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Diversity of rotavirus genotypes circulating in children < 5 years of age hospitalized for acute gastroenteritis in India from 2005 to 2016: analysis of temporal and regional genotype variation.
BMC Infect Dis. 2020 Oct 09; 20(1):740.BI

Abstract

BACKGROUND

From 2016, the Government of India introduced the oral rotavirus vaccine into the national immunization schedule. Currently, two indigenously developed vaccines (ROTAVAC, Bharat Biotech; ROTASIIL, Serum Institute of India) are included in the Indian immunization program. We report the rotavirus disease burden and the diversity of rotavirus genotypes from 2005 to 2016 in a multi-centric surveillance study before the introduction of vaccines.

METHODS

A total of 29,561 stool samples collected from 2005 to 2016 (7 sites during 2005-2009, 3 sites from 2009 to 2012, and 28 sites during 2012-2016) were included in the analysis. Stools were tested for rotavirus antigen using enzyme immunoassay (EIA). Genotyping was performed on 65.8% of the EIA positive samples using reverse transcription- polymerase chain reaction (RT-PCR) to identify the G (VP7) and P (VP4) types. Multinomial logistic regression was used to quantify the odds of detecting genotypes across the surveillance period and in particular age groups.

RESULTS

Of the 29,561 samples tested, 10,959 (37.1%) were positive for rotavirus. There was a peak in rotavirus positivity during December to February across all sites. Of the 7215 genotyped samples, G1P[8] (38.7%) was the most common, followed by G2P[4] (12.3%), G9P[4] (5.8%), G12P[6] (4.2%), G9P[8] (4%), and G12P[8] (2.4%). Globally, G9P[4] and G12P[6] are less common genotypes, although these genotypes have been reported from India and few other countries. There was a variation in the geographic and temporal distribution of genotypes, and the emergence or re-emergence of new genotypes such as G3P[8] was seen. Over the surveillance period, there was a decline in the proportion of G2P[4], and an increase in the proportion of G9P[4]. A higher proportion of mixed and partially typed/untyped samples was also seen more in the age group 0-11 months.

CONCLUSIONS

This 11 years surveillance highlights the high burden of severe rotavirus gastroenteritis in Indian children < 5 years of age before inclusion of rotavirus vaccines in the national programme. Regional variations in rotavirus epidemiology were seen, including the emergence of G3P[8] in the latter part of the surveillance. Having pre-introduction data is important to track changing epidemiology of rotaviruses, particularly following vaccine introduction.

Authors+Show Affiliations

Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India. Indian Council of Medical Research, New Delhi, India.National Institute of Epidemiology, Chennai, Tamil Nadu, India.Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.National Institute of Virology, Pune, Maharashtra, India.National Institute of Virology, Pune, Maharashtra, India.Jamia Hamdard, New Delhi, India.National Institute of Epidemiology, Chennai, Tamil Nadu, India.Regional Medical Research Centre, Dibrugarh, Assam, India.National Institute of Traditional Medicine, Belgaum, Karnataka, India.National Institute for Research in Tribal Health, Jabalpur, Madhya Pradesh, India.Regional Medical Research Centre, Bhubaneswar, Odisha, India.Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India.Regional Medical Research Centre, Port Blair, Andaman & Nicobar Islands, India.Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India. Baylor College of Medicine, Houston, TX, USA.Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.Indian Council of Medical Research, New Delhi, India. Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, India.Indian Council of Medical Research, New Delhi, India.Indian Council of Medical Research, New Delhi, India.Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India. gkang@cmcvellore.ac.in. Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, India. gkang@cmcvellore.ac.in.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

