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Nyaga MM, Jere KC, Esona MD, Seheri ML, Stucker KM, Halpin RA, Akopov A, Stockwell TB, Peenze I, Diop A, Ndiaye K, Boula A, Maphalala G, Berejena C, Mwenda JM, Steele AD, Wentworth DE, Mphahlele MJ. Whole genome detection of rotavirus mixed infections in human, porcine and bovine samples co-infected with various rotavirus strains collected from sub-Saharan Africa. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2015; 31:321-34. [PMID: 25701122 PMCID: PMC4361293 DOI: 10.1016/j.meegid.2015.02.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/27/2015] [Accepted: 02/10/2015] [Indexed: 01/13/2023]
Abstract
Group A rotaviruses (RVA) are among the main global causes of severe diarrhea in children under the age of 5years. Strain diversity, mixed infections and untypeable RVA strains are frequently reported in Africa. We analysed rotavirus-positive human stool samples (n=13) obtained from hospitalised children under the age of 5years who presented with acute gastroenteritis at sentinel hospital sites in six African countries, as well as bovine and porcine stool samples (n=1 each), to gain insights into rotavirus diversity and evolution. Polyacrylamide gel electrophoresis (PAGE) analysis and genotyping with G-(VP7) and P-specific (VP4) typing primers suggested that 13 of the 15 samples contained more than 11 segments and/or mixed G/P genotypes. Full-length amplicons for each segment were generated using RVA-specific primers and sequenced using the Ion Torrent and/or Illumina MiSeq next-generation sequencing platforms. Sequencing detected at least one segment in each sample for which duplicate sequences, often having distinct genotypes, existed. This supported and extended the PAGE and RT-PCR genotyping findings that suggested these samples were collected from individuals that had mixed rotavirus infections. The study reports the first porcine (MRC-DPRU1567) and bovine (MRC-DPRU3010) mixed infections. We also report a unique genome segment 9 (VP7), whose G9 genotype belongs to lineage VI and clusters with porcine reference strains. Previously, African G9 strains have all been in lineage III. Furthermore, additional RVA segments isolated from humans have a clear evolutionary relationship with porcine, bovine and ovine rotavirus sequences, indicating relatively recent interspecies transmission and reassortment. Thus, multiple RVA strains from sub-Saharan Africa are infecting mammalian hosts with unpredictable variations in their gene segment combinations. Whole-genome sequence analyses of mixed RVA strains underscore the considerable diversity of rotavirus sequences and genome segment combinations that result from a complex evolutionary history involving multiple host species.
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Affiliation(s)
- Martin M Nyaga
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
| | - Khuzwayo C Jere
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa; Institute of Infection and Global Health, Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, United Kingdom.
| | - Mathew D Esona
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa; Gastroenteritis and Respiratory Viruses Laboratory Branch, Division of Viral Diseases, NCIRD, CDC, Atlanta, GA, USA.
| | - Mapaseka L Seheri
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
| | | | | | | | | | - Ina Peenze
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
| | - Amadou Diop
- Albert Royer National Paediatric Hospital Laboratory, Dakar, Senegal.
| | - Kader Ndiaye
- Unite de Virologie Medicale Institut Pasteur, Dakar, Senegal.
| | - Angeline Boula
- Mother and Child Center, Chantal Biya Foundation, Yaoundé, Cameroon.
| | - Gugu Maphalala
- The National Clinical Laboratory Service, Mbabane, Swaziland.
| | - Chipo Berejena
- University of Zimbabwe, Department of Medical Microbiology, Virology Section, Harare, Zimbabwe.
| | - Jason M Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville, People's Republic of Congo.
| | - A Duncan Steele
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa; Enteric and Diarrhoeal Diseases Programme, Global Health Program, Bill and Melinda Gates Foundation, Seattle, WA, USA.
| | | | - M Jeffrey Mphahlele
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa.
