection, with an increase in the level of carbohydrates in the feces by 0,5%, the frequency of liquid stools increases by 1 time per day. The prognostic sign of long-term diarrheal syndrome (≥9 days) is the total level of reducing sugars in the feces ≥1% on the fifth day of illness. If the result of the Benedict's test increases by 0,4% in this term, the duration of diarrhea increases by 1 day. When the level of carbohydrates in the stool ≥ 0,75% on the tenth day of the disease the risk of residual effects on discharge from the hospital (such as unstable stools 2-3 times a day, meteorism and flatulence) increases.
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Affiliation(s)
- N Vorobiova
- Zaporozhye State Medical University, Ukraine
| | - E Usachova
- Zaporozhye State Medical University, Ukraine
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206
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Liu C, Huang P, Zhao D, Xia M, Zhong W, Jiang X, Tan M. Effects of rotavirus NSP4 protein on the immune response and protection of the S R69A-VP8* nanoparticle rotavirus vaccine. Vaccine 2021; 39:263-271. [PMID: 33309483 PMCID: PMC7822095 DOI: 10.1016/j.vaccine.2020.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/05/2020] [Accepted: 12/01/2020] [Indexed: 12/14/2022]
Abstract
Rotavirus causes severe diarrhea and dehydration in young children. Even with the implementation of the current live vaccines, rotavirus infections still cause significant mortality and morbidity, indicating a need for new rotavirus vaccines with improved efficacy. To this end, we have developed an SR69A-VP8*/S60-VP8* nanoparticle rotavirus vaccine candidate that will be delivered parenterally with Alum adjuvant. In this study, as parts of our further development of this nanoparticle vaccine, we evaluated 1) roles of rotavirus nonstructural protein 4 (NSP4) that is the rotavirus enterotoxin, a possible vaccine target, and an immune stimulator, and 2) effects of CpG adjuvant that is a toll-like receptor 9 (TLR9) ligand and agonist on the immune response and protection of our SR69A-VP8*/S60-VP8* nanoparticle vaccine. The resulted vaccine candidates were examined for their IgG responses in mice. In addition, the resulted mouse sera were assessed for i) blocking titers against interactions of rotavirus VP8* proteins with their glycan ligands, ii) neutralization titers against rotavirus replication in cell culture, and iii) passive protection against rotavirus challenge with diarrhea in suckling mice. Our data showed that the Alum adjuvant appeared to work better with the SR69A-VP8*/S60-VP8* nanoparticles than the CpG adjuvant, while an addition of the NSP4 antigen to the SR69A-VP8*/S60-VP8* vaccine may not help to further increase the immune response and protection of the resulted vaccine.
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Affiliation(s)
- Cunbao Liu
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, Yunnan Province, China
| | - Pengwei Huang
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dandan Zhao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ming Xia
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Weiming Zhong
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Xi Jiang
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ming Tan
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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207
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Bhandari D, Bi P, Dhimal M, Sherchand JB, Hanson-Easey S. Non-linear effect of temperature variation on childhood rotavirus infection: A time series study from Kathmandu, Nepal. Sci Total Environ 2020; 748:141376. [PMID: 32798872 DOI: 10.1016/j.scitotenv.2020.141376] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/07/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This study aimed to investigate the effects of temperature variability on rotavirus infections among children under 5 years of age in Kathmandu, Nepal. Findings may inform infection control planning, especially in relation to the role of environmental factors in the transmission of rotavirus infection. METHODS Generalized linear Poisson regression equations with distributed lag non-linear model were fitted to estimate the effect of temperature (maximum, mean and minimum) variation on weekly counts of rotavirus infections among children under 5 years of age living in Kathmandu, Nepal, over the study period (2013 to 2016). Seasonality and long-term effects were adjusted in the model using Fourier terms up to the seventh harmonic and a time function, respectively. We further adjusted the model for the confounding effects of rainfall and relative humidity. RESULTS During the study period, a total of 733 cases of rotavirus infection were recorded, with a mean of 3 cases per week. We detected an inverse non-linear association between rotavirus infection and average weekly mean temperature, with increased risk (RR: 1.52; 95% CI: 1.08-2.15) at the lower quantile (10th percentile) and decreased risk (RR: 0.64; 95% CI: 0.43-0.95) at the higher quantile (75th percentile). Similarly, we detected an increased risk [(RR: 1.93; 95% CI: 1.40-2.65) and (RR: 1.42; 95% CI: 1.04-1.95)] of rotavirus infection for both maximum and minimum temperature at their lower quantile (10th percentile). We estimated that 344 (47.01%) cases of rotavirus diarrhoea among the children under 5 years of age were attributable to minimum temperature. The significant effect of temperature on rotavirus infection was not observed beyond lag zero week. CONCLUSION An inverse non-linear association was estimated between rotavirus incidence and all three indices of temperature, indicating a higher risk of infection during the cooler times of the year, and suggesting that transmission of rotavirus in Kathmandu, Nepal may be influenced by temperature.
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Affiliation(s)
- Dinesh Bhandari
- The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia.
| | - Peng Bi
- The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia.
| | | | | | - Scott Hanson-Easey
- The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia.
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208
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Hitchings MDT, Cummings DAT, Grais RF, Isanaka S. A mixture model to assess the the immunogenicity of an oral rotavirus vaccine among healthy infants in Niger. Vaccine 2020; 38:8161-8166. [PMID: 33162202 DOI: 10.1016/j.vaccine.2020.10.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/18/2022]
Abstract
Analysis of immunogenicity data is a critical component of vaccine development, providing a biological basis to support any observed protection from vaccination. Conventional methods for analyzing immunogenicity data use either post-vaccination titer or change in titer, often defined as a binary variable using a threshold. These methods are simple to implement but can be limited especially in populations experiencing natural exposure to the pathogen. A mixture model can overcome the limitations of the conventional approaches by jointly modeling the probability of an immune response and the level of the immune marker among those who respond. We apply a mixture model to analyze the immunogenicity of an oral, pentavalent rotavirus vaccine in a cohort of children enrolled into a placebo-controlled vaccine efficacy trial in Niger. Among children with undetectable immunoglobulin A (IgA) at baseline, vaccinated children had 5.2-fold (95% credible interval (CrI) 3.7, 8.3) higher odds of having an IgA response than placebo children, but the mean log IgA among vaccinated responders was 0.9-log lower (95% CrI 0.6, 1.3) than among placebo responders. This result implies that the IgA response generated by vaccination is weaker than that generated by natural infection. Multivariate logistic regression of seroconversion defined by ≥ 3-fold rise in IgA similarly found increased seroconversion among vaccinated children, but could not demonstrate lower IgA among those who seroresponded. In addition, we found that the vaccine was less immunogenic among children with detectable IgA pre-vaccination, and that pre-vaccination infant serum IgG and mother's breast milk IgA modified the vaccine immunogenicity. Increased maternal antibodies were associated with weaker IgA response in placebo and vaccinated children, with the association being stronger among vaccinated children. The mixture model is a powerful and flexible method for analyzing immunogenicity data and identifying modifiers of vaccine response and independent predictors of immune response.
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Affiliation(s)
- Matt D T Hitchings
- Department of Biology, University of Florida, United States; Emerging Pathogens Institute, University of Florida, United States.
| | - Derek A T Cummings
- Department of Biology, University of Florida, United States; Emerging Pathogens Institute, University of Florida, United States
| | | | - Sheila Isanaka
- Department of Research, Epicentre, Paris, France; Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, United States
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209
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Mujuru HA, Burnett E, Nathoo KJ, Ticklay I, Gonah NA, Mukaratirwa A, Berejena C, Manangazira P, Rupfutse M, Chavers T, Weldegebriel GG, Mwenda JM, Parashar UD, Tate JE. Cost estimates of diarrhea hospitalizations among children <5 years old in Zimbabwe. Vaccine 2020; 38:6735-6740. [PMID: 32873405 DOI: 10.1016/j.vaccine.2020.08.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Diarrhoea is a leading killer of children <5 years old, accounting for 480,000 deaths in 2017. Zimbabwe introduced Rotarix into its vaccination program in 2014. In this evaluation, we estimate direct medical, direct non-medical, and indirect costs attributable to a diarrhea hospitalization in Zimbabwe after rotavirus vaccine introduction. METHODS Children <5 years old admitted to Harare Central Hospital from June 2018 to April 2019 with acute watery diarrhea were eligible for this evaluation. A 3-part structured questionnaire was used to collect data by interview from the child's family and by review of the medical record. A stool specimen was also collected and tested for rotavirus. Direct medical costs were the sum of medications, consumables, diagnostic tests, and service delivery costs. Direct non-medical costs were the sum of transportation, meals and lodging for caregivers. Indirect costs are the lost income for household members. RESULTS A total of 202 children were enrolled with a median age of 12 months (IQR: 7-21) and 48 (24%) had malnutrition. Children were sick for a median of 2 days and most had received outpatient medical care prior to admission. The median monthly household income was higher for well-nourished children compared to malnourished children (p < 0.001). The median total cost of a diarrhea illness resulting in hospitalization was $293.74 (IQR: 188.42, 427.89). Direct medical costs, with a median of $251.74 (IQR: 155.42, 390.96), comprised the majority of the total cost. Among children who tested positive for rotavirus, the median total illness cost was $243.78 (IQR: 160.92, 323.84). The median direct medical costs were higher for malnourished than well-nourished children (p < 0.001). CONCLUSION Direct medical costs are the primary determinant of diarrhea illness costs in Zimbabwe. The descriptive findings from this evaluation are an important first step in calculating the cost effectiveness of rotavirus vaccine.
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Affiliation(s)
- Hilda A Mujuru
- Harare Central Hospital, Harare, Zimbabwe; Department of Paediatrics and Child Health, University of Zimbabwe, Zimbabwe.
| | - Eleanor Burnett
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kusum J Nathoo
- Harare Central Hospital, Harare, Zimbabwe; Department of Paediatrics and Child Health, University of Zimbabwe, Zimbabwe
| | - Ismail Ticklay
- Department of Paediatrics and Child Health, University of Zimbabwe, Zimbabwe; Parirenyatwa Group Hospitals, Harare, Zimbabwe
| | | | | | | | - Portia Manangazira
- Epidemiology and Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe
| | | | - Tyler Chavers
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Jason M Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Umesh D Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jacqueline E Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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210
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Aliabadi N, Bonkoungou IJO, Pindyck T, Nikièma M, Leshem E, Seini E, Kam M, Konaté S, Ouattara M, Ouédraogo B, Gue E, Nezien D, Ouedraogo I, Parashar U, Medah I, Mwenda JM, Tate JE. Cost of pediatric hospitalizations in Burkina Faso: A cross-sectional study of children aged <5 years enrolled through an acute gastroenteritis surveillance program. Vaccine 2020; 38:6517-6523. [PMID: 32868131 DOI: 10.1016/j.vaccine.2020.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/31/2020] [Accepted: 08/12/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Diarrheal illness is a leading cause of hospitalizations among children <5 years. We estimated the costs of inpatient care for rotavirus and all-cause acute gastroenteritis (AGE) in two Burkina Faso hospitals. METHODS We conducted a cross-sectional study among children <5 years from December 2017 to June 2018 in one urban and one rural pediatric hospital. Costs were ascertained through caregiver interview and chart abstraction. Direct medical, non-medical, and indirect costs per child incurred are reported. Costs were stratified by rotavirus results. RESULTS 211 children <5 years were included. AGE hospitalizations cost 161USD (IQR 117-239); 180USD (IQR 121-242) at the urban and 154USD (IQR 116-235) at the rural site. Direct medical costs were higher in the urban compared to the rural site (140USD (IQR 102-182) vs. 90USD (IQR 71-108), respectively). Direct non-medical costs were higher at the rural versus urban site (15USD (IQR 10, 15) vs. 11USD (IQR 5-20), respectively). Indirect costs were higher at the rural versus urban site (35USD (IQR 8-91) vs. 0USD (IQR 0-26), respectively). Rotavirus hospitalizations incurred less direct medical costs as compared to non-rotavirus hospitalizations at the rural site (79USD (IQR 64-103) vs. 95USD (IQR 80-118)). No other differences by rotavirus testing status were observed. The total median cost of a hospitalization incurred by households was 24USD (IQR 12-49) compared to 75USD for government (IQR 59-97). Direct medical costs for households were higher in the urban site (median 49USD (IQR 31-81) versus rural (median 14USD (IQR 8-25)). Households in the lowest wealth quintiles at the urban site expended 149% of their monthly income on the child's hospitalization, compared to 96% at the rural site. CONCLUSIONS AGE hospitalization costs differed between the urban and rural hospitals and were most burdensome to the lowest income households. Rotavirus positivity was not associated with greater household costs.
