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Circulating Genotypes of Rotavirus Prior to Rotarix?vaccine Introduction in Kathmandu, Nepal
Sony Shrestha1, Ocean Thakali1, Sunayana Raya1
1Public Health Research Laboratory, Department of Clinical Microbiology, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu Nepal.
Insights
Rotavirus diarrhea affects millions of children in Nepal. Before vaccine introduction, G12P[6] was the most common rotavirus strain, highlighting the need for ongoing surveillance.
Area of Science:
- Pediatrics
- Virology
- Public Health
Background:
- Diarrhea poses a significant health risk to young children in Nepal, with rotavirus identified as a primary cause.
- Rotavirus is a major etiological agent of diarrhea in children under five in Nepal, affecting an estimated 3 million annually.
- The Rotarix® vaccine was integrated into Nepal's national immunization program in July 2020 due to the high burden of rotavirus disease.
Purpose of the Study:
- To assess the prevalence of rotavirus diarrhea in children under five.
- To identify the circulating rotavirus genotypes prior to the national vaccine introduction.
- To establish a baseline for future rotavirus vaccine effectiveness studies in Nepal.
Main Methods:
- A hospital-based cross-sectional study was conducted at Kanti Children's Hospital.
- Rotavirus antigen detection was performed using enzyme immunoassay (EIA).
- Genotyping of rotavirus A strains was achieved through Reverse-Transcription Polymerase Chain Reaction (RT-PCR).
Main Results:
- Rotavirus antigen was detected in 112 (21.1%) of the 530 enrolled children.
- The most prevalent rotavirus genotype identified was G12P[6] (30.3%).
- Other common genotypes included G3P[8] (26.8%), mixed types (14.3%), and G1P[6] (13.4%).
Conclusions:
- The study identified key rotavirus genotypes circulating in Nepal before vaccination.
- Continued nationwide surveillance is recommended to monitor the impact of the Rotarix® vaccination program.
- Monitoring genotype trends is crucial for understanding vaccine effectiveness and detecting potential shifts in circulating strains.
Background:
In Nepal, it is estimated that about 3 million children under 5 years of age are prone to diarrhea and previous studies have shown rotavirus as the major etiological agent. Given the high burden of rotavirus, Rotarix® vaccine was introduced in the national immunization schedule in July 2020. This study was carried out in a tertiary health center from January- September 2018 to determine the burden of rotavirus diarrhea as well as genotypic variations in the circulating virus prior to vaccine introduction in Kathmandu, Nepal.
Methods:
Hospital based cross sectional study was conducted among children less than 5 years of age attending Kanti Children's Hospital. Rotavirus antigen detection was performed by enzyme immunoassay using ProSpecT Rotavirus Microplate Assay. Rotavirus A positive samples were further confirmed by genotyping using Reverse-Transcription Polymerase Chain Reaction.
Results:
A total of 530 children that included 184 males and 346 females were enrolled in this study. Rotavirus antigen was detected in 112 (21.1%) stool samples. Of the total 112 positive EIA stool samples that were genotyped, G12P[6] (30.3%) was found to be the most common type, followed by G3P[8] (26.8%), mixed type (14.3%), and G1P[6] (13.4%).
Conclusions:
Continued surveillance should be carried out nationwide in Nepal to understand the effectiveness of the vaccination program and to report any new trends in the circulating genotypes.
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