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Givon-Lavi N, Ben-Shimol S, Cohen R, Greenberg D, Dagan R. Rapid impact of rotavirus vaccine introduction to the National Immunization plan in southern Israel: comparison between 2 distinct populations. Vaccine 2015; 33:1934-40. [PMID: 25744226 DOI: 10.1016/j.vaccine.2015.02.062] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 02/19/2015] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Rotavirus vaccines were licensed in Israel in 2007, and in 2011 the pentavalent-vaccine (RV5) was introduced into the Israeli National Immunization plan. AIM To determine the effect of rotavirus-vaccines on the incidence of hospital visits due to rotavirus gastroenteritis (RVGE) and all-cause diarrhea in Jewish and Bedouin children <5 year residing in southern Israel. METHODS We conducted a population-based, prospective, observational study. Data from 2006 through 2013 were analyzed. Our hospital is the only medical center in the region, enabling age-specific incidences calculation. RESULTS In the pre-vaccine period, the overall RVGE hospital visits rates per 1000 in children <12, 12-23 and 24-59 m were 16.1, 18.6 and 1.4 in Jewish children, respectively. The respective rates in Bedouin children were 26.4, 12.5 and 0.7 (P<0.001 for <12 m). Hospitalization rates were higher among Bedouin than among Jewish children (60.0% vs. 39.7%, P<0.001). Vaccine uptake was faster in the Jewish vs. the Bedouin population. In the year following RV5 introduction, RVGE hospital visits rates declined by 82%, 70% (P<0.001 both) and 36% (P=0.092) in Jewish children <12, 12-23 and 24-59 m, respectively. In Bedouin children, the respective RVGE rates declined by 70% (P<0.001), 21% (P=ns) and 14% (P=ns). Throughout the study, RVGE rates declined significantly in children <12, and 12-23 m by 80% and 88% in Jewish children, respectively, and by 62 and 75% in Bedouin children, respectively (P<0.001 for all declines). In children 24-59 m, RVGE rates declined by 46% (P=0.025) in Jewish children, but no reduction was observed in Bedouin children. The dynamics of all-cause diarrhea rates were similar to that of RVGE. CONCLUSIONS Significant reductions of RVGE rates were observed, following Rota-vaccine introduction in southern Israel in both Jewish and Bedouin children. However, the impact was faster and more profound in Jewish children, probably related to higher vaccine uptake and possibly to lifestyle differences.
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Affiliation(s)
- Noga Givon-Lavi
- The Pediatric Infectious Disease Unit, The Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka University Medical Center, Beer-Sheva, Israel
| | - Shalom Ben-Shimol
- The Pediatric Infectious Disease Unit, The Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka University Medical Center, Beer-Sheva, Israel
| | | | - David Greenberg
- The Pediatric Infectious Disease Unit, The Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka University Medical Center, Beer-Sheva, Israel
| | - Ron Dagan
- The Pediatric Infectious Disease Unit, The Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka University Medical Center, Beer-Sheva, Israel.
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Page AL, Jusot V, Mamaty AA, Adamou L, Kaplon J, Pothier P, Djibo A, Manzo ML, Toure B, Langendorf C, Collard JM, Grais RF. Rotavirus surveillance in urban and rural areas of Niger, April 2010-March 2012. Emerg Infect Dis 2014; 20:573-80. [PMID: 24655441 PMCID: PMC3966376 DOI: 10.3201/eid2004.131328] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Knowledge of rotavirus epidemiology is necessary to make informed decisions about vaccine introduction and to evaluate vaccine impact. During April 2010–March 2012, rotavirus surveillance was conducted among 9,745 children <5 years of age in 14 hospitals/health centers in Niger, where rotavirus vaccine has not been introduced. Study participants had acute watery diarrhea and moderate to severe dehydration, and 20% of the children were enrolled in a nutrition program. Of the 9,745 children, 30.6% were rotavirus positive. Genotyping of a subset of positive samples showed a variety of genotypes during the first year, although G2P[4] predominated. G12 genotypes, including G12P[8], which has emerged as a predominant strain in western Africa, represented >80% of isolates during the second year. Hospitalization and death rates and severe dehydration among rotavirus case-patients did not differ during the 2 years. The emergence of G12P[8] warrants close attention to the characteristics of associated epidemics and possible prevention measures.
