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Trends and Geographic Distribution of Rotavirus Genotypes Among Children Aged Under 5 Years Hospitalized with Acute

Anupama Machathi1, Varsha Sudhir Chaudhary1, Tintu Varghese2

  • 1Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India.

Indian Journal of Pediatrics
|October 1, 2025
PubMed

Insights

Rotavirus genotype surveillance in Indian children reveals shifts in common strains like G3P[8] and G2P[4] post-vaccination. Understanding these changes is crucial for adapting rotavirus vaccines to evolving circulating genotypes.

Area of Science:

  • Virology
  • Pediatric Gastroenterology
  • Public Health

Background:

  • Rotavirus is a leading cause of severe diarrhea and mortality in children under 5, especially in low- and middle-income countries.
  • India accounts for a significant portion of global rotavirus-related deaths in young children.
  • The introduction of rotavirus vaccines into India's Universal Immunization Program necessitates monitoring genotype shifts.

Purpose of the Study:

  • To characterize rotavirus genotypes in hospitalized children under 5 with acute gastroenteritis in India.
  • To track changes and identify new rotavirus variants following vaccine introduction.
  • To inform vaccine adaptation strategies for enhanced protection.

Main Methods:

  • A descriptive study involving 4,996 stool samples from children under 5 hospitalized with acute gastroenteritis across 32 hospitals in seven Indian states (2019-2023).
  • Rotavirus antigen detection using enzyme-linked immunosorbent assay (ELISA).
  • Genotyping of positive samples and analysis of genotype distribution by region and year.

Main Results:

  • Rotavirus was detected in 27.9% (1,396/4,996) of samples.
  • The predominant genotypes were G3P[8] (35%), G2P[4] (31.1%), and G1P[8] (15.2%), with mixed variants comprising 8.5%.
  • Regional variations observed: G3P[8] in south/west, G2P[4] in east. Mixed genotypes showed an increasing trend over the study period.

Conclusions:

  • Circulating rotavirus genotypes in India exhibit temporal and regional variability.
  • Continuous surveillance is essential to monitor emerging rotavirus genotypes.
  • Data supports the need for potential adaptation of rotavirus vaccines to match prevalent strains for optimal efficacy.
Abstract

Keywords:
Acute gastroenteritisEnzyme-linked immunosorbent assayGenotypeIndiaRotavirus

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