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Affiliation(s)
- Negar Aliabadi
- US Centers for Disease Control and Prevention, Atlanta, USA.
| | | | - Talia Pindyck
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Moumouni Nikièma
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Eyal Leshem
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Emmanuel Seini
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Madibélé Kam
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | | | - Ma Ouattara
- World Health Organization, Burkina Faso Country Office, Ouagadougou, Burkina Faso
| | - Boureima Ouédraogo
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Edmond Gue
- Centre Hospitalier Regional de Gaoua, Burkina Faso
| | - Désiré Nezien
- National Public Health Laboratory, Ouagadougou, Burkina Faso
| | - Issa Ouedraogo
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Umesh Parashar
- US Centers for Disease Control and Prevention, Atlanta, USA
| | - Isaïe Medah
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | - Jason M Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
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211
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Guajardo-Leiva S, Chnaiderman J, Gaggero A, Díez B. Metagenomic Insights into the Sewage RNA Virosphere of a Large City. Viruses 2020; 12:v12091050. [PMID: 32967111 PMCID: PMC7551614 DOI: 10.3390/v12091050] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023] Open
Abstract
Sewage-associated viruses can cause several human and animal diseases, such as gastroenteritis, hepatitis, and respiratory infections. Therefore, their detection in wastewater can reflect current infections within the source population. To date, no viral study has been performed using the sewage of any large South American city. In this study, we used viral metagenomics to obtain a single sample snapshot of the RNA virosphere in the wastewater from Santiago de Chile, the seventh largest city in the Americas. Despite the overrepresentation of dsRNA viruses, our results show that Santiago’s sewage RNA virosphere was composed mostly of unknown sequences (88%), while known viral sequences were dominated by viruses that infect bacteria (60%), invertebrates (37%) and humans (2.4%). Interestingly, we discovered three novel genogroups within the Picobirnaviridae family that can fill major gaps in this taxa’s evolutionary history. We also demonstrated the dominance of emerging Rotavirus genotypes, such as G8 and G6, that have displaced other classical genotypes, which is consistent with recent clinical reports. This study supports the usefulness of sewage viral metagenomics for public health surveillance. Moreover, it demonstrates the need to monitor the viral component during the wastewater treatment and recycling process, where this virome can constitute a reservoir of human pathogens.
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Affiliation(s)
- Sergio Guajardo-Leiva
- Department of Molecular Genetics and Microbiology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile;
| | - Jonás Chnaiderman
- Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile;
| | - Aldo Gaggero
- Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile;
- Correspondence: (A.G.); (B.D.)
| | - Beatriz Díez
- Department of Molecular Genetics and Microbiology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile;
- Center for Climate and Resilience Research (CR)2, Santiago 8370449, Chile
- Correspondence: (A.G.); (B.D.)
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212
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Low YY, Lin HC, Wu FT, Chou IC, Hwang KP. Detection of rotavirus antigen in a child with acute necrotizing encephalopathy. J Formos Med Assoc 2020; 120:1029-1031. [PMID: 32919877 DOI: 10.1016/j.jfma.2020.08.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 08/08/2020] [Accepted: 08/30/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Yan Yi Low
- Division of Pediatric Infectious Diseases, China Medical University Children's Hospital, China Medical University, Taichung, 40447, Taiwan
| | - Hsiao-Chuan Lin
- Division of Pediatric Infectious Diseases, China Medical University Children's Hospital, China Medical University, Taichung, 40447, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Fang-Tzy Wu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Taipei, Taiwan
| | - I-Ching Chou
- Division of Pediatric Neurology, China Medical University Children's Hospital, China Medical University, Taichung, 40447, Taiwan; Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Kao-Pin Hwang
- Division of Pediatric Infectious Diseases, China Medical University Children's Hospital, China Medical University, Taichung, 40447, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
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213
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Huang WT, Juan YC, Liu CH, Yang YY, Chan KA. Intussusception and Kawasaki disease after rotavirus vaccination in Taiwanese infants. Vaccine 2020; 38:6299-6303. [PMID: 32736940 DOI: 10.1016/j.vaccine.2020.07.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Since 2006, two rotavirus vaccines have been licensed in Taiwan, either as a 2- (RV1) or 3-dose (RV5) schedule administered at ages 2, 4, and 6 months. This study assessed the risk of intussusception and Kawasaki disease (KD) associated with rotavirus vaccines among infants. METHODS Cases of intussusception and KD in infants aged less than 365 days were identified from the National Health Insurance databases, from 1 January 2007 through 31 December 2014, using the first-ever ICD-9-CM diagnosis codes. Histories of rotavirus vaccination were obtained from the National Immunization Information System. The modified self-controlled case series design included vaccinated cases, and compared incidence rate ratios (IRRs) between the risk period (postvaccination days 1-21 [intussusception] or days 1-28 [KD]) and control period (ages 0-364 days outside the -14 to +21 [intussusception] or +28 [KD] days of vaccination) by each type and dose of vaccine. Conditional Poisson regression models were adjusted for age using age-in-week (7-day) categorization. RESULTS Overall 2064 intussusception cases and 2079 KD cases were diagnosed in 567,726 recipients (5313 [0.9%] received both RV5 and RV1). An increase in intussusception risk was observed in the 1-7 days (IRR 12.59, 95% confidence interval [CI] 8.07-19.66) and 8-21 days (IRR 1.78, 95% CI 1.00-3.16) post dose 1 of RV1, but not RV5. Risk of KD was higher during the third week post dose 2 of RV5 (IRR 2.33, 95% CI 1.35-4.00), and fourth week post dose 1 of RV1 (IRR 1.98, 95% CI 1.16-3.40). CONCLUSION Our finding of an increased risk of intussusception associated with RV1 in the first week after dose 1 is consistent with results of previous postlicensure studies. Further research should verify a potentially delayed risk of KD after rotavirus vaccination.
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Affiliation(s)
| | - Yi-Chen Juan
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
| | - Chia-Hung Liu
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yen-Yun Yang
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
| | - K Arnold Chan
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
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214
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Prez VE, Poma HR, Giordano GG, Victoria M, Nates SV, Rajal VB, Barril PA. Rotavirus contamination of surface waters from the northwest of Argentina. J Water Health 2020; 18:409-415. [PMID: 32589625 DOI: 10.2166/wh.2020.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Fecal pollution of water is a serious concern because it is associated with the transmission of pathogens. The aim of this study was to analyze the occurrence of group A rotavirus (RVA) in surface waters from the Arias-Arenales River in Salta, a northern city in Argentina, and to define possible sources of fecal viral pollution. A total of 116 water samples were analyzed and RVA was detected in 3.4% (95% CI: 0.1-7.0%), with concentrations ranging from 1.9 × 105 to 3.8 × 106 genome copies per liter. RVA strains were characterized as G1P[8], G4P[8] and G9P[8], which are common genotypes circulating in the local population. The Arias-Arenales River presented unusual and sporadic contamination by RVA, originated from stormwater discharges and a variety of non-identified sources, and support the essential need of viral indicators for enhanced monitoring of water quality.
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Affiliation(s)
- Verónica Emilse Prez
- Instituto de Virología 'Dr. J. M. Vanella', Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina E-mail:
| | - Hugo Ramiro Poma
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina E-mail: ; Instituto de Investigaciones para la Industria Química (INIQUI), CONICET - Universidad Nacional de Salta (UNSa), Salta, Argentina
| | - Georgina Gisela Giordano
- Instituto de Virología 'Dr. J. M. Vanella', Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Matías Victoria
- Laboratorio de Virología Molecular, CENUR Litoral Norte, Centro Universitario de Salto, Universidad de la República, Salto, Uruguay
| | - Silvia Viviana Nates
- Instituto de Virología 'Dr. J. M. Vanella', Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Verónica Beatriz Rajal
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina E-mail: ; Instituto de Investigaciones para la Industria Química (INIQUI), CONICET - Universidad Nacional de Salta (UNSa), Salta, Argentina; Facultad de Ingeniería, Universidad Nacional de Salta (UNSa), Salta, Argentina and Singapore Centre for Environmental Life Sciences Engineering (SCELSE), School of Biological Sciences, Nanyang Technological University, Singapore
| | - Patricia Angélica Barril
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina E-mail: ; Centro de Investigación y Asistencia Técnica a la Industria - Asociación Civil (CIATI A.C.), Centenario, Neuquén, Argentina
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215
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Khagayi S, Omore R, Otieno GP, Ogwel B, Ochieng JB, Juma J, Apondi E, Bigogo G, Onyango C, Ngama M, Njeru R, Owor BE, Mwanga MJ, Addo Y, Tabu C, Amwayi A, Mwenda JM, Tate JE, Parashar UD, Breiman RF, Nokes DJ, Verani JR. Effectiveness of Monovalent Rotavirus Vaccine Against Hospitalization With Acute Rotavirus Gastroenteritis in Kenyan Children. Clin Infect Dis 2020; 70:2298-2305. [PMID: 31326980 PMCID: PMC7245145 DOI: 10.1093/cid/ciz664] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/17/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Rotavirus remains a leading cause of pediatric diarrheal illness and death worldwide. Data on rotavirus vaccine effectiveness in sub-Saharan Africa are limited. Kenya introduced monovalent rotavirus vaccine (RV1) in July 2014. We assessed RV1 effectiveness against rotavirus-associated hospitalization in Kenyan children. METHODS Between July 2014 and December 2017, we conducted surveillance for acute gastroenteritis (AGE) in 3 Kenyan hospitals. From children age-eligible for ≥1 RV1 dose, with stool tested for rotavirus and confirmed vaccination history we compared RV1 coverage among rotavirus positive (cases) vs rotavirus negative (controls) using multivariable logistic regression and calculated effectiveness based on adjusted odds ratio. RESULTS Among 677 eligible children, 110 (16%) were rotavirus positive. Vaccination data were available for 91 (83%) cases; 51 (56%) had 2 RV1 doses and 33 (36%) 0 doses. Among 567 controls, 418 (74%) had vaccination data; 308 (74%) had 2 doses and 69 (16%) 0 doses. Overall 2-dose effectiveness was 64% (95% confidence interval [CI], 35%-80%); effectiveness was 67% (95% CI, 30%-84%) for children aged <12 months and 72% (95% CI, 10%-91%) for children aged ≥12 months. Significant effectiveness was seen in children with normal weight for age, length/height for age and weight for length/height; however, no protection was found among underweight, stunted, or wasted children. CONCLUSIONS RV1 in the Kenyan immunization program provides significant protection against rotavirus-associated hospitalization which persisted beyond infancy. Malnutrition appears to diminish vaccine effectiveness. Efforts to improve rotavirus uptake and nutritional status are important to maximize vaccine benefit.