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Hartwig S, Uhari M, Renko M, Bertet P, Hemming M, Vesikari T. Hospital bed occupancy for rotavirus and all cause acute gastroenteritis in two Finnish hospitals before and after the implementation of the national rotavirus vaccination program with RotaTeq®. BMC Health Serv Res 2014; 14:632. [PMID: 25494641 PMCID: PMC4266892 DOI: 10.1186/s12913-014-0632-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 12/02/2014] [Indexed: 12/05/2022] Open
Abstract
Background Vaccination-impact studies of the live-attenuated pentavalent oral vaccine Rotateq® have demonstrated that the burden of rotavirus gastroenteritis has been reduced significantly after the introduction of RotaTeq® vaccination, but less is known about the benefit of this vaccination on hospital overcrowding. Methods As part of an observational surveillance conducted during the RV seasons 2000/2001 to 2011/2012, we analysed hospital discharge data collected retrospectively from two Finnish hospitals (Oulu and Tampere), concerning ICD 10 codes A00-09 (acute gastroenteritis, AGE) and A08.0 (rotaviral acute gastroenteritis RV AGE). We estimated the reduction in the number of beds occupied and analysed the bed occupancy rate, for RV AGE and all cause AGE, among 0–16 year-old children, before and after the implementation of the RV immunisation program. Results The rate of bed days occupied for RV AGE was reduced by 86% (95% CI 66%-94%) in Tampere and 79% (95% CI 47%-92%) in Oulu after RV vaccination implementation. For all cause AGE, reduction was 50% (95% CI 29% to 65%) in Tampere and 70% (95% CI 58% to 79%) in Oulu. Results were similar among 0–2 year-old children. This effect was also observed on overcrowding in both hospitals, with a bed occupancy rate for all cause AGE >25% in only 1% of the time in Tampere and 9% in Oulu after the implementation of the immunisation program, compared to 13% and 48% in the pre-vaccination period respectively. After extrapolation to the whole country, the annual number of prevented hospitalizations for all cause AGE in the post-vaccination period in Finland was estimated at 1,646 and 2,303 admissions for 0–2 and 0–16 year-old children respectively. Conclusions This study demonstrated that universal RV vaccination is associated with a clear decrease in the number of bed days and occupancy rates for RV AGE and all cause AGE. Positive consequences include increase in quality of care and a better healthcare management during winter epidemics.
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Groome MJ, Page N, Cortese MM, Moyes J, Zar HJ, Kapongo CN, Mulligan C, Diedericks R, Cohen C, Fleming JA, Seheri M, Mphahlele J, Walaza S, Kahn K, Chhagan M, Steele AD, Parashar UD, Zell ER, Madhi SA. Effectiveness of monovalent human rotavirus vaccine against admission to hospital for acute rotavirus diarrhoea in South African children: a case-control study. THE LANCET. INFECTIOUS DISEASES 2014; 14:1096-1104. [DOI: 10.1016/s1473-3099(14)70940-5] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Vaccines are now available to combat rotavirus, the most common cause of severe diarrhea among children worldwide. We review clinical trial data for available rotavirus vaccines and summarize postlicensure data on effectiveness, impact, and safety from countries routinely using these vaccines in national programs. In these countries, rotavirus vaccines have reduced all-cause diarrhea and rotavirus hospitalizations by 17%-55% and 49%-92%, respectively, and all-cause diarrhea deaths by 22%-50% in some settings. Indirect protection of children who are age-ineligible for rotavirus vaccine has also been observed in some high and upper middle income countries. Experience with routine use of rotavirus vaccines in lower middle income countries has been limited to date, but vaccine introductions in such countries have been increasing in recent years. The risk-benefit analysis of rotavirus vaccines is extremely favorable but other strategies to improve the effectiveness of the vaccine, particularly in lower middle income settings, should be considered.
