Rotavirus Genotypes in Hospitalized Children With Acute Gastroenteritis Before and After Rotavirus Vaccine Introduction in Blantyre, Malawi, 1997–2019

Journal article


Mhango, C, Mandolo, J.J, Chinyama, E, Wachepa, R, Kanjerwa, O, Malamba-Banda, C, Matambo, P.B, Barnes, K.G, Chaguza, C, Shawa, I., Nyaga, M.M, Hungerford, D, Parashar, U.D, Pitzer, V.E, Kamng’ona, A.W, Iturriza-Gomara, M, Cunliffe, N.A and Jere, K.C 2022. Rotavirus Genotypes in Hospitalized Children With Acute Gastroenteritis Before and After Rotavirus Vaccine Introduction in Blantyre, Malawi, 1997–2019. The Journal of Infectious Diseases. 225 (12), pp. 2127 - 2136. https://doi.org/10.1093/infdis/jiaa616
AuthorsMhango, C, Mandolo, J.J, Chinyama, E, Wachepa, R, Kanjerwa, O, Malamba-Banda, C, Matambo, P.B, Barnes, K.G, Chaguza, C, Shawa, I., Nyaga, M.M, Hungerford, D, Parashar, U.D, Pitzer, V.E, Kamng’ona, A.W, Iturriza-Gomara, M, Cunliffe, N.A and Jere, K.C
Abstract

Background
Rotavirus vaccine (Rotarix [RV1]) has reduced diarrhea-associated hospitalizations and deaths in Malawi. We examined the trends in circulating rotavirus genotypes in Malawi over a 22-year period to assess the impact of RV1 introduction on strain distribution.

Methods
Data on rotavirus-positive stool specimens among children aged <5 years hospitalized with diarrhea in Blantyre, Malawi before (July 1997–October 2012, n = 1765) and after (November 2012–October 2019, n = 934) RV1 introduction were analyzed. Rotavirus G and P genotypes were assigned using reverse-transcription polymerase chain reaction.

Results
A rich rotavirus strain diversity circulated throughout the 22-year period; Shannon (H′) and Simpson diversity (D′) indices did not differ between the pre- and postvaccine periods (H′ P < .149; D′ P < .287). Overall, G1 (n = 268/924 [28.7%]), G2 (n = 308/924 [33.0%]), G3 (n = 72/924 [7.7%]), and G12 (n = 109/924 [11.8%]) were the most prevalent genotypes identified following RV1 introduction. The prevalence of G1P[8] and G2P[4] genotypes declined each successive year following RV1 introduction, and were not detected after 2018. Genotype G3 reemerged and became the predominant genotype from 2017 onward. No evidence of genotype selection was observed 7 years post–RV1 introduction.

Conclusions
Rotavirus strain diversity and genotype variation in Malawi are likely driven by natural mechanisms rather than vaccine pressure.

Keywordsrotavirus; genotypes; gastroenteritis; Malawi; surveillance; Africa
Year2022
JournalThe Journal of Infectious Diseases
Journal citation225 (12), pp. 2127 - 2136
PublisherOxford University Press
ISSN1537-6613
Digital Object Identifier (DOI)https://doi.org/10.1093/infdis/jiaa616
Web address (URL)https://academic.oup.com/jid/article/225/12/2127/5919783
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200156/
Output statusPublished
Publication dates
Online15 Jun 2022
Publication process dates
Deposited06 Jun 2023
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