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Affiliation(s)
- Sammy Khagayi
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Richard Omore
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Grieven P Otieno
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Billy Ogwel
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - John B Ochieng
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Jane Juma
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Evans Apondi
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Godfrey Bigogo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu
| | - Clayton Onyango
- Division of Global Health Protection, Centers for Disease Control and Prevention (CDC)–Kenya, Kisumu, Kenya
| | - Mwanajuma Ngama
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Regina Njeru
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Betty E Owor
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Mike J Mwanga
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
| | - Yaw Addo
- Emory Global Health Institute, Emory University, Atlanta, Georgia
| | - Collins Tabu
- National Vaccines and Immunisations Programme, and
| | - Anyangu Amwayi
- Disease Surveillance and Response Unit, Ministry of Health, Nairobi, Kenya
| | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Jacqueline E Tate
- Viral Gastroenteritis Branch, Division of Viral Diseases, CDC, Atlanta, Georgia
| | - Umesh D Parashar
- Viral Gastroenteritis Branch, Division of Viral Diseases, CDC, Atlanta, Georgia
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia
| | - D James Nokes
- Centre for Geographic Medicine Research–Coast, KEMRI–Wellcome Trust Research Programme, Kilifi, and
- School of Life Sciences, and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Jennifer R Verani
- Division of Global Health Protection, CDC–Kenya, Nairobi, Kenya; and
- Division of Global Health Protection, CDC, Atlanta, Georgia
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216
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McQuade ETR, Platts-Mills JA. Monitoring the impact of rotavirus vaccines on a global scale. Lancet Glob Health 2020; 7:e817-e818. [PMID: 31200877 DOI: 10.1016/s2214-109x(19)30232-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Elizabeth T Rogawski McQuade
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA 22908, USA; Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA 22908, USA.
| | - James A Platts-Mills
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA 22908, USA
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217
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Gastañaduy PA, Parashar UD. Efficient transmission of viral gastroenteritis in Dutch households. Lancet Infect Dis 2020; 20:519-520. [PMID: 32087774 DOI: 10.1016/s1473-3099(20)30054-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Affiliation(s)
- Paul A Gastañaduy
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Umesh D Parashar
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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218
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Johne R, Tausch SH, Grützke J, Falkenhagen A, Patzina-Mehling C, Beer M, Höper D, Ulrich RG. Distantly Related Rotaviruses in Common Shrews, Germany, 2004-2014. Emerg Infect Dis 2020; 25:2310-2314. [PMID: 31742508 PMCID: PMC6874240 DOI: 10.3201/eid2512.191225] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We screened samples from common shrews (Sorex araneus) collected in Germany during 2004–2014 and identified 3 genetically divergent rotaviruses. Virus protein 6 sequence similarities to prototype rotaviruses were low (64.5% rotavirus A, 50.1% rotavirus C [tentative species K], 48.2% rotavirus H [tentative species L]). Shrew-associated rotaviruses might have zoonotic potential.
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219
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Sandvik H. Children with gastroenteritis attending emergency primary healthcare units before and after the introduction of the rotavirus vaccine. Tidsskr Nor Laegeforen 2020; 140:19-0761. [PMID: 32238975 DOI: 10.4045/tidsskr.19.0761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND The rotavirus is the most frequent cause of severe diarrhoea in small children. The purpose of this study was to map emergency primary health care consultations due to gastroenteritis in small children before and after the introduction of the rotavirus vaccine on 1 October 2014. MATERIAL AND METHOD The material consists of data from all electronic reimbursement claims from emergency primary health care doctors in the period 2010-18. Quarterly consultation rates at the emergency primary health care units for children aged 0-4 years with gastroenteritis were calculated. The consultation rate ratio for the years 2015-18 was calculated by dividing the consultation rate by the corresponding mean for the years 2010-13. RESULTS The consultation rate was highest in the first quarter of the year. In the years 2010-13 (prior to the introduction of the vaccine), infants had a mean consultation rate of 9.7 per 1000 inhabitants, one-year-olds 14.3 and two-year-olds 7.3. In 2016 (after the introduction of the vaccine), the consultation rate ratio in the first quarter was 0.5 for infants, 0.3 for one-year-olds and 0.4 for two-year-olds. In 2017 and 2018, the corresponding consultation rate ratio was 0.5 for infants, 0.4 for one-year-olds and 0.5 for two-year-olds. Three-year-olds and four-year-olds had lower consultation rates and fewer changes over time. INTERPRETATION The strong decline in gastroenteritis-related consultation rates may be related to the introduction of the rotavirus vaccine as part of the Childhood Immunisation Programme.
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220
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Church JA, Chasekwa B, Rukobo S, Govha M, Lee B, Carmolli MP, Ntozini R, Mutasa K, McNeal MM, Majo FD, Tavengwa NV, Kirkpatrick BD, Moulton LH, Humphrey JH, Prendergast AJ. Predictors of oral rotavirus vaccine immunogenicity in rural Zimbabwean infants. Vaccine 2020; 38:2870-2878. [PMID: 32088018 PMCID: PMC7065039 DOI: 10.1016/j.vaccine.2020.01.097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/16/2020] [Accepted: 01/26/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Oral rotavirus vaccines (RVV) have poor immunogenicity in low-income countries, for reasons that remain unclear. This study identified the determinants of RVV immunogenicity among infants in rural Zimbabwe. METHODS Anti-rotavirus IgA titres were measured among a sub-group of infants enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial (NCT01824940). SHINE was a cluster-randomized trial of improved infant and young child feeding, and improved water, sanitation and hygiene (WASH) in two rural Zimbabwean districts. Infants received RVV as part of the national immunisation programme. Among HIV-unexposed infants in the non-WASH trial arms, we evaluated associations between potential risk factors (vaccine schedule and dose, maternal and infant nutritional status, infant diarrhoea, and household environment) and RVV immunogenicity (seroconversion, seropositivity and geometric mean titres) using multivariable regression. RESULTS Among 219 infants with seroconversion data, 43 (20%) successfully seroconverted and 176 (80%) failed to seroconvert to RVV. Seroconversion was positively associated with a higher length-for-age Z-score (LAZ) around the time of vaccination (adjusted RR 1.27 (95% CI 1.04, 1.55), P = 0.021), and negatively associated with concurrent OPV and RVV administration (adjusted RR 0.36 (0.19, 0.71), P = 0.003). Among 472 infants with post-vaccination titres, a higher LAZ score was associated with increased seropositivity (aRR 1.21 (95% CI 1.06, 1.38), P = 0.004), and higher birthweight was associated with increased IgA titres (0.45 (95%CI 0.18, 1.09) U/mL greater per 100 g gain in birthweight; P = 0.001). CONCLUSIONS Infant ponderal and linear growth were positively associated with RVV immunogenicity, while concurrent administration of OPV was negatively associated with RVV immunogenicity. Together, these findings suggest that improving foetal growth and separating RVV and OPV administration are plausible approaches to increasing RVV immunogenicity.
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Affiliation(s)
- James A Church
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, UK.
| | - Bernard Chasekwa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Sandra Rukobo
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Margaret Govha
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Benjamin Lee
- Vaccine Testing Center, Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Marya P Carmolli
- Vaccine Testing Center, Department of Microbiology & Molecular Genetics, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Kuda Mutasa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Monica M McNeal
- Department of Pediatrics, University of Cincinnati College of Medicine, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Florence D Majo
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Naume V Tavengwa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Beth D Kirkpatrick
- Vaccine Testing Center, Department of Microbiology & Molecular Genetics, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Lawrence H Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jean H Humphrey
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, UK; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Bhattarai V, Sharma S, Rijal KR, Banjara MR. Co-infection with Campylobacter and rotavirus in less than 5 year old children with acute gastroenteritis in Nepal during 2017-2018. BMC Pediatr 2020; 20:68. [PMID: 32054497 PMCID: PMC7020500 DOI: 10.1186/s12887-020-1966-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrhoea, although easily curable, is a global cause of death for a half million children every year. Rotavirus and Campylobacter are the most common etiological agents of diarrhoea in children less than 5 years of age. However, in Nepal, these causative agents are not routinely examined for the diagnosis and treatment. The main objective of this study was to determine Campylobacter co-infection associated with rotavirus diarrhoea in children less than 5 years of age. METHODS A cross-sectional study was conducted at Kanti Children's Hospital (KCH), Kathmandu, Nepal from November 2017 to April 2018. A total of 303 stool specimens from children affected with diarrhoea were processed to detect rotavirus using a rapid rotavirus antigen detection test kit, and Campylobacter by microscopy, culture and biochemical tests. Antibiotic susceptibility tests of Campylobacter isolates were performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines 2015. RESULTS Of 303 samples, 91 (30.0%) were positive for co-infection with rotavirus and Campylobacter. Rotavirus mono-infection was detected in 61 (20.1%), and Campylobacter mono-infection was detected in 81 (26.7%) samples. Patient's age, month of infection, untreated water and frequent soil contact were the major risk factors for infections. Clinical features such as > 9 loose motions per day, fever, vomiting, mild to moderate dehydration, diarrhea persisting 6-9 days and presence of mucus in stool were significant (p < 0.05) clinical features, and were more severe in coinfection compared to mono-infections in multivariate analysis. CONCLUSION The study shows a high rate of rotavirus and Campylobacter coinfection in children with diarrhoea. Diagnosis based management of diarrhoeal cases can guide the specific treatment.
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Affiliation(s)
- Vishnu Bhattarai
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Saroj Sharma
- Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
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Olson DR, Lopman BA, Konty KJ, Mathes RW, Papadouka V, Ternier A, Zucker JR, Simonsen L, Grenfell BT, Pitzer VE. Surveillance data confirm multiyear predictions of rotavirus dynamics in New York City. Sci Adv 2020; 6:eaax0586. [PMID: 32133392 PMCID: PMC7043922 DOI: 10.1126/sciadv.aax0586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 12/06/2019] [Indexed: 05/17/2023]
Abstract
Prediction skill is a key test of models for epidemic dynamics. However, future validation of models against out-of-sample data is rare, partly because of a lack of timely surveillance data. We address this gap by analyzing the response of rotavirus dynamics to infant vaccination. Syndromic surveillance of emergency department visits for diarrhea in New York City reveals a marked decline in diarrheal incidence among infants and young children, in line with data on rotavirus-coded hospitalizations and laboratory-confirmed cases, and a shift from annual to biennial epidemics increasingly affecting older children and adults. A published mechanistic model qualitatively predicted these patterns more than 2 years in advance. Future efforts to increase vaccination coverage may disrupt these patterns and lead to further declines in the incidence of rotavirus-attributable gastroenteritis.
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Affiliation(s)
- Donald R. Olson
- New York City Department of Health and Mental Hygiene, New York City, NY, USA
- Corresponding author. (D.R.O.); (V.E.P.)
| | - Benjamin A. Lopman
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kevin J. Konty
- New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Robert W. Mathes
- New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Vikki Papadouka
- New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Alexandra Ternier
- New York City Department of Health and Mental Hygiene, New York City, NY, USA
| | - Jane R. Zucker
- New York City Department of Health and Mental Hygiene, New York City, NY, USA
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lone Simonsen
- Department of Science and Environment, Roskilde University, Rodskilde, Denmark
- Department of Global Health, George Washington University, Washington, DC, USA
| | - Bryan T. Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Virginia E. Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Corresponding author. (D.R.O.); (V.E.P.)
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Clemens H, Pang L, Morgan LK, Weaver L. Attenuation of rotavirus, MS2 bacteriophage and biomolecule-modified silica nanoparticles in undisturbed silt loam over gravels dosed with onsite wastewater. Water Res 2020; 169:115272. [PMID: 31726397 DOI: 10.1016/j.watres.2019.115272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/07/2019] [Accepted: 11/02/2019] [Indexed: 05/24/2023]
Abstract
Contamination of potable groundwater by pathogenic viruses from on-site wastewater treatment systems (OWTS) poses a serious health risk. This study investigated the attenuation and transport of rotavirus, bacteriophage MS2 and DNA-labelled-glycoprotein-coated silica nanoparticles (DGSnp) in 2 intact cores of silt loam over gravels dosed with wastewater from an OWTS at 3.53 L/day. To simulate a worst-case scenario, experiments were conducted under saturated conditions. The results from 6 experiments demonstrated that the rotavirus and DGSnp reductions were very similar and markedly greater than the MS2 reduction. This was reflected in the peak concentrations, relative mass recoveries, and temporal and spatial reduction rates. For a given log10 reduction, the estimated soil depth required for MS2 was over twice that required for rotavirus and DGSnp. This is the first study in which DGSnp was used as a rotavirus surrogate in soil under wastewater applications. Consistent with previous studies, DGSnp showed promise at mimicking rotavirus attenuation and transport in porous media. The results suggest DGSnp could be used to assess the attenuation capacity of subsurface media to rotavirus. However, DGSnp is not conservative and will underestimate the setback distances required for rotavirus reductions by 3%. On the other hand, separation distances determined using the rotavirus parameters and criteria but based on MS2 attenuation, can be too conservative in some subsurface media. To determine safe and realistic separation distances, it would be beneficial and complementary to apply both conservative virus surrogate using MS2 bacteriophage and representative but non-conservative new virus surrogates using biomolecule-modified silica nanoparticles.
