Human rotavirus group a serotypes causing gastroenteritis in children less than 5 years and HIV-infected adults in Viwandani Slum, Nairobi

Background: Rotavirus remains a leading cause of acute gastroenteritis in children worldwide with an estimated 2000 deaths each day in developing countries. Due to HIV/AIDS scourge in Kenya, it is possible that rotavirus-related gastroenteritis has been aggravated in adults. The Global Alliance for Immunizations has ranked rotavirus infection a priority for vaccine, and, to ensure its success, there is a need to document the local strain(s) circulating in different regions.Methods: A cross-sectional study wasconducted to documenthuman rotavirus group A serotypes in children below 5 years and HIV-infected adults in Viwandani slum in Nairobi, Kenya. A total of 260 (128 from children and 132 from HIV infected adults) fecal specimen samples were analyzed from August 2012 to July 2013. Screening for rotavirus was done by antigen based enzyme immune-sorbent assay (ELISA), Polyacrylamide gel electrophoresis (PAGE) was used to detect rotavirus electropherotypes and finally genotyping was done by RT-PCR using genotype-specific primer sets targeting VP4 and VP7 genes.Results: Rotavirus was detected in 23% and 8% of children and adult,respectively. Prevalence was high in children of < 2years and adults of > 48 years.  Long electropherotypes accounted for 80% and 60% while short electropherotypes accounted for 20% and 40% in children and adult, respectively. The common globally distributed strains, G1 and G3, accounted for 60% detections while the unusual G9 strain accounted for 80% infection in adults. G1P[8]was the common genotypic combination in children, accounting for 40% infection, whereas G9[P8]accounted for 60% of the infections in adults.Conclusion: This study shows the existence of strain diversity between rotavirus circulating in children and adults withinthis study group. It further shows that as currently constituted, the 2 vaccines recommended for rotavirus would cover the circulating strain in Viwandani slum. Finally,there is a need for continuous rotavirus strain surveillance in children and a further focus on HIV infected adults.Keywords: Rotavirus, Diarrhoea, Gastroenteritis, Viwandani slum, Keny

Expanding global distribution of rotavirus serotype G9: detection in Libya, Kenya, and Cuba.

Serotype G9 may be the fifth most common human rotavirus serotype, after serotypes G1 to G4. In three cross-sectional studies of childhood diarrhea, we have detected serotype G9 rotaviruses for the first time in Libya, Kenya, and Cuba. Serotype G9 constituted 27% of all rotaviruses identified, emphasizing the reemergence of serotype G9 and suggesting that future human rotavirus vaccines will need to protect against disease caused by this serotype

A cost effectiveness and capacity analysis for the introduction of universal rotavirus vaccination in Kenya : comparison between Rotarix and RotaTeq vaccines

Background Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination. Methods Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain. Results The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix. Conclusion Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability

Detection and indentification of echovirus 7 from a child wtih gatro-enteritis

No Abstract. East African Medical Journal Vol. 83 (12) 2006: pp. 666-66

Clinical Features Associated with Group A Rotavirus in Children Presenting with Acute Diarrhoea at Kenyatta National Hospital, Nairobi, Kenya

Background: Worldwide rotavirus (RV) infection is a major cause of diarrhea in children \u3c5 years of age. Continual monitoring of RV prevalenceand its associated clinical characteristics is necessary to estimate the burden of the disease. In this study, we evaluated the clinical featuresassociated with RV diarrhea such as dehydration and levels of electrolytes, urea and creatinine at Kenyatta National Hospital, Nairobi, Kenya.Methods: A total of 192 diarrheic stool samples were collected from children under 5 years of age and tested for presence of RV using enzymeimmunoassay (EIA). A further 92 blood samples collected from the same cohort but only targeting severely dehydrated children, were used for theanalysis of electrolytes (Potassium and Sodium ions), urea and creatinine.Results: Rotavirus was detected in 53.4% (103/192) of stool specimens. Dehydration was common in most of the children who presented withdiarrhea regardless of RV status (172/192; 89.6%). However, RV patients had increased duration and frequency of vomiting compared with nonrotavirus patients but levels of dehydration were similar in both groups. There was loss of electrolytes and elevated levels of both urea (\u3e7.5mmol/l)and creatinine (\u3e80μmol/l) in all severely dehydrated cases.Conclusion: Rotavirus was associated with increased duration and frequency of vomiting, but loss of electrolytes and elevated levels of bothurea and creatinine were similar among severely dehydrated RV positive and negative children. This study provides useful information to policymakers on RV that could, together with other studies in Kenya on RV, aid in understanding the disease burden, earlier clinical diagnosis andevaluation of cost benefit analysis for RV vaccines in Keny

