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  11. Distribution Of Rotavirus Alphagastroenteritidis Strains In Blantyre, Malawi, During And After The Covid-19 Pandemic

Distribution of Rotavirus alphagastroenteritidis Strains in Blantyre, Malawi, During and After the COVID-19 Pandemic

End Chinyama1,2, Chimwemwe Mhango1,3,4, Rothwell Taia4

  • 1Malawi-Liverpool-Wellcome Programme, Blantyre 312225, Malawi.

Pathogens (Basel, Switzerland)
|November 27, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Rotavirus gastroenteritis remains a major threat to young children. Despite vaccination, COVID-19 impacted surveillance, revealing shifts in rotavirus genotypes, particularly G2 emerging as a predominant strain.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology
Keywords:
COVID-19 pandemicMalawiR. alphagastroenteritidis infectionR. alphagastroenteritidis vaccines

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Background:

  • Rotavirus gastroenteritis is a leading cause of severe illness in children under five globally.
  • The COVID-19 pandemic potentially influenced rotavirus transmission and disrupted healthcare services, including vaccination.
  • Understanding rotavirus epidemiology is crucial for public health interventions and vaccine strategies.

Purpose of the Study:

  • To conduct hospital-based surveillance of rotavirus gastroenteritis in children under five in Malawi.
  • To analyze rotavirus prevalence, age distribution, and G-genotype dynamics during the COVID-19 pandemic.
  • To assess the impact of vaccination and pandemic-related factors on rotavirus epidemiology.

Main Methods:

  • Hospital-based surveillance of acute gastroenteritis in children under five at Queen Elizabeth Central Hospital, Malawi (Oct 2019-Oct 2024).
  • Stool sample analysis for rotavirus using enzyme immunoassay (EIA) and RT-PCR for G-genotyping.
  • Data collection included vaccination status, age, and clinical presentation.

Main Results:

  • Rotavirus was detected in 29.1% of 1135 enrolled children; 99.1% of vaccine-eligible children received at least one vaccine dose.
  • Prevalence varied significantly by age group (p = 0.0046).
  • Common G-genotypes were G3 (38.7%), G2 (25.4%), and G12 (17.2%), with G2 becoming predominant from June 2023. G3P[8] was the most frequent G-P combination (25%). Rotavirus prevalence remained stable, but genotype distribution shifted compared to pre-pandemic patterns.

Conclusions:

  • Rotavirus gastroenteritis surveillance in Malawi shows sustained prevalence but a shift in genotype distribution during the pandemic.
  • The emergence of G2 strains highlights the need for ongoing genomic monitoring.
  • Sustained surveillance and genomic analysis are essential for adapting rotavirus vaccine policy and control strategies.
gastroenteritis
genotypes