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Affiliation(s)
- Hazel Clemens
- Institute of Environmental Science and Research, PO Box 29181, Christchurch, 8540, New Zealand; Waterways Centre for Freshwater Management, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - Liping Pang
- Institute of Environmental Science and Research, PO Box 29181, Christchurch, 8540, New Zealand.
| | - Leanne K Morgan
- Waterways Centre for Freshwater Management, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - Louise Weaver
- Institute of Environmental Science and Research, PO Box 29181, Christchurch, 8540, New Zealand
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Atabakhsh P, Kargar M, Doosti A. Molecular surveillance of human rotaviruses in drinking water and investigation of the efficiency of their removal in Isfahan water treatment plant. Environ Monit Assess 2019; 191:759. [PMID: 31741059 DOI: 10.1007/s10661-019-7834-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 09/22/2019] [Indexed: 06/10/2023]
Abstract
Enteric viruses, especially human rotaviruses present in aquatic environments, are microbial criteria in quality assessment of water resources. The present research aimed to investigate molecular monitoring of human rotavirus and efficacy evaluation of Isfahan water treatment plant (WTP) in the elimination of viruses. In total, 60 water samples were collected from different units of WTP. Zeta plus electropositive Virosorb cartridge filter and elution buffer was used for concentrating water samples. Enzyme-linked immunosorbent assay (ELISA) was used for detecting rotavirus antigen. Quantitative real-time reverse transcription PCR (qRT-PCR) with SYBR Green I fluorescent dye was performed for molecular detection of rotavirus. Multiplex nested reverse transcription-polymerase chain reaction (RT-PCR) was used for rotavirus G genotyping. Total coliform count varies from 102-103 CFU/mL in the raw water resources. Rotavirus antigen was detected in 17 samples (28.33%) by ELISA, and 13 samples (21.67%) were found positive by RT-PCR. These included 41.18% (7 cases) of raw water influent, 29.41% (5 cases) after sedimentation, 23.52% (4 cases) after ozonation, and 5.88% (1 case) after filtration in ELISA method. The highest number of rotaviruses was detected by qRT-PCR in autumn (46.15% (6 cases)). The commonest circulating G type in the sampling points was the mixed types, which was identified in 6 samples (46.15%), followed by non-typeable (23.07%), G3 (15.38%), G1 (7.69%), and G8 (7.69%), respectively. Despite the presence of rotavirus in raw water, after clarification and ozonation, filtration and treated water did not show the presence of rotavirus. The results of this study showed that multi-stage treatment has a positive effect on virus removal in WTP.
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Affiliation(s)
- Paymaneh Atabakhsh
- Department of Microbiology, Jahrom Branch, Islamic Azad University, Jahrom, Iran
| | - Mohammad Kargar
- Department of Microbiology, Jahrom Branch, Islamic Azad University, Jahrom, Iran.
| | - Abbas Doosti
- Biotechnology Research Center, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
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Bijlsma A, Hemels MAC, van Straaten HLM, Debast SB, d'Haens EJ. [ Rotavirus infections in neonates: not as innocent as expected]. Ned Tijdschr Geneeskd 2019; 163:D4108. [PMID: 31769637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Rotavirus is a common cause of gastroenteritis in children. It is much less known that rotavirus infections can lead to encephalitis with convulsions in neonates. CASE DESCRIPTION A premature boy (36 weeks + 5 days) developed neonatal convulsions 17 days post-partum. His sister had symptoms of gastroenteritis. Cerebral MRIs showed extensive white matter abnormalities in diffusion-weighted images and, a few weeks later, cystic white matter abnormalities. There were no gastrointestinal phenomena or pleocytosis in the cerebrospinal fluid. Rotavirus was detected in the stools, using molecular diagnostics (PCR). CONCLUSION Rotavirus infection at a neonatal age can have serious consequences. Due to the absence of gastrointestinal phenomena, pleocytosis and demonstrability of rotavirus in faeces and not in CSF, this clinical picture has long remained undiagnosed. Instructions on hand hygiene during the post-partum period contributes to the prevention of rotavirus infection in neonates. Herd immunity through rotavirus vaccination for all neonates could lead to significant risk reduction.
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Affiliation(s)
- Alja Bijlsma
- Isala klinieken, Neonatale Intensive Care, Zwolle
| | | | | | - Sylvia B Debast
- Isala klinieken, Laboratorium Medische Microbiologie en Infectieziekten, Zwolle
| | - Esther J d'Haens
- Isala klinieken, Neonatale Intensive Care, Zwolle
- Contact: E.J. d'Haens
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Lee B, Carmolli M, Dickson DM, Colgate ER, Diehl SA, Uddin MI, Islam S, Hossain M, Rafique TA, Bhuiyan TR, Alam M, Nayak U, Mychaleckyj JC, McNeal MM, Petri WA, Qadri F, Haque R, Kirkpatrick BD. Rotavirus-Specific Immunoglobulin A Responses Are Impaired and Serve as a Suboptimal Correlate of Protection Among Infants in Bangladesh. Clin Infect Dis 2019; 67:186-192. [PMID: 29394355 PMCID: PMC6030840 DOI: 10.1093/cid/ciy076] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/27/2018] [Indexed: 01/04/2023] Open
Abstract
Background Rotavirus (RV)–specific immunoglobulin A (IgA) responses following oral RV vaccination are impaired in low-income countries, where the utility of RV-IgA as a correlate of protection (CoP) remains unclear. In a monovalent oral RV vaccine (Rotarix) efficacy trial among infants in Dhaka, Bangladesh, we identified factors associated with poor RV-IgA responses and explored the utility of RV-IgA as a CoP. Methods Infants were randomized to receive Rotarix or no Rotarix at 10 and 17 weeks of life and followed with active diarrheal surveillance. RV-IgA concentration, seroconversion, and seropositivity were determined at 18 weeks of life and analyzed for correlation(s) with rotavirus diarrhea (RVD) and for contribution to Rotarix vaccine effect. Results Among vaccinated infants, overall RV-IgA geometric mean concentration was 21 U/mL; only 27% seroconverted and 32% were seropositive after vaccination. Increased RV-specific maternal antibodies significantly impaired immunogenicity. Seroconversion was associated with reduced risk of RVD through 1 year of life, but RV-IgA seropositivity only explained 7.8% of the vaccine effect demonstrated by the clinical endpoint (RVD). Conclusions RV-IgA responses were low among infants in Bangladesh and were significantly impaired by maternal antibodies. RV-IgA is a suboptimal CoP in this setting; an improved CoP for RV in low-income countries is needed. Clinical Trials Registration NCT01375647.
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Affiliation(s)
- Benjamin Lee
- Department of Pediatrics, Vaccine Testing Center, University of Vermont Larner College of Medicine, Burlington
- Correspondence: B. Lee, University of Vermont Vaccine Testing Center, Department of Pediatrics, University of Vermont Larner College of Medicine, 89 Beaumont Ave, Given C219, Burlington, VT 05405 ()
| | - Marya Carmolli
- Department of Medicine, Vaccine Testing Center, University of Vermont Larner College of Medicine, Burlington
| | - Dorothy M Dickson
- Department of Medicine, Vaccine Testing Center, University of Vermont Larner College of Medicine, Burlington
| | - E Ross Colgate
- Department of Medicine, Vaccine Testing Center, University of Vermont Larner College of Medicine, Burlington
| | - Sean A Diehl
- Department of Medicine, Vaccine Testing Center, University of Vermont Larner College of Medicine, Burlington
| | | | - Shahidul Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Motaher Hossain
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | - Masud Alam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Uma Nayak
- Center for Public Health Genomics and Department of Public Health Sciences, University of Virginia, Charlottesville
| | - Josyf C Mychaleckyj
- Center for Public Health Genomics and Department of Public Health Sciences, University of Virginia, Charlottesville
| | - Monica M McNeal
- Laboratory of Specialized Clinical Studies, Cincinnati Children’s Hospital Medical Center, Ohio
| | - William A Petri
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Beth D Kirkpatrick
- Department of Medicine, Vaccine Testing Center, University of Vermont Larner College of Medicine, Burlington
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Boehm AB, Silverman AI, Schriewer A, Goodwin K. Systematic review and meta-analysis of decay rates of waterborne mammalian viruses and coliphages in surface waters. Water Res 2019; 164:114898. [PMID: 31404902 DOI: 10.1016/j.watres.2019.114898] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/04/2019] [Accepted: 07/21/2019] [Indexed: 05/04/2023]
Abstract
Surface waters are essential natural resources. They are also receiving waters for a variety of anthropogenic waste streams that carry a myriad of pollutants including pathogens. Watershed and fate and transport models can help inform the spatial and temporal extent of microbial pollution from point and non-point sources and thus provide useful information for managing surface waters. Viruses are particularly important water-related pathogens because they often have a low infectious dose, which means that ingestion of even a small volume of water containing a low concentration of virions has the potential to cause disease. We conducted a systematic review of the literature, following best practices, to gather decay rate constants (k) of mammalian waterborne viruses (enteroviruses, adenoviruses, noroviruses, astroviruses, rotaviruses, and hepatitis A viruses) and coliphages in raw surface waters to aid in the parameterization of virus fate and transport models. We identified 562 k values from the literature, with the largest number identified for enteroviruses and coliphages and the smallest for astrovirus, hepatitis A virus, and norovirus. Average k values for each virus varied from 0.07 to 0.9 per day, in order from smallest to largest: Norwalk virus (i.e., noroviruses) < Human astrovirus < Mastadenovirus (i.e., adenoviruses) < Hepatovirus A (i.e., hepatitis A viruses) < Rotavirus A < coliphages < Enterovirus. A meta-analysis investigated how k varied among viruses for experiments conducted with different virus serotypes or species at different temperatures, salinities, and sunlight exposures, and for experiments that enumerated viruses using different methodologies. Virus species or serotype did not affect k among decay experiments. k values were generally larger for experiments conducted at higher temperatures, in sunlight, and in estuarine waters, and enumerated using culture methods. k values were statistically different between virus types with Norwalk virus, Hepatovirus A, and Mastadenovirus having smaller k values than other viruses, controlling for experimental condition and enumeration method. While F+ coliphage k values were similar to those of Enterovirus, Human astrovirus, and Rotavirus A, they were different from those of the other mammalian viruses. This compilation of coliphage and mammalian virus k values provides essential information for researchers and risk assessors who model virus fate and transport in surface waters and identifies avenues for future research to fill knowledge gaps.
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Affiliation(s)
- Alexandria B Boehm
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, 94305, USA.
| | - Andrea I Silverman
- Department of Civil and Urban Engineering, Tandon School of Engineering, New York University, Brooklyn, NY, 11201, USA; College of Global Public Health, New York University, New York, NY, 10012, USA
| | - Alexander Schriewer
- Weston Solutions, Inc., 5817 Dryden Place Suite 101, Carlsbad, CA, 92008, USA
| | - Kelly Goodwin
- Atlantic Oceanographic and Meteorological Laboratory, National Oceanic and Atmospheric Administration (stationed at NOAA/NMFS/SWFSC, La Jolla, CA), Miami, FL, USA
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Fuzawa M, Araud E, Li J, Shisler JL, Nguyen TH. Free Chlorine Disinfection Mechanisms of Rotaviruses and Human Norovirus Surrogate Tulane Virus Attached to Fresh Produce Surfaces. Environ Sci Technol 2019; 53:11999-12006. [PMID: 31517478 DOI: 10.1021/acs.est.9b03461] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
To fill the knowledge gap on how effective free chlorine is against viral-contaminated produce, we inoculated the surfaces of outdoor- or greenhouse-grown kale and mustard with Rotavirus (RV) or a human norovirus surrogate (Tulane virus, TV) and then disinfected the leaves with free chlorine. Disinfection efficacies for RV strain OSU and Wa were approximately 1-log10 higher when attached to mustard than to kale. Similar disinfection efficacies were observed for TV attached to mustard or kale. When examining TV and RV OSU in suspension (not attached to leaf surfaces), TV was more resistant to free chlorine than RV OSU. Inactivation efficacies were higher for these viruses in suspension versus viruses attached to produce the surface. We also found that free chlorine damaged viral capsids, allowing free chlorine access to viral RNA to damage viral genomes. Exposure to free chlorine at 1.7 ppm over 1 min caused VP8* of RV OSU to lose its ability to bind to its host receptors. TV lost its ability to bind to its receptor only after exposure to free chlorine at 29 ppm over 1 min. Thus, to reduce foodborne viral infections, it is important to consider the differences in virus' reactivity and inactivation mechanisms with free chlorine.
