Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population

<p>Abstract</p> <p>Background</p> <p>Rotavirus gastroenteritis (RVGE) is the most common cause of severe childhood diarrhea worldwide. Objectives were to estimate the burden of RVGE among children less than five years old in the Middle East (Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Syria, UAE, Yemen), North Africa (Algeria, Egypt, Libya, Morocco, Tunisia) and Turkey.</p> <p>Methods</p> <p>A comprehensive literature search was conducted in major databases on the epidemiology and burden of rotavirus among children less than five years old between 1999 and 2009. Data from each country was extracted and compared.</p> <p>Results</p> <p>The search identified 43 studies. RVGE was identified in 16-61% of all cases of acute gastroenteritis, with a peak in the winter. RVGE-related hospitalization rates ranged from 14% to 45%, compared to 14%-28% for non-RVGE. Annually, RVGE caused up to 112 fatalities per 100,000 in certain countries in the region. Hospitalization costs ranged from $1.8 to$4.6 million annually, depending on the country. The most recent literature available showed that G1P[8] was the most prevalent genotype combination in 8 countries (range 23%-56%). G2P[4] was most prevalent in 4 countries (26%-48%). G9P[8] and G4P[8] were also frequently detected.</p> <p>Conclusions</p> <p>RVGE is a common disease associated with significant morbidity, mortality, and economic burden. Given the variety and diverse rotavirus types in the region, use of a vaccine with broad and consistent serotype coverage would be important to help decrease the burden of RVGE in the Middle East and North Africa.</p

Molecular characterization of rotaviruses circulating in the population in Turkey

Of a total of 508 stool specimens from children with acute diarrhoea, mostly under the age of 5 years, collected in nine cities in the western and southeastern regions of Turkey between May 2000 and October 2002, 119 (23.4%) were found positive for rotaviruses (RV) by ELISA. Positive samples were characterized by electropherotyping and G and P genotyping. A subset of G and P types were confirmed by nucleic acid sequencing. The most prevalent types found in this collection included G4P[8], accounting for 27/64 (42.2%) of the fully characterized strains. G1P[8], G2P[4] and G3P[8] were found in 17 (26.6%), 2 (3.1%) and one (1.5%) samples respectively. Less common strains such as G9P[8] were found in two (3.2%) samples and G2P[8], G1P[6], G2P[6] and G4P[6], possible reassortant viruses, were found in five (7.8%), 2 (3.1%), one (1.5%) and four (6.3%) samples respectively. Mixed infections were found in six (7.3%) samples and were associated with combinations of G1 + G2, G1 + G4, G1 + G9 and G4 + G9 strains. This is the first molecular epidemiology study of its kind to be carried out in Turkey and suggests a significant diversity of co-circulating rotavirus strains