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Affiliation(s)
- Jacqueline E Tate
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Umesh D Parashar
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Seheri L, Mwenda J, Page N. Report of the 7th African Rotavirus Symposium, Cape Town, South Africa, 8th November 2012. Vaccine 2014; 32:6336-41. [DOI: 10.1016/j.vaccine.2014.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 04/29/2014] [Accepted: 05/01/2014] [Indexed: 11/30/2022]
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Martinez M, Galeano ME, Akopov A, Palacios R, Russomando G, Kirkness EF, Parra GI. Whole-genome analyses reveals the animal origin of a rotavirus G4P[6] detected in a child with severe diarrhea. INFECTION GENETICS AND EVOLUTION 2014; 27:156-62. [PMID: 25075468 DOI: 10.1016/j.meegid.2014.07.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/12/2014] [Accepted: 07/16/2014] [Indexed: 12/15/2022]
Abstract
Group A rotaviruses are a major cause of severe gastroenteritis in children worldwide. Currently, two rotavirus vaccines are being used in vaccination programs, and one of the factors involved in lower vaccine efficacy is the mismatch among the circulating strains and the vaccine strains. Thus, the emergence of animal strains in the human population could affect the efficacy of vaccination programs. Here we report the presence of a G4P[6] strain in a Paraguayan child presenting acute gastroenteritis in 2009. Genomic analyses revealed that the strain presents a porcine-like genome (G4-P[6]-I1-R1-C1-M1-A8-N1-T7-E1-H1), suggesting a direct animal-to-human transmission. Continuous surveillance of rotaviruses in humans and animals will help us to better understand rotavirus epidemiology and evolution.
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Affiliation(s)
- Magaly Martinez
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Maria E Galeano
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Asmik Akopov
- The J. Craig Venter Institute, Rockville, MD, USA
| | - Ruth Palacios
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Graciela Russomando
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | | | - Gabriel I Parra
- Departamento de Biología Molecular y Genética, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay.
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Steyer A, Sagadin M, Kolenc M, Poljšak-Prijatelj M. Molecular characterization of rotavirus strains from pre- and post-vaccination periods in a country with low vaccination coverage: the case of Slovenia. INFECTION GENETICS AND EVOLUTION 2014; 28:413-25. [PMID: 24999235 DOI: 10.1016/j.meegid.2014.06.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 06/23/2014] [Accepted: 06/25/2014] [Indexed: 11/18/2022]
Abstract
Rotavirus vaccination started in Slovenia in 2007 on a voluntarily basis. The vaccination rate is relatively low (up to 27%) and no increasing trend is observed. We present rotavirus genotype distribution among children hospitalized for rotavirus gastroenteritis in Slovenia. Eight consecutive rotavirus seasons were followed, from 2005/06 to 2012/13, and 113 strains of the most common rotavirus genotypes were randomly selected for molecular characterization of rotavirus VP7 and VP4 (VP8(∗)) genome segments. During the vaccine introduction period, from 2007 to 2013, rotavirus genotype prevalences changed, with G1P[8] decreasing from 74.1% to 8.7% between 2007/08 and 2010/11 seasons, replaced by G4P[8] and G2P[4], with up to 52.0% prevalence. Comparable analysis of VP7 and VP8(∗) genome fragments within G1P[8] genotype lineages revealed considerable differences for rotavirus strains circulating before and during the vaccination period. The G1P[8] rotavirus strains from the pre-vaccination period clustered in a phylogenetic tree within Rotarix®-like VP7 and VP8(∗) lineages. However, since 2007, the majority of G1P[8] strains have shifted to distant genetic lineages with lower nucleotide (88.1-94.0% for VP7 and 86.6-91.1% for VP8(∗)) and amino acid (93.8-95.2% for VP7 and 85.3-94.6% for VP8(∗)) identities to the vaccine Rotarix® strain. This change also resulted in a different deduced amino acid profile at the major VP7 and VP8(∗) antigenic epitopes.