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Affiliation(s)
| | | | - Jianrong Li
- Department of Veterinary Biosciences , The Ohio State University , Columbus 43210 , Ohio , United States
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Nahar S, Paul SK, Kubayashi N. Group B Rotavirus Infections in Mymensingh, 2015. Mymensingh Med J 2019; 28:792-796. [PMID: 31599242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Rotaviruses are the most important etiological agents of severe diarrheal illness in infants, children, and adults throughout the world. Group A rotavirus causes approximately 40% of hospitalization for diarrhea among under 5 years children. The prevalence of Group B rotaviruses is not as high as that of Group A. ICDDRB, in 2008 reported Group B rotaviruses as 2.4%. Polyacrylamide gel electrophoresis (PAGE) and silver staining was applied to detect rotavirus dsRNA from acute diarrheic stool of 364 hospitalized adult patients with mild to severe diarrhea. The study was conducted in Mymensingh district, Bangladesh from January 2013 to December 2014. Among 364 stool specimens tested 14(3.9%) were positive in adult by PAGE. Males were slightly higher than females and infection rate was more in winter. PAGE technique could be applied as an excellent method for studying different groups of rotavirus including Group B rotaviruses.
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Affiliation(s)
- S Nahar
- Dr Samsoon Nahar Joly, Associate Professor, Department of Microbiology, Kumudini Women's College, Mirzapur, Tangail, Bangladesh; E-mail:
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Mukherjee S, Pal S, Pal A, Ghosh D, Sarkar S, Bhand S, Sarkar P, Bhattacharyya N. UIIS Scan 1.1: A Field portable high-throughput platform tool for biomedical and agricultural applications. J Pharm Biomed Anal 2019; 174:70-80. [PMID: 31158608 DOI: 10.1016/j.jpba.2019.05.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022]
Abstract
The colorimetric sensing technology has evolved into an essential tool for high-throughput analysis including portability and cost-effectiveness among available biomedical and agricultural screening approach. In this endeavor, the objective of work is to focus on the development of a field-portable instrument based on an Uniform Illumination Imaging System (UIIS), which will facilitate the colorimetric biochemical sensing. The developed field-portable, wavelength independent UIIS has been exploited for (a) rotavirus detection using commercial enzymatic immunoassay based microplate kit; (b) pesticide residue detection and quantification; The proposed system exhibited a good correlation in comparison to another two conventional techniques, i.e., multi-plate reader (r = 0.9991938) and LC-MS/MS (r = 0.998877399) with a short analysis time of 5 min for 95 test samples. Moreover, the feasibility of UIIS system has also been explored as field-portable enzyme-linked immunosorbent assay (ELISA) plate reader. By incorporating the Mahalanobis distance calculation, the advanced algorithm has been investigated and developed to analyze the data. The overall dataset was transformed into a matrix format to give a good correlation with a conventional plate reader, i.e., r = 0.915389612. Internet of things (IoT) enabled decision support system can be exploited by using big data analytics. Finally, test results can be shared with concerned stakeholders and the remote users. Thus, the developed UIIS will help to identify potential public health threats expeditiosly compared to conventional time consuming process of sample submission to the laboratory for analysis.
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Affiliation(s)
- Subhankar Mukherjee
- Agri and Environmental Electronics (AEE) Group, Centre for Development of Advanced Computing (C-DAC), Sector - V, Salt Lake, Kolkata, West Bengal 700091, India.
| | - Souvik Pal
- Agri and Environmental Electronics (AEE) Group, Centre for Development of Advanced Computing (C-DAC), Sector - V, Salt Lake, Kolkata, West Bengal 700091, India; Biosensor Lab. Department of Chemistry, BITS, Pilani -KK Birla Goa Campus, Goa 403726, India.
| | - Abhra Pal
- Agri and Environmental Electronics (AEE) Group, Centre for Development of Advanced Computing (C-DAC), Sector - V, Salt Lake, Kolkata, West Bengal 700091, India
| | - Devdulal Ghosh
- Agri and Environmental Electronics (AEE) Group, Centre for Development of Advanced Computing (C-DAC), Sector - V, Salt Lake, Kolkata, West Bengal 700091, India
| | - Subrata Sarkar
- Agri and Environmental Electronics (AEE) Group, Centre for Development of Advanced Computing (C-DAC), Sector - V, Salt Lake, Kolkata, West Bengal 700091, India
| | - Sunil Bhand
- Biosensor Lab. Department of Chemistry, BITS, Pilani -KK Birla Goa Campus, Goa 403726, India
| | - Priyabrata Sarkar
- Calcutta Institute of Technology. NH6, Banitabla, Uluberia, Howrah, West Bengal 711316, India
| | - Nabarun Bhattacharyya
- Agri and Environmental Electronics (AEE) Group, Centre for Development of Advanced Computing (C-DAC), Sector - V, Salt Lake, Kolkata, West Bengal 700091, India.
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Azagra-Boronat I, Massot-Cladera M, Knipping K, Van't Land B, Tims S, Stahl B, Knol J, Garssen J, Franch À, Castell M, Pérez-Cano FJ, Rodríguez-Lagunas MJ. Oligosaccharides Modulate Rotavirus-Associated Dysbiosis and TLR Gene Expression in Neonatal Rats. Cells 2019; 8:E876. [PMID: 31405262 PMCID: PMC6721706 DOI: 10.3390/cells8080876] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 08/09/2019] [Accepted: 08/09/2019] [Indexed: 02/07/2023] Open
Abstract
Colonization of the gut in early life can be altered through multiple environmental factors. The present study aimed to investigate the effects of 2'-fucosyllactose (2'-FL), a mixture of short-chain galactooligosaccharides/long-chain fructooligosaccharides (scGOS/lcFOS) 9:1 and their combination (scGOS/lcFOS/2'-FL) on dysbiosis induced during rotavirus (RV) diarrhea in neonatal rats, elucidating crosstalk between bacteria and the immune system. The dietary interventions were administered daily by oral gavage at days 2-8 of life in neonatal Lewis rats. On day 5, RV SA11 was intragastrically delivered to induce infection and diarrhea assessment, microbiota composition, and gene expression of Toll-like receptors (TLRs) in the small intestine were studied. All dietary interventions showed reduction in clinical variables of RV-induced diarrhea. RV infection increased TLR2 expression, whereas 2'-FL boosted TLR5 and TLR7 expressions and scGOS/lcFOS increased that of TLR9. RV-infected rats displayed an intestinal dysbiosis that was effectively prevented by the dietary interventions, and consequently, their microbiota was more similar to microbiota of the noninfected groups. The preventive effect of 2'-FL, scGOS/lcFOS, and their combination on dysbiosis associated to RV diarrhea in rats could be due to changes in the crosstalk between gut microbiota and the innate immune system.
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Affiliation(s)
- Ignasi Azagra-Boronat
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Malén Massot-Cladera
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Karen Knipping
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CA Utrecht, The Netherlands
| | - Belinda Van't Land
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands
- University Medical Centre Utrecht/Wilhelmina Children's Hospital, Department of Pediatric Immunology, 3584 EA Utrecht, The Netherlands
| | - Sebastian Tims
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands
| | - Bernd Stahl
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands
| | - Jan Knol
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands
| | - Johan Garssen
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CA Utrecht, The Netherlands
| | - Àngels Franch
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Margarida Castell
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Francisco J Pérez-Cano
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain.
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain.
| | - Maria J Rodríguez-Lagunas
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
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Ureña-Castro K, Ávila S, Gutierrez M, Naumova EN, Ulloa-Gutierrez R, Mora-Guevara A. Seasonality of Rotavirus Hospitalizations at Costa Rica's National Children's Hospital in 2010-2015. Int J Environ Res Public Health 2019; 16:E2321. [PMID: 31262051 PMCID: PMC6651376 DOI: 10.3390/ijerph16132321] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 06/27/2019] [Accepted: 06/28/2019] [Indexed: 11/17/2022]
Abstract
Rotavirus is a leading cause of acute diarrhea in children worldwide. Costa Rica recently started universal rotavirus vaccinations for infants with a two-dose schedule in February 2019. We aimed to study the seasonality of rotavirus during the pre-vaccination era. We retrospectively studied a six-year period of hospital admissions due to rotavirus gastroenteritis. We estimated seasonal peak timing and relative intensities using trend-adjusted negative binomial regression models with the δ-method. We assessed the relationship between rotavirus cases and weather characteristics and estimated their effects for the current month, one-month prior and two months prior, by using Pearson correlation coefficients. A total of 798 cases were analyzed. Rotavirus cases predominated in the first five months of the year. On average, the peak of admissions occurred between late-February and early-March. During the seasonal peaks, the monthly count tended to increase 2.5-2.75 times above the seasonal nadir. We found the strongest negative association of monthly hospitalizations and joint percentiles of precipitation and minimal temperature at a lag of two months (R = -0.265, p = 0.027) and we detected correlations of -0.218, -0.223, and -0.226 (p < 0.05 for all three estimates) between monthly cases and the percentile of precipitation at lags 0, 1, and 2 months. In the warm tropical climate of Costa Rica, the increase in rotavirus hospitalizations coincided with dry and cold weather conditions with a two-month lag. The findings serve as the base for predictive modeling and estimation of the impact of a nation-wide vaccination campaign on pediatric rotaviral infection morbidity.
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Affiliation(s)
- Katarina Ureña-Castro
- Servicio de Pediatría, Hospital William Allen Taylor, Caja Costarricense del Seguro Social (CCSS), Turrialba 30501, Costa Rica.
| | - Silvia Ávila
- Posgrado de Pediatría, Universidad de Costa Rica (UCR) & Caja Costarricense de Seguro Social (CCSS), San José 2060, Costa Rica
| | - Mariela Gutierrez
- Servicio de Emergencias, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José 10103, Costa Rica
| | - Elena N Naumova
- Division of Nutrition Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Rolando Ulloa-Gutierrez
- Servicio de Infectología, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José 10103, Costa Rica
| | - Alfredo Mora-Guevara
- Servicio de Gastroenterología y Nutrición, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José 10103, Costa Rica
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234
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Bischel HN, Caduff L, Schindelholz S, Kohn T, Julian TR. Health Risks for Sanitation Service Workers along a Container-Based Urine Collection System and Resource Recovery Value Chain. Environ Sci Technol 2019; 53:7055-7067. [PMID: 31082211 PMCID: PMC6587154 DOI: 10.1021/acs.est.9b01092] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 05/24/2023]
Abstract
Container-based sanitation (CBS) within a comprehensive service system value chain offers a low-cost sanitation option with potential for revenue generation but may increase microbial health risks to sanitation service workers. This study assessed occupational exposure to rotavirus and Shigella spp. during CBS urine collection and subsequent struvite fertilizer production in eThekwini, South Africa. Primary data included high resolution sequences of hand-object contacts from annotated video and measurement of fecal contamination from urine and surfaces likely to be contacted. A stochastic model incorporated chronological surface contacts, pathogen concentrations in urine, and literature data on transfer efficiencies of pathogens to model pathogen concentrations on hands and risk of infection from hand-to-mouth contacts. The probability of infection was highest from exposure to rotavirus during urine collection (∼10-1) and struvite production (∼10-2), though risks from Shigella spp. during urine collection (∼10-3) and struvite production (∼10-4) were non-negligible. Notably, risk of infection was higher during urine collection than during struvite production due to contact with contaminated urine transport containers. In the scale-up of CBS, disinfection of urine transport containers is expected to reduce pathogen transmission. Exposure data from this study can be used to evaluate the effectiveness of measures to protect sanitation service workers.
