Rotavirus is the leading cause of hospitalizations for severe acute gastroenteritis among Afghan children <5?years old |
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| Institution: | 1. Afghanistan National Immunization Technical Advisory Group, Kabul, Afghanistan;2. General Directorate of Preventive Medicines, Ministry of Public Health, Kabul, Afghanistan;3. Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA;4. International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;5. Eastern Mediterranean Regional Office, World Health Organization, Kabul, Afghanistan;6. Expanded Program on Immunization, General Directorate of Preventive Medicines, Ministry of Public Health, Kabul, Afghanistan;1. World Health Organization, Geneva, Switzerland;2. Centers for Disease Control and Prevention, Atlanta, GA, USA;3. World Health Organization, Geneva, Switzerland;4. Centers for Disease Control and Prevention, Atlanta, GA, USA;5. World Health Organization, Geneva, Switzerland;6. Centers for Disease Control and Prevention, Atlanta, GA, USA;1. Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK;2. Vaccine Preventable Diseases, NHS National Services Scotland, Health Protection Scotland, Glasgow G2 6QE, UK;3. Virology Laboratory, Department of Medical Microbiology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZD, UK;4. Institute of Infection and Global Health, University of Liverpool, Liverpool, UK;1. University Teaching Hospital, Department of Pathology & Microbiology, Virology Laboratory, Lusaka, Zambia;2. University Teaching Hospital, Department of Pediatrics'' and Child Health, Lusaka, Zambia;3. Sefako Makgatho Health Sciences University, South African Medical Research Council Diarrhoeal Pathogens Research Unit and WHO AFRO Rotavirus Regional Reference Laboratory, Department of Virology, Medunsa, Pretoria, South Africa;4. WHO Country Office, Lusaka, Zambia;5. Centres for Disease Control and Prevention, Atlanta, GA, USA;6. World Health Organization Regional office for Africa (WHO/AFRO), Brazzaville, Congo;1. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine;2. State Institution “Ukrainian Center for Disease Control and Monitoring, Ministry of Health”, Kyiv, Ukraine;3. State Institution “Odesa Oblast Laboratory Center, Ministry of Health”, Odesa, Ukraine;4. Republican Research and Practical Center for Epidemiology and Microbiology, Ministry of Health, Minsk, Belarus;5. Vaccine-preventable Diseases and Immunization, World Health Organization Regional Office for Europe, Copenhagen, Denmark;6. Expanded Programme on Immunization, World Health Organization, Geneva, Switzerland;7. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia |
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| Abstract: | BackgroundRotavirus gastroenteritis is estimated to cause approximately five thousand deaths annually among Afghan children under 5 years old. Because laboratory confirmation of rotavirus is not routinely performed in clinical settings, assessing the precise burden of disease attributable to severe rotavirus gastroenteritis typically requires active surveillance efforts. This study describes the current burden of pediatric hospitalizations attributable to rotavirus gastroenteritis among Afghan children using surveillance data collected from 2013 to 2015.MethodsRotavirus surveillance was conducted from January 2013 through December 2015 at two of the largest hospitals in the country, Indira Gandhi Children Hospital in Kabul and Herat Regional Hospital. Children between 1 and 60 months of age who were admitted to these hospitals for diarrhea were consented and enrolled. Information on age, gender, and seasonality were collected. Stool specimens were collected and tested by enzyme immunoassay for the presence of rotavirus at the central public health laboratory in Afghanistan.ResultsOverall, 1,413 of 2,737 (52%) of hospitalized children under five years old with diarrhea were rotavirus cases. The overwhelming majority of rotavirus hospitalizations occurred in children younger than two years of age (93%) while 42% of all rotavirus hospitalizations occurred in children between 6 and 11 months of age. Rotavirus transmission occurred year-round.ConclusionsRotavirus is a major cause of severe acute gastroenteritis hospitalizations in young Afghan children, responsible for over half of diarrheal hospitalizations in this population. The Afghanistan Ministry of Public Health has prioritized reducing child mortality by 2020 and is actively working towards the introduction of rotavirus vaccination in Afghan children. These data will be instrumental in understanding the potential impact upon child health that may be achieved through the introduction of rotavirus vaccines in Afghanistan. |
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| Keywords: | Acute gastroenteritis Rotavirus Diarrhea Disease burden Surveillance Hospitalizations Rotavirus vaccine Afghanistan |
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