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Affiliation(s)
- Andrej Steyer
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
| | - Martin Sagadin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
| | - Marko Kolenc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
| | - Mateja Poljšak-Prijatelj
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
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Yen C, Tate JE, Hyde TB, Cortese MM, Lopman BA, Jiang B, Glass RI, Parashar UD. Rotavirus vaccines: current status and future considerations. Hum Vaccin Immunother 2014; 10:1436-48. [PMID: 24755452 DOI: 10.4161/hv.28857] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Rotavirus is the leading cause of severe diarrhea among children<5 years worldwide. Currently licensed rotavirus vaccines have been efficacious and effective, with many countries reporting substantial declines in diarrheal and rotavirus-specific morbidity and mortality. However, the full public health impact of these vaccines has not been realized. Most countries, including those with the highest disease burden, have not yet introduced rotavirus vaccines into their national immunization programs. Research activities that may help inform vaccine introduction decisions include (1) establishing effectiveness, impact, and safety for rotavirus vaccines in low-income settings; (2) identifying potential strategies to improve performance of oral rotavirus vaccines in developing countries, such as zinc supplementation; and (3) pursuing alternate approaches to oral vaccines, such as parenteral immunization. Policy- and program-level barriers, such as financial implications of new vaccine introductions, should be addressed to ensure that countries are able to make informed decisions regarding rotavirus vaccine introduction.
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Affiliation(s)
- Catherine Yen
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA; Global Immunization Division; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - Jacqueline E Tate
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - Terri B Hyde
- Global Immunization Division; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - Margaret M Cortese
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - Benjamin A Lopman
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - Baoming Jiang
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - Roger I Glass
- Fogarty International Center; National Institutes of Health; Bethesda, MD USA
| | - Umesh D Parashar
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
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High index of suspicion of intussusception in an 8-month South African child: a case report. Pediatr Infect Dis J 2014; 33 Suppl 1:S104-6. [PMID: 24343606 DOI: 10.1097/inf.0000000000000097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This case report describes diagnosis and management of intussusception in an 8-month-old baby girl seen at the Ventersdorp District Hospital, South Africa. According to the vaccination card, the child had been immunized with rotavirus vaccine with the last dose given 6 months and 2 weeks before presentation to Ventersdorp Hospital. This case of intussusception was unlikely associated with rotavirus vaccination.
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Mwenda JM, Tate JE, Mihigo R, Agócs M, Serhan F, Parashar UD, Nshimirimana D. African rotavirus surveillance network: a brief overview. Pediatr Infect Dis J 2014; 33 Suppl 1:S6-8. [PMID: 24343616 PMCID: PMC12046586 DOI: 10.1097/inf.0000000000000174] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
With the imminent availability of new and prospective rotavirus vaccines, reliable information on burden of rotavirus diseases in the different African countries was required to enable evidence-based decision making regarding introduction of rotavirus vaccines. World Health Organization has been supporting Member States since 2006 to establish sentinel surveillance for rotavirus diarrhea in children <5 years of age using standardized guidelines. African countries are using this platform to generate high quality country specific data to document and demonstrate the burden of rotavirus gastroenteritis. The data gathered are being used by policy makers to guide decisions on appropriate intervention strategies for diarrhea control including the value and timing of the introduction of new rotavirus vaccines in the national immunization programs.
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Affiliation(s)
- Jason M. Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Jacqueline E. Tate
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Richard Mihigo
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Mary Agócs
- World Health Organization, Geneva, Switzerland
| | | | - Umesh D. Parashar
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Deo Nshimirimana
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
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