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Affiliation(s)
- Heather N. Bischel
- School
of Architecture, Civil, and Environmental Engineering (ENAC), École Polytechnique Fédérale
de Lausanne (EPFL), CH 1015 Lausanne, Switzerland
- Department
of Civil & Environmental Engineering, University of California at Davis, Davis, California 95616, United States
| | - Lea Caduff
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH 8600 Dübendorf, Switzerland
| | - Simon Schindelholz
- School
of Architecture, Civil, and Environmental Engineering (ENAC), École Polytechnique Fédérale
de Lausanne (EPFL), CH 1015 Lausanne, Switzerland
| | - Tamar Kohn
- School
of Architecture, Civil, and Environmental Engineering (ENAC), École Polytechnique Fédérale
de Lausanne (EPFL), CH 1015 Lausanne, Switzerland
| | - Timothy R. Julian
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH 8600 Dübendorf, Switzerland
- Swiss
Tropical and Public Health Institute, CH 4002 Basel, Switzerland
- University
of Basel, CH 4003 Basel, Switzerland
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235
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Mwenda JM, Mandomando I, Jere KC, Cunliffe NA, Duncan Steele A. Evidence of reduction of rotavirus diarrheal disease after rotavirus vaccine introduction in national immunization programs in the African countries: Report of the 11 th African rotavirus symposium held in Lilongwe, Malawi. Vaccine 2019; 37:2975-2981. [PMID: 31029514 DOI: 10.1016/j.vaccine.2019.03.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/07/2019] [Accepted: 03/21/2019] [Indexed: 12/23/2022]
Abstract
The 11th African Rotavirus Symposium was held in Lilongwe, Malawi from May 28th to 30th 2017. Over 270 delegates (73% from Africa) from 40 countries of which 30 (75%) were from African countries attended the symposium. Participants in this symposium included research scientists, clinicians, immunization managers, public health officials, policymakers and vaccine manufacturers. At the time of the symposium, 38 of the 54 (70%) countries in Africa had introduced rotavirus vaccines into their national immunization schedules. Delegates shared progress from rotavirus surveillance and vaccine impact monitoring, demonstrating the impact of the vaccine against rotavirus diarrheal hospitalizations. Data supported the beneficial effect and safety of WHO pre-qualified available vaccines up to 2017 (RotaTeq, Rotarix). This symposium highlighted the dramatic impact of the rotavirus vaccination, called for urgent adoption of these vaccines in remaining countries, particularly those with high disease burden and large birth cohorts (e.g. Nigeria, Democratic Republic of Congo) to attain the full public health benefits of rotavirus vaccination in Africa.
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Affiliation(s)
- Jason M Mwenda
- World Health Organization (WHO), Regional Office for Africa, Brazzaville, Congo.
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Khuzwayo C Jere
- Malawi-Liverpool-Wellcome Clinical Research Programme/Department of Medical Laboratory Sciences, College of Medicine, University of Malawi, Blantyre, Malawi; Institute of Infection & Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Nigel A Cunliffe
- Institute of Infection & Global Health, University of Liverpool, Liverpool, United Kingdom
| | - A Duncan Steele
- Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation, Seattle, WA, USA
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Li Y, Luo G, Yang H, Jia L, Zeng Y, Zhao B, Li T, Ge S. [Polymerization and evaluation of the protective efficacy of rotavirus VP4* proteins]. Sheng Wu Gong Cheng Xue Bao 2019; 35:281-289. [PMID: 30806058 DOI: 10.13345/j.cjb.180208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In previous studies, we found that truncated rotavirus VP4* (aa 26-476) could be expressed in soluble form in Escherichia coli and confer high protection against rotavirus in the mouse mode. In this study, we further improved the immunogenicity of VP4* by polymerization. The purified VP4* was polymerized through incubation at 37 ℃ for 24 h, and then the homogeneity of the particles was analyzed by HPLC, TEM and AUC, while the thermal stability and antigenicity was analyzed by DSC and ELISA, respectively. Finally, the immunogenicity and protective efficacy of the polymers analyzed by a mouse maternal antibody model. The results showed that VP4* aggregated into homogeneous polymers, with high thermostability and neutralizing antibody binding activity. In addition, VP4* polymers (endotoxin <20 EU/dose) stimulated higher neutralizing antibodies and confer higher protection against rotavirus-induced diarrhoea compared with the VP4* trimers when immunized with aluminium adjuvant. In summary, the study in VP4* polymers provides a new strategy for the development of recombinant rotavirus vaccines.
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Affiliation(s)
- Yijian Li
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Life Sciences, Xiamen University, Xiamen 361102, Fujian, China
| | - Guoxing Luo
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Life Sciences, Xiamen University, Xiamen 361102, Fujian, China
| | - Han Yang
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Public Health, Xiamen University, Xiamen 361102, Fujian, China
| | - Lianzhi Jia
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Public Health, Xiamen University, Xiamen 361102, Fujian, China
| | - Yuanjun Zeng
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Public Health, Xiamen University, Xiamen 361102, Fujian, China
| | - Biyan Zhao
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Public Health, Xiamen University, Xiamen 361102, Fujian, China
| | - Tingdong Li
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Public Health, Xiamen University, Xiamen 361102, Fujian, China
| | - Shengxiang Ge
- State Key of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infection Disease, School of Public Health, Xiamen University, Xiamen 361102, Fujian, China
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Maciel JF, Matter LB, Tasca C, Scheid DAR, Gressler LT, Ziech RE, Vargas ACD. Characterization of intestinal Escherichia coli isolated from calves with diarrhea due to rotavirus and coronavirus. J Med Microbiol 2019; 68:417-423. [PMID: 30720419 DOI: 10.1099/jmm.0.000937] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To address more information about changes in commensal Escherichia coli during virus intestinal infection, we characterized 30 faecal E. coli isolates from calves (21 to 60 days old) with diarrhea due to rotavirus and coronavirus, which received, before diagnosis, tetracycline, gentamicin and enrofloxacin drugs. METHODOLOGY Clermont's phylogenetic classification; presence of genes for curli, cellulose, fimbriae (F4, F5, F6, F18, F41); and antimicrobial susceptibility were used to characterize the isolates. Disk diffusion technique and PCR were used as methodologies. RESULTS E. coli isolates from calves with diarrhea were phylogenetically classified as B1 (70%, 21/30), B2 (3.33%, 1/30), C (3.33%, 1/30), D (3.33%, 1/30), E (13.33%, 4/30) and unknown (6.7 %; 2/30), whereas E. coli isolates from the control group were classified only as B1 (83.3%, 25/30), E (10 %; 3/30) and unknown (6,7 %; 2/30). E. coli isolates from calves with diarrhea showed a much higher resistance profile with 16 (53.3%) multiresistant isolates. Only isolates (30%-9/30) from diarrheic calves were also positive for fimbriae, specifically 16.7% (5/30) for F5 and 13.3% (4/30) for F18. CONCLUSION To sum up, E. coli isolates from calves with diarrhea showed differences in relation to the control group, confirming changes in commensal E. coli during virus intestinal infection. It can be emphasized that some care should be taken to manage diarrheic calves: the pathological agent must be diagnosed prior to treatment; antibacterial treatment should be with antimicrobials with a different mechanism of action; and finally, treated animals should be maintained separately from others because they can carry micro-organisms with a resistant profile.
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Affiliation(s)
- Jonas Fernandes Maciel
- 1 Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Letícia Beatriz Matter
- 1 Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Caiane Tasca
- 1 Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Daniela Alessandra Rambo Scheid
- 1 Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Letícia Trevisan Gressler
- 1 Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
- 2 Instituto Federal Farroupilha, Campus Frederico Westphalen, Laboratório de Microbiologia e Doenças Infecciosas, Curso de Medicina Veterinária, Frederico Westphalen, Rio Grande do Sul, Brazil
| | - Rosângela Estel Ziech
- 1 Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Agueda Castagna de Vargas
- 1 Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
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238
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Smiyan OI, Smiian-Horbunova KO, Bynda TP, Loboda AM, Popov SV, Vysotsky IY, Moshchych OP, Vasylieva OG, Manko YA, Ovsianko OL, Kolesnikova MV, Dolgova NO, Aleksakhina TO, Al-Rawashdeh B. Optimization of the treatment of rotavirus infection in children by using bacillus clausii. Wiad Lek 2019; 72:1320-1323. [PMID: 31398163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Introduction: Rotavirus infection is a leading place in the structure of acute intestinal infections in children. Rotavirus is excreted in 40-60 % of children hospitalized with gastroenteritis all over the world. Every year, 2 million patients are hospitalized with a severe form of RVI, 25 million need medical help from a doctor and 111 million cases are treated at home. The aim: The purpose of our study was to optimize the treatment of rotavirus infection in children by using Bacillus clausii. PATIENTS AND METHODS Materials and methods: There were 65 children with a rotavirus infection under supervision. The control group was consisted of 28 practically healthy children. The study of humoral immunity was carried out on the basis of determining the serum content of immunoglobulin G, immunoglobulin M, immunoglobulin A, and secretory immunoglobulin A in coprofiltrate. In the process of treatment, the children were divided into two groups: the first received standard treatment, the second group were added to standard treatment with a probiotic drug (Bacillus clausii). RESULTS Results: In children with RVI with modified treatment main symptoms were reduced compared with the children receiving standard treatment, (p <0.001). In patients with rotavirus infection in the acute period of the disease, a decrease in the concentration of IgA (p < 0.001) and an increase in IgM (p < 0.001) in serum and a decrease in sIgA (p < 0.001) in coprofiltrate was observed in comparison with children in control group. In the period of reconvalescence in children after the traditional treatment, it wasn`t revealed normalization of the immunoglobulins. Patients receiving a probiotic drug in addition to traditional treatment it was revealed normalization of the parameters of serum immunoglobulins A, M, G and sIgA in coprofiltrate. CONCLUSION Conclusions: So, the probiotic drug containing Bacillus clausii has a positive effect on the humoral immune system in children with rotavirus infection.
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Anwari P, Debellut F, Pecenka C, Parwiz SM, Clark A, Groman D, Safi N. Potential impact and cost-effectiveness of rotavirus vaccination in Afghanistan. Vaccine 2018; 36:7769-7774. [PMID: 29107346 PMCID: PMC6290387 DOI: 10.1016/j.vaccine.2017.10.058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/12/2017] [Accepted: 10/18/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Despite progress made in child survival in the past 20 years, 5.9 million children under five years died in 2015, with 9% of these deaths due to diarrhea. Rotavirus is responsible for more than a third of diarrhea deaths. In 2013, rotavirus was estimated to cause 215,000 deaths among children under five years, including 89,000 in Asia. As of April 2017, 92 countries worldwide have introduced rotavirus vaccination in their national immunization program. Afghanistan has applied for Gavi support to introduce rotavirus vaccination nationally. This study estimates the potential impact and cost-effectiveness of a national rotavirus immunization program in Afghanistan. METHODS This study examined the use of Rotarix® (RV1) administered using a two-dose schedule at 6 and 10 weeks of age. We used the ProVac Initiative's UNIVAC model (version 1.2.09) to evaluate the impact and cost-effectiveness of a rotavirus vaccine program compared with no vaccine over ten birth cohorts from 2017 to 2026 with a 3% annual discount rate. All monetary units are adjusted to 2017 US$. RESULTS Rotavirus vaccination in Afghanistan has the potential to avert more than one million cases; 660,000 outpatient visits; approximately 50,000 hospital admissions; 650,000 DALYs; and 12,000 deaths, over 10 years. Not accounting for any Gavi subsidy, rotavirus vaccination can avert DALYs at US$82/DALY from the government perspective and US$80/DALY from the societal perspective. With Gavi support, DALYs can be averted at US$29/DALY and US$31/DALY from the societal and government perspective, respectively. The average yearly cost of a rotavirus vaccination program would represent 2.8% of the total immunization budget expected in 2017 and 0.1% of total health expenditure. CONCLUSION The introduction of rotavirus vaccination would be highly cost-effective in Afghanistan, and even more so with a Gavi subsidy.
