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Study of rotavirus genotypes G and P in one Egyptian center-cross-sectional study
AbelRahman Eid Mahmoud1, Maysaa El Sayed Zaki2, Eman Hamdy Mohamed3
1Pediatrics Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Insights
Rotavirus gastroenteritis is common in Egyptian children, with G1, G2, and G3 being the most prevalent G genotypes and P9, P4, P10 the most common P genotypes. Vaccination is recommended for national programs.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Epidemiology
Background:
- Rotavirus gastroenteritis poses a significant health challenge in children globally.
- Genotype variations in rotavirus are influenced by geographic location and vaccination practices.
- Understanding local rotavirus epidemiology is crucial for public health interventions.
Purpose of the Study:
- To identify common G and P genotypes of rotavirus in children under 5 in Egypt.
- To correlate rotavirus genotypes with demographic and clinical data.
- To assess the prevalence of mixed G and P genotypes in infected children.
Main Methods:
- A cross-sectional study involving children with acute gastroenteritis aged ≤5 years.
- Stool samples analyzed using Enzyme-Linked Immunosorbent Assay (ELISA) for rotavirus antigen detection.
- Nested Polymerase Chain Reaction (PCR) used for G and P genotype identification.
Main Results:
- The most common G genotypes were G1 (24.7%), G2 (21.1%), G3 (20%), G9 (20%), and G4 (14.1%).
- The most common P genotypes were P9 (24.7%), P4 (21.2%), P10 (20%), P8 (17.6%), and P6 (16.5%).
- Frequent co-infections included G1P4, G3P8, and G2P6. Rotavirus was more prevalent in females and associated with fever and summer season.
Conclusions:
- G1, G2, G3 and P9, P4, P10 are the predominant rotavirus genotypes in the studied Egyptian cohort.
- Rotavirus remains a major cause of acute gastroenteritis in children in Egypt, irrespective of limited vaccination.
- Integration of rotavirus vaccination into the national immunization program is recommended.
Background:
Rotavirus-associated gastroenteritis is a common health problem in children, different variations of rotavirus genotypes differ according to geographic locations and the practice of wide-scale vaccination. Therefore, the present study aimed to detect both the G and P genotypes of rotavirus in children ≤ 5 years old in one center in Egypt as a cross-sectional study, to correlate the genotypes with various demographic and clinical data in infected children and to evaluate the common mixed genotypes G and P in infected children.
Method:
The cross-sectional study included children with acute gastroenteritis ≤ 5 years old from January 2023 till March 2024 recruited from Mansoura University Children's Hospital, Egypt based upon laboratory diagnosis by exclusion of bacterial and protozoa pathogens. The stool samples were obtained from each child and subjected to detection of rotavirus antigen by enzyme-linked immunosorbent assay (ELISA) followed by genotypes identification of G and P genotypes by nested polymerase chain reaction (PCR).
Result:
A nested PCR study for rotavirus genotypes revealed that G1 was the most common genotype (24.7%) followed by G2 (21.1%), G3 (20%), G9 (20%), and G4 (14.1%). The genotyping of the P genotype revealed that P9 was the commonest genotype (24.7%), followed by P4 (21.2%), P10 (20%), P8 (17.6%) and P6 (16.5%). The commonest combined genotypes of G and P were G1P4 (85.7%), G3P8(88.2%), followed by G2P6 (77.8%) and G9P9(76.5%) and G4P9 (66.7%) followed by G4P10 (33.3%), G9P10(23.5%), G2P10(22.2%), G1P10 (14.3%), G3P10(11.8%). The distribution was significant (P = 0.001). The positive rotavirus antigen was more frequently detected in females (55.3%) than males (44.7%, Odd ratio 0.2, 95% CI 0.22-0.71, P = 0.001). There was a significant association between the summer season and positive rotavirus antigen (P = 0.001) and rural residence of the patients (Odd ratio 6,9 95%CI 3,5-13.5, P = 0.001). The significant associated clinical sign with positive rotavirus antigen was fever (Odd ratio 3,3, 95%CI 1,8-6.05, P = 0.001). The genotypes G and P were significantly associated with positive rotavirus antigen as all cases positive by antigen had been detected by nested PCR with the commonest genotypes G4 (24.7%, P = 0.001) and genotype P9 (24.7%, P = 0.001).
Conclusion:
The present study highlights the common genotypes of rotavirus at one center in Egypt, G1, G2, and G3 were the commonest G genotypes. As regard genotype P the commonest genotypes were P9, P4, and P10. The commonest combined genotypes were G1P4, G3P8, G2P6. There was no effect of the practice of rotavirus vaccination at limited rates at private health sections as the rotavirus is still a major pathogen of acute gastroenteritis in children. There is a need for the inclusion of rotavirus vaccination in the national program of children vaccination in Egypt.