Validation of the bag-mediated filtration system for environmental surveillance of poliovirus in Nairobi, Kenya

AIMS : This study compared the bag-mediated filtration system (BMFS) and standard WHO two-phase separation methods for poliovirus (PV) environmental surveillance, examined factors impacting PV detection and monitored Sabin-like (SL) PV type 2 presence with withdrawal of oral polio vaccine type 2 (OPV2) in April 2016. METHODS AND RESULTS : Environmental samples were collected in Nairobi, Kenya (Sept 2015–Feb 2017), concentrated via BMFS and two-phase separation methods, then assayed using the WHO PV isolation algorithm and intratypic differentiation diagnostic screening kit. SL1, SL2 and SL3 were detected at higher rates in BMFS than two-phase samples (P < 0 05). In BMFS samples, SL PV detection did not significantly differ with volume filtered, filtration time or filter shipment time (P > 0 05), while SL3 was detected less frequently with higher shipment temperatures (P = 0 027). SL2 was detected more frequently before OPV2 withdrawal in BMFS and two-phase samples (P < 1 9 10 5). CONCLUSIONS : Poliovirus was detected at higher rates with the BMFS, a method that includes a secondary concentration step, than using the standard WHO two-phase method. SL2 disappearance from the environment was commensurate with OPV2 withdrawal. SIGNIFICANCE AND IMPACT OF THE STUDY : The BMFS offers comparable or improved PV detection under the conditions in this study, relative to the twophase method.SUPPORTING INFORMATION: Appendix S1. Nairobi environmental surveillance sites. Appendix S2. Statistical methods. Appendix S3. Replicate BMFS samples. Appendix S4. Samples included in statistical analyses. Appendix S5. NPEV detection in BMFS and two‐phase samples.Funding was provided by the Paul G. Allen Foundation, Grant Number NPT.1938-603689, and the Bill and Melinda Gates Foundation, Grant Number OPP1170548. This work was supported in part by the UW NIEHS sponsored Biostatistics, Epidemiologic and Bioinformatic Training in Environmental Health (BEBTEH) Training Grant, Grant #: NIEHS T32ES015459. We would like to thank James Angawa, Public Health Surveillance Officer, Nairobi County and Pius Odhiambo, Community Health Volunteer, for their assistance sampling; Director of KEMRI for facilitating the study; Graciela Matrajt for her technical writing assistance; and Dan Phillips for his assistance with project coordination.The Paul G. Allen Foundation and the Bill and Melinda Gates Foundation.https://sfamjournals.onlinelibrary.wiley.com/journal/13652672am2020Medical Virolog

Detection of potentially pathogenic enteric viruses in environmental samples from Kenya using the bag-mediated filtration system

Enteric virus environmental surveillance via a highly sensitive method is critical, as many enteric viruses have low infectious doses and can persist in the environment for extended periods. This study determined the potential of the novel bag-mediated filtration system (BMFS) to recover human enteric viruses and pepper mild mottle virus (PMMoV) from wastewater and wastewater-impacted surface waters, examined PMMoV use as a fecal contamination indicator in Kenya, and identified potential BMFS process controls. From April 2015 to April 2016, BMFS samples were collected from seven sites in Kenya (n = 59). Enteroviruses and PMMoV were detected in 100% of samples, and human adenovirus, human astrovirus, hepatitis A virus, norovirus GI, norovirus GII, sapovirus, and human rotavirus were detected in the majority of samples. The consistent detection of enteroviruses and PMMoV suggests that these viruses could be used as indicators in similarly fecally contaminated sites and BMFS process controls. As contamination of surface water sources remains a global issue, enteric virus environmental surveillance is necessary. This study demonstrates an effective way to sample large volumes of wastewater and wastewater-impacted surface waters for the detection of multiple enteric viruses simultaneously.The Paul G. Allen Family Foundation (NPT.1938-603689), with management by the Bill and Melinda Gates Foundation, the UW NIEHS sponsored Biostatistics, Epidemiologic and Bioinformatic Training in Environmental Health (BEBTEH) Training Grant (NIEHS T32ES015459) and the National Science Foundation (OCE-1566562).http://wst.iwaponline.comhj2019Medical Virolog