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Affiliation(s)
- Palwasha Anwari
- Afghanistan National Immunization Technical Advisory Group, District 10, Kabul, Afghanistan
| | | | - Clint Pecenka
- PATH, 2201 Westlake Ave, Suite 200, Seattle, WA 98121, USA
| | - Sardar M Parwiz
- Expanded Program on Immunization, Directorate General of Preventive Medicine, Ministry of Public Health, District 1, Afghanistan
| | - Andrew Clark
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Devin Groman
- PATH, 2201 Westlake Ave, Suite 200, Seattle, WA 98121, USA
| | - Najibullah Safi
- Directorate General of Preventive Medicine, Ministry of Public Health, Masood Square, District 10, Kabul, Afghanistan
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240
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Marinho ANR, Rocha DCC, Kanai YK, Alves CM, Costa DC, Sousa AH, Barros BCV, Bonfim MCMS, Mascarenhas JDP. Rotavirus analyses by SYBR Green real-time PCR and microbiological contamination in bivalves cultivated in coastal water of Amazonian Brazil. J Water Health 2018; 16:970-979. [PMID: 30540271 DOI: 10.2166/wh.2018.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The contamination of mussels and oysters by viruses and bacteria is often associated with water contamination and gastroenteritis in humans. The present study evaluated viral and bacterial contamination in 380 samples, from nine mollusk-producing regions in coastal water north of the Brazilian Amazon. Rotavirus contamination was studied for groups A to H, using a two-step SYBR Green RT-qPCR (quantitative reverse transcription polymerase chain reaction), and bacterial families Enterobacteriaceae, Vibrionaceae, and Aeromonadaceae by classical and molecular methods. From the 19 pools analyzed, 26.3% (5/19) were positive for group A Rotavirus, I2 genotype for VP6 region, without amplifications for groups B-H. Bacteriological analysis identified Escherichia coli isolates in 89.5% (17/19) with identification of atypical enteropathogenic E. coli aEPEC in 10.5% (2/19), Salmonella (Groups C1 and G) (10.5%, 2/19), Vibrio alginolyticus (57.9%, 11/19) V. parahaemolyticus (63.2%, 12/19), V. fluvialis (42.1%, 8/19), V. vulnificus (10.5%, 2/19), V. cholerae non-O1, non O139(10.5%, 2/19) and Aeromonas salmonicida (52.6%, 10/19). All the samples investigated presented some level of contamination by enterobacteria, rotavirus, or both, and these results may reflect the level of contamination in the Northern Amazon Region, due to the natural maintenance of some of these agents or by the proximity with human populations and their sewer.
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Affiliation(s)
- A N R Marinho
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail: ; Health Surveillance Secretariat, Brazilian Ministry of Health, Evandro Chagas Institute, Rodovia BR 316-KM 07, S/N, Levilandia, 67.030-000, Ananindeua, Para, Brazil
| | - D C C Rocha
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
| | - Y K Kanai
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
| | - C M Alves
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
| | - D C Costa
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
| | - A H Sousa
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
| | - B C V Barros
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
| | - M C M S Bonfim
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
| | - J D P Mascarenhas
- Instituto Evandro Chagas, IEC, BR-316 km 7, Ananindeua, Para, Brazil E-mail:
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241
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Wang P, Goggins WB, Chan EYY. A time-series study of the association of rainfall, relative humidity and ambient temperature with hospitalizations for rotavirus and norovirus infection among children in Hong Kong. Sci Total Environ 2018; 643:414-422. [PMID: 29940452 DOI: 10.1016/j.scitotenv.2018.06.189] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 04/13/2023]
Abstract
BACKGROUND Rotavirus and norovirus are infectious pathogens primarily affecting children under 5 years old. The impact of rainfall on diarrheal diseases remains inconclusive. This study aimed to evaluate the association between short-term variation in rainfall, temperature and humidity, and rotavirus and norovirus hospitalizations among young children in Hong Kong. METHODS Generalized additive negative binomial regression models with distributed lag non-linear terms, were fit with daily counts of hospital admissions due to rotavirus and norovirus infection as the outcomes and daily total rainfall and other meteorological variables as predictors, adjusting for seasonality and trend. RESULTS Generally, greater rainfall was associated with fewer rotavirus, but more norovirus hospitalizations. Extreme precipitation (99.5 mm, 99th percentile) was found to be associated with 0.40 (95% confidence interval (CI) 0.20-0.79) and 1.93 (95% CI 1.21-3.09) times the risk of hospitalization due to rotavirus and norovirus infection respectively, relative to trace rainfall. Stronger associations were observed in winter for rotavirus and in summer for norovirus. The duration of association with rotavirus was notably longer than norovirus. Higher temperatures were found to be associated with fewer hospitalizations for both rotavirus and norovirus infection, while higher relative humidity was generally associated with more norovirus, but fewer rotavirus, hospitalizations. CONCLUSIONS Both rotavirus and norovirus hospitalizations were strongly associated with recent precipitation variation but in opposite directions. With the introduction of the rotavirus vaccine norovirus is likely to become a greater threat than rotavirus and thus greater precipitation may become more clearly associated with more childhood diarrhea.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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242
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Affiliation(s)
| | - Jason M Mwenda
- World Health Organization, Brazzaville, Republic of the Congo
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243
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Carvalho MF, Gill D. Rotavirus vaccine efficacy: current status and areas for improvement. Hum Vaccin Immunother 2018; 15:1237-1250. [PMID: 30215578 PMCID: PMC6663136 DOI: 10.1080/21645515.2018.1520583] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/12/2018] [Accepted: 08/28/2018] [Indexed: 12/16/2022] Open
Abstract
The difference noted in Rotavirus vaccine efficiency between high and low income countries correlates with the lack of universal access to clean water and higher standards of hygiene. Overcoming these obstacles will require great investment and also time, therefore more effective vaccines should be developed to meet the needs of those who would benefit the most from them. Increasing our current knowledge of mucosal immunity, response to Rotavirus infection and its modulation by circadian rhythms could point at actionable pathways to improve vaccination efficacy, especially in the case of individuals affected by environmental enteropathy. Also, a better understanding and validation of Rotavirus entry factors as well as the systematic monitoring of dominant strains could assist in tailoring vaccines to individual's needs. Another aspect that could improve vaccine efficiency is targeting to M cells, for which new ligands could potentially be sought. Finally, alternative mucosal adjuvants and vaccine expression, storage and delivery systems could have a positive impact in the outcome of Rotavirus vaccination.
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Affiliation(s)
| | - Davinder Gill
- MSD Wellcome Trust Hilleman Laboratories Pvt. Ltd., New Delhi, India
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244
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McCowan C, Crameri S, Kocak A, Shan S, Fegan M, Forshaw D, Rubbenstroth D, Chen H, Holmes C, Harper J, Dearnley M, Batovska J, Bergfeld J, Walker C, Wang J. A novel group A rotavirus associated with acute illness and hepatic necrosis in pigeons (Columba livia), in Australia. PLoS One 2018; 13:e0203853. [PMID: 30204797 PMCID: PMC6133385 DOI: 10.1371/journal.pone.0203853] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 08/28/2018] [Indexed: 12/17/2022] Open
Abstract
Cases of vomiting and diarrhoea were reported in racing pigeons in Western Australia in May, 2016. Morbidity and mortality rates were high. Similar clinical disease was seen in Victoria in December and by early 2017 had been reported in all states except the Northern Territory, in different classes of domestic pigeon–racing, fancy and meat bird–and in a flock of feral pigeons. Autopsy findings were frequently unremarkable; histological examination demonstrated significant hepatic necrosis as the major and consistent lesion, often with minimal inflammatory infiltration. Negative contrast tissue suspension and thin section transmission electron microscopy of liver demonstrated virus particles consistent with a member of the Reoviridae. Inoculation of trypsin-treated Vero, MDBK and MA-104 cell lines resulted in cytopathic changes at two days after infection. Next generation sequencing was undertaken using fresh liver samples and a previously undescribed group A rotavirus (genotype G18P[17]) of avian origin was identified and the virus was isolated in several cell lines. A q-RT-PCR assay was developed and used to screen a wider range of samples, including recovered birds. Episodes of disease have continued to occur and to reoccur in previously recovered lofts, with variable virulence reported. This is the first report of a rotavirus associated with hepatic necrosis in any avian species.
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Affiliation(s)
| | - Sandra Crameri
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Ayfer Kocak
- Agriculture Victoria, Bundoora, Victoria, Australia
| | - Songhua Shan
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Mark Fegan
- Agriculture Victoria, Bundoora, Victoria, Australia
| | - David Forshaw
- Department of Primary Industries and Regional Development, Albany, Western Australia, Australia
| | - Dennis Rubbenstroth
- Institute of Virology, Medical Center–University of Freiburg, Freiburg, Germany
- Institute for Diagnostic Virology, Friedrich-Loeffler-Institute (FLI), Greifswald–Insel Riems, Germany
| | - Honglei Chen
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Clare Holmes
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Jenni Harper
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Megan Dearnley
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Jana Batovska
- Agriculture Victoria, Bundoora, Victoria, Australia
- School of Applied Systems Biology, La Trobe University, Bundoora, Victoria, Australia
| | - Jemma Bergfeld
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Colin Walker
- Melbourne Bird Veterinary Clinic, Scoresby, Melbourne, Australia
| | - Jianning Wang
- Australian Animal Health Laboratory, Geelong, Victoria, Australia
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245
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Guo X, Wang S, Zhao CL, Li JW, Zhong JY. An integrated cell absorption process and quantitative PCR assay for the detection of the infectious virus in water. Sci Total Environ 2018; 635:964-971. [PMID: 29710618 DOI: 10.1016/j.scitotenv.2018.04.223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
Here we developed an integrated cell absorption process and quantitative (reverse transcription) polymerase chain reaction (ICAP-q(RT)PCR) assay to detect infectious viruses, which based on the detection of the viral nucleic acid (RNA or DNA) in the early stage of viral attachment and entry towards cells. The results showed that the poliovirus or adenovirus whose concentration was as low as 0.2 TCID50/mL could be detected by ICAP-q(RT)PCR after 4 h incubation. The ICAP-q(RT)PCR exhibited much higher sensitivity than the plaque assay. In parallel, it took shorter time to detect the viruses towards field samples compared with the integrated cell culture (ICC)-qPCR, but could still get the consistent detecting results with ICC-qPCR. This method is verified by detecting four different kinds of viruses including poliovirus, adenovirus, rotavirus, and astrovirus, which existed in the actual water samples. Among all the 24 Jinhe river samples, 50% (12/24) of river water samples were positive for poliovirus when detected by ICAP-q(RT)PCR, which was in accordance with the results detected by ICC-qPCR. However, 21% (5/24) and 68% (18/24) of the samples were detected to be positive for poliovirus by the plaque counting and the direct qPCR method, respectively. Compared with ICAP-q(PT)PCR and ICC-qPCR, the detecting results of qPCR or plaque assay displayed a marked expansion or decline, respectively, which lead to the evident deviations in the accuracy. The results demonstrated that our developed ICAP-q(RT)PCR method could dramatically reduce the test duration and quite improve the sensitivity towards infectious viruses. Therefore, the ICAP-q(RT)PCR method could be an effective and quantitative tool for detecting infectious viruses in water environments.
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Affiliation(s)
- Xuan Guo
- Research Institute of Chemical Defense, No. 1 Huaiyin Road, Beijing 102205, China; State Key Lab of NBC Protection for Civilian, No. 1 Huaiyin Road, Beijing 102205, China.
| | - Shang Wang
- Institute of Environmental and Operational Medicine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, No. 1 Dali Road, Tianjin 300050, China
| | - Chong-Lin Zhao
- Research Institute of Chemical Defense, No. 1 Huaiyin Road, Beijing 102205, China; State Key Lab of NBC Protection for Civilian, No. 1 Huaiyin Road, Beijing 102205, China
| | - Jun-Wen Li
- Institute of Environmental and Operational Medicine, Key Laboratory of Risk Assessment and Control for Environment & Food Safety, No. 1 Dali Road, Tianjin 300050, China
| | - Jin-Yi Zhong
- Research Institute of Chemical Defense, No. 1 Huaiyin Road, Beijing 102205, China; State Key Lab of NBC Protection for Civilian, No. 1 Huaiyin Road, Beijing 102205, China.
