Temporal association of rotavirus vaccination and genotype circulation in South Africa: Observations from 2002 to 2014 |
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| Institution: | 1. National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa;2. Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa;3. South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa, South Africa;4. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa;5. Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of Witwatersrand, Johannesburg, South Africa;6. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa;7. Department of Paediatrics, Ngwelezane Hospital, Empangeni, South Africa;8. Department of Paediatrics and Child Health/MRC Unit on Child & Adolescent Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa;9. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States;10. Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa;1. Centers for Disease Control and Prevention, Atlanta, GA, USA;2. World Health Organization Regional Office for Africa (WHO/AFRO), Brazzaville, Congo;3. World Health Organization, Geneva, Switzerland;4. Centers for Disease Control and Prevention, Atlanta, GA, USA;1. Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa;2. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa;3. National Institute for Communicable Diseases (NICD): A Division of the National Health Laboratory Service (NHLS), Sandringham, South Africa;4. Department of Global Health, Rollins School of Public Health, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA;5. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;6. Centre for Global Health Research, Umeå University, Umeå, Sweden;7. INDEPTH Network, Accra, Ghana;1. Department of Medical Research, Ministry of Health and Sports, Myanmar;2. Yangon Children’s Hospital, Ministry of Health and Sports, Myanmar;1. National Institute for Communicable Diseases, Private Bag x4, Sandringham, 2131, South Africa;2. School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private Bag x20, Hatfield, 0028, South Africa;3. Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, Pretoria, 0007, South Africa;4. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa;5. Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of Witwatersrand, Johannesburg, South Africa;6. Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa;7. School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa;8. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa;1. Institute for Veterinary Medical Research, Centre for Agricultural Research, Hungarian Academy of Sciences, Budapest, Hungary;2. Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary;3. Department of Veterinary Medicine, University of Bari “Aldo Moro”, Bari, Italy;4. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;1. National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia;2. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States;3. Edward Francis Small Teaching Hospital, Ministry of Health and Social Welfare, Banjul, Gambia;4. University of Noguchi, Ghana;5. ExpandedProgrammes in Immunization, Ministry of Health and Social Welfare, Kotu Layout, Kotu, Gambia;6. Ministry of Health and Social Welfare, Banjul, Gambia;7. World Health Organization, Regional Office for Africa, Immunization, Vaccines and Emergencies (IVE) Cluster, Brazzaville, Congo;8. World Health Organization, Geneva, Switzerland;1. University Teaching Hospital, Department of Paediatrics and Child Health, Lusaka, Zambia;2. University Teaching Hospital, Virology Laboratory, Lusaka, Zambia;3. World Health Organisation, Regional Office for Africa (WHO/AFRO), Brazzaville, People’s Republic of Congo;4. WHO Country Office, Lusaka, Zambia;5. Centres for Disease Control and Prevention, Atlanta, GA, USA |
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| Abstract: | BackgroundRotavirus vaccination has reduced diarrhoeal morbidity and mortality globally. The monovalent rotavirus vaccine was introduced into the public immunization program in South Africa (SA) in 2009 and led to approximately 50% reduction in rotavirus hospitalization in young children. The aim of this study was to investigate the rotavirus genotype distribution in SA before and after vaccine introduction.Materials and methodsIn addition to pre-vaccine era surveillance conducted from 2002 to 2008 at Dr George Mukhari Hospital (DGM), rotavirus surveillance among children <5 years hospitalized for acute diarrhoea was established at seven sentinel sites in SA from April 2009 to December 2014. Stool specimens were screened by enzyme immunoassay and rotavirus positive specimens genotyped using standardised methods.ResultsAt DGM, there was a significant decrease in G1 strains from pre-vaccine introduction (34%; 479/1418; 2002–2009) compared to post-vaccine introduction (22%; 37/170; 2010–2014; p for trend <.001). Similarly, there was a significant increase in non-G1P8] strains at this site (p for trend <.001). In expanded sentinel surveillance, when adjusted for age and site, the odds of rotavirus detection in hospitalized children with diarrhoea declined significantly from 2009 (46%; 423/917) to 2014 (22%; 205/939; p < .001). The odds of G1 detection declined significantly from 2009 (53%; 224/421) to 2010–2011 (26%; 183/703; aOR = 0.5; p < .001) and 2012–2014 (9%; 80/905; aOR = 0.1; p < .001). Non-G1P8] strains showed a significant increase from 2009 (33%; 139/421) to 2012–2014 (52%; 473/905; aOR = 2.5; p < .001).ConclusionsRotavirus vaccination of children was associated with temporal changes in circulating genotypes. Despite these temporal changes in circulating genotypes, the overall reduction in rotavirus disease in South Africa remains significant. |
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| Keywords: | Rotavirus Vaccine Genotype South Africa |
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