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Abstract
BACKGROUND The effectiveness of rotavirus vaccines in low and very low birth weight infants (LBW and VLBW) weighing <2500 and <1500 g at birth, respectively, a high-risk population for severe rotavirus gastroenteritis, has not been well examined. METHODS We analyzed inpatient commercial claims data for US children <5 years of age from July 2001 to June 2015. Claims for acute gastroenteritis (AGE) and rotavirus-coded hospitalizations and LBW, VLBW and normal birth weight (NBW) infants were identified. Receipt of rotavirus vaccine was defined using Current Procedural Terminology. Rate reductions were calculated using prevaccine (2001-2006) and postvaccine (2007-2015) annual AGE and rotavirus hospitalization rates. RESULTS As of December 2014, rotavirus vaccine coverage was 87%, 82% and 64%, for NBW, LBW and VLBW infants, respectively. For 2014-2015, among NBW, LBW and VLBW children <5 years of age, AGE hospitalization rate reductions relative to the prevaccine introduction period were 60% [95% confidence interval (CI): 58%-61%], 64% (95% CI: 57%-70%) and 55% (95% CI: 39%-67%), respectively. Rotavirus hospitalization rate reductions were 91% (95% CI: 90%-92%), 98% (95% CI: 93%-100%) and 93% (95% CI: 70%-98%). Rotavirus vaccines resulted in a 62% (95% CI: 51%-71%), 72% (95% CI: 44%-86%) and 71% (95% CI: 7%-91%) reduction in AGE hospitalization rates comparing vaccinated versus unvaccinated NBW, LBW and VLBW children 3-23 months of age, respectively. CONCLUSIONS Rotavirus vaccines have substantially reduced AGE hospitalizations and are highly effective in LBW and VLBW infants, similar to NBW infants. Efforts to improve vaccination coverage, particularly in LBW and VLBW infants, should continue.
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Affiliation(s)
- Rebecca M. Dahl
- MAXIMUS Federal, Contracting Agency to the Division of Viral Diseases, Centers for Disease Control & Prevention, Atlanta, Georgia
| | - Aaron T. Curns
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, Georgia
| | - Jacqueline E. Tate
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, Georgia
| | - Umesh D. Parashar
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, Georgia
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247
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Rheingans R, Anderson JD, Bagamian KH, Pecenka CJ. Effects of geographic and economic heterogeneity on rotavirus diarrhea burden and vaccination impact and cost-effectiveness in the Lao People's Democratic Republic. Vaccine 2018; 36:7868-7877. [PMID: 30007827 DOI: 10.1016/j.vaccine.2018.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/25/2017] [Accepted: 02/01/2018] [Indexed: 11/15/2022]
Abstract
Rotavirus enteritis is responsible for nearly 200,000 child deaths worldwide in 2015. Globally, many low- and middle-income countries have introduced rotavirus vaccine, resulting in documented reductions in hospitalizations and child mortality. We examined the potential impact and cost-effectiveness of introducing rotavirus vaccination in Lao People's Democratic Republic using an Excel-based spreadsheet model. We estimated mortality risk factors, patterns of care seeking, and vaccination access to predict outcomes for regional, provincial, and socioeconomic subpopulations for one birth cohort through their first five years of life and life course in Disability-Adjusted Life Years estimates. Socioeconomic status was defined by categorizing households into regional wealth quintiles based on a national asset index. We modeled a two-dose ROTARIX vaccine under current Gavi pricing and efficacy estimates from Bangladesh and Vietnam. DPT1 and DPT2 coverages were used to estimate rotavirus vaccination coverage. Probabilistic sensitivity analysis was used to assess the impact of uncertainty on model parameters on predicted incremental cost-effectiveness ratios (ICERs), including scenarios of increases in vaccination coverage. Rotavirus vaccination would prevent 143 child deaths/year, or 28% of annual rotavirus burden. The estimated national level ICER for rotavirus vaccination was $140/DALY, with regional socioeconomic subpopulation estimates ranging from $72/DALY for the poorest in the Central region to $353/DALY for the richest in the North region, indicating high cost-effectiveness. Within regions, ICERs are most favorable for children in the poorer and poorest quintiles. However, the full benefits of rotavirus vaccination will only be realized by reducing disparities in vaccination coverage, access to treatment, and environmental health. Improving vaccination coverage to equitable levels alone would prevent 87 additional child deaths per year.
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Affiliation(s)
- Richard Rheingans
- Department of Sustainable Development, Appalachian State University, ASU Box 32080, Boone, NC 28608, USA.
| | - John D Anderson
- Department of Sustainable Development, Appalachian State University, ASU Box 32080, Boone, NC 28608, USA
| | - Karoun H Bagamian
- Department of Environmental and Global Health, University of Florida, 1225 Center Drive, Room 4160, Gainesville, FL 32610, USA; Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL 32610 USA
| | - Clinton J Pecenka
- PATH, Center for Vaccine Innovation and Access, 2201 Westlake, Suite 200, Seattle, WA 98121 USA
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248
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Ella R, Bobba R, Muralidhar S, Babji S, Vadrevu KM, Bhan MK. A Phase 4, multicentre, randomized, single-blind clinical trial to evaluate the immunogenicity of the live, attenuated, oral rotavirus vaccine (116E), ROTAVAC®, administered simultaneously with or without the buffering agent in healthy infants in India. Hum Vaccin Immunother 2018; 14:1791-1799. [PMID: 29543547 PMCID: PMC6067888 DOI: 10.1080/21645515.2018.1450709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/16/2018] [Accepted: 03/07/2018] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND The World Health Organization recommends that rotavirus vaccines should be included in all national immunization programs. Some currently licensed oral rotavirus vaccines contain a buffering agent (either as part of a ready-to-use liquid formulation or added during reconstitution) to reduce possible degradation of the vaccine virus in the infant gut, which poses several programmatic challenges (the large dose volume or the reconstitution requirement) during vaccine administration. Because ROTAVAC®, a WHO prequalified vaccine, was derived from the 116E neonatal strain, we evaluated the immunogenicity and safety of ROTAVAC® without buffer and ROTAVAC® with buffer in a phase 4, multicentre, single-blind, randomized clinical trial in healthy infants in India. METHODS 900 infants, approximately 6, 10 and 14 weeks of age, were assigned to 3 groups to receive ROTAVAC® (0.5 mL dose) orally: (i) 2.5 mL of citrate-bicarbonate buffer 5 minutes prior to administration of ROTAVAC® (Group I), (ii) ROTAVAC®, alone, without any buffer (Group II), or (iii) ROTAVAC®, mixed with buffer immediately before administration (Group III). Non-inferiority was compared among the groups for differences in serological responses (detected by serum anti-rotavirus IgA) and safety. RESULTS Geometric mean titers post vaccination at day 84 (28 days after dose 3) were 19.6 (95%CI: 17.0, 22.7), 20.7 (95%CI: 17.9, 24) and 19.2 (95%CI: 16.8, 22.1) for groups I, II and III respectively. Further, seroconversion rates and distribution of adverse events were similar among groups. CONCLUSIONS Administration of ROTAVAC® at a 0.5 mL dose volume without buffering agent was shown to be well tolerated and immunogenic. Given the homologous nature of the strain, it is plausible that ROTAVAC® replicates well and confers immunity even without buffer administration.
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Affiliation(s)
- Raches Ella
- Bharat Biotech International Limited, Genome Valley, Shameerpet, Hyderabad, India
| | - Radhika Bobba
- Bharat Biotech International Limited, Genome Valley, Shameerpet, Hyderabad, India
| | - Sanjay Muralidhar
- Bharat Biotech International Limited, Genome Valley, Shameerpet, Hyderabad, India
| | - Sudhir Babji
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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249
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Abstract
Two rotavirus (RV) strains (sialidase-resistant Wa and sialidase-sensitive OSU) were irradiated with simulated solar UVA and visible light in sensitizer-free phosphate buffered solution (PBS) (lacking exogenous reactive oxygen species (ROS)) or secondary effluent wastewater (producing ROS). Although light attenuated for up to 15% through the secondary effluent wastewater (SEW), the inactivation efficacies increased by 0.7 log10 for Wa and 2 log10 for OSU compared to those in sensitizer-free phosphate buffered solution (PBS) after 4 h of irradiation. A binding assay using magnetic beads coated with porcine gastric mucin containing receptors for rotaviruses (PGM-MB) was developed to determine if inactivation influenced RV binding to its receptors. The linear correlation between the reduction in infectivity and the reduction in binding after irradiation in sensitizer-free solution suggests that the main mechanism of RV inactivation in the absence of exogenous ROS was due to damage to VP8*, the RV protein that binds to host cell receptors. For a given reduction in infectivity, greater damage in VP8* was observed with sialidase-resistant Wa compared to sialidase-sensitive OSU. The lack of correlation between the reduction in infectivity and the reduction in binding, in SEW, led us to include RNase treatment before the binding step to quantify virions with intact protein capsids and exclude virions that can bind to the receptors but have their capsid permeable after irradiation. This assay showed a linear correlation between the reduction in RV infectivity and RV-receptor interactions, suggesting that RV inactivation in SEW was due to compromised capsid proteins other than the VP8* protein. Thus, rotavirus inactivation by UVA and visible light irradiation depends on both the formation of ROS and the stability of viral proteins.
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Affiliation(s)
- Elbashir Araud
- Department of Civil and Environmental Engineering , University of Illinois at Urbana-Champaign , Urbana , Illinois 61801 , United States
| | - Joanna L Shisler
- Department of Microbiology and Department of Pathobiology , University of Illinois at Urbana-Champaign , Urbana , Illinois 61801 , United States
| | - Thanh H Nguyen
- Department of Civil and Environmental Engineering , University of Illinois at Urbana-Champaign , Urbana , Illinois 61801 , United States
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Sibomana H, Rugambwa C, Mwenda JM, Sayinzoga F, Iraguha G, Uwimana J, Parashar UD, Tate JE. Impact of routine rotavirus vaccination on all-cause and rotavirus hospitalizations during the first four years following vaccine introduction in Rwanda. Vaccine 2018; 36:7135-7141. [PMID: 29754701 DOI: 10.1016/j.vaccine.2018.01.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/10/2018] [Accepted: 01/29/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Rwanda introduced pentavalent rotavirus vaccine into its national immunization program in 2012. To determine the long-term impact of rotavirus vaccine on disease burden in a high burden setting, we examined trends in rotavirus and all-cause diarrhea hospitalizations in the first four years following rotavirus vaccine introduction. METHODS We used data from an active surveillance system, from a review of pediatric ward registries, and from the Health Management Information System to describe trends in rotavirus and all-cause diarrhea hospitalizations from January 2009 through December 2016. Percent reductions were calculated to compare the number of all-cause and rotavirus diarrhea hospitalizations pre- and post-rotavirus vaccine introduction. RESULTS The proportion of diarrhea hospitalizations due to rotavirus declined by 25-44% among all children <5 years of age during 2013-2015 with a shift in rotavirus hospitalizations to older age groups. The proportion of total hospitalizations due to diarrhea among children <5 years of age decreased from 19% pre-vaccine introduction to 12-13% post-vaccine introduction. In the national hospital discharge data, substantial decreases were observed in all-cause diarrhea hospitalizations among children <5 years of age in 2013 and 2014 but these gains lessened in 2015-2016. DISCUSSION Continued monitoring of long-term trends in all-cause diarrhea and rotavirus hospitalizations is important to ensure that the impact of the vaccination program is sustained over time and to better understand the changing age dynamics of diarrhea and rotavirus hospitalizations in the post-vaccine introduction era.
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Affiliation(s)
- Hassan Sibomana
- Expanded Program of Immunization, Ministry of Health, Rwanda
| | | | | | - Felix Sayinzoga
- Maternal Child Health (MCCH) Division, Ministry of Health, Rwanda
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