33036575

Citation

Giri, Sidhartha, et al. "Diversity of Rotavirus Genotypes Circulating in Children < 5 Years of Age Hospitalized for Acute Gastroenteritis in India From 2005 to 2016: Analysis of Temporal and Regional Genotype Variation." BMC Infectious Diseases, vol. 20, no. 1, 2020, p. 740.
Giri S, Kumar CPG, Khakha SA, et al. Diversity of rotavirus genotypes circulating in children < 5 years of age hospitalized for acute gastroenteritis in India from 2005 to 2016: analysis of temporal and regional genotype variation. BMC Infect Dis. 2020;20(1):740.
Giri, S., Kumar, C. P. G., Khakha, S. A., Chawla-Sarkar, M., Gopalkrishna, V., Chitambar, S. D., Ray, P., Venkatasubramanian, S., Borkakoty, B. J., Roy, S., Bhat, J., Dwibedi, B., Das, P., Paluru, V., Ramani, S., Babji, S., Arora, R., Mehendale, S. M., Gupte, M. D., & Kang, G. (2020). Diversity of rotavirus genotypes circulating in children < 5 years of age hospitalized for acute gastroenteritis in India from 2005 to 2016: analysis of temporal and regional genotype variation. BMC Infectious Diseases, 20(1), 740. https://doi.org/10.1186/s12879-020-05448-y
Giri S, et al. Diversity of Rotavirus Genotypes Circulating in Children < 5 Years of Age Hospitalized for Acute Gastroenteritis in India From 2005 to 2016: Analysis of Temporal and Regional Genotype Variation. BMC Infect Dis. 2020 Oct 9;20(1):740. PubMed PMID: 33036575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diversity of rotavirus genotypes circulating in children < 5 years of age hospitalized for acute gastroenteritis in India from 2005 to 2016: analysis of temporal and regional genotype variation. AU - Giri,Sidhartha, AU - Kumar,C P Girish, AU - Khakha,Shainey Alokit, AU - Chawla-Sarkar,Mamta, AU - Gopalkrishna,Varanasi, AU - Chitambar,Shobha D, AU - Ray,Pratima, AU - Venkatasubramanian,S, AU - Borkakoty,Biswa Jyoti, AU - Roy,Subarna, AU - Bhat,Jyothi, AU - Dwibedi,Bhagirathi, AU - Das,Pradeep, AU - Paluru,Vijayachari, AU - Ramani,Sasirekha, AU - Babji,Sudhir, AU - Arora,Rashmi, AU - Mehendale,Sanjay M, AU - Gupte,Mohan D, AU - Kang,Gagandeep, AU - ,, Y1 - 2020/10/09/ PY - 2020/01/18/received PY - 2020/09/23/accepted PY - 2020/10/10/entrez PY - 2020/10/11/pubmed PY - 2020/10/21/medline KW - Diarrhoea KW - Enzyme immunoassay KW - Gastroenteritis KW - Genotypes KW - India KW - Polymerase chain reaction KW - Rotavirus SP - 740 EP - 740 JF - BMC infectious diseases JO - BMC Infect Dis VL - 20 IS - 1 N2 - BACKGROUND: From 2016, the Government of India introduced the oral rotavirus vaccine into the national immunization schedule. Currently, two indigenously developed vaccines (ROTAVAC, Bharat Biotech; ROTASIIL, Serum Institute of India) are included in the Indian immunization program. We report the rotavirus disease burden and the diversity of rotavirus genotypes from 2005 to 2016 in a multi-centric surveillance study before the introduction of vaccines. METHODS: A total of 29,561 stool samples collected from 2005 to 2016 (7 sites during 2005-2009, 3 sites from 2009 to 2012, and 28 sites during 2012-2016) were included in the analysis. Stools were tested for rotavirus antigen using enzyme immunoassay (EIA). Genotyping was performed on 65.8% of the EIA positive samples using reverse transcription- polymerase chain reaction (RT-PCR) to identify the G (VP7) and P (VP4) types. Multinomial logistic regression was used to quantify the odds of detecting genotypes across the surveillance period and in particular age groups. RESULTS: Of the 29,561 samples tested, 10,959 (37.1%) were positive for rotavirus. There was a peak in rotavirus positivity during December to February across all sites. Of the 7215 genotyped samples, G1P[8] (38.7%) was the most common, followed by G2P[4] (12.3%), G9P[4] (5.8%), G12P[6] (4.2%), G9P[8] (4%), and G12P[8] (2.4%). Globally, G9P[4] and G12P[6] are less common genotypes, although these genotypes have been reported from India and few other countries. There was a variation in the geographic and temporal distribution of genotypes, and the emergence or re-emergence of new genotypes such as G3P[8] was seen. Over the surveillance period, there was a decline in the proportion of G2P[4], and an increase in the proportion of G9P[4]. A higher proportion of mixed and partially typed/untyped samples was also seen more in the age group 0-11 months. CONCLUSIONS: This 11 years surveillance highlights the high burden of severe rotavirus gastroenteritis in Indian children < 5 years of age before inclusion of rotavirus vaccines in the national programme. Regional variations in rotavirus epidemiology were seen, including the emergence of G3P[8] in the latter part of the surveillance. Having pre-introduction data is important to track changing epidemiology of rotaviruses, particularly following vaccine introduction. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/33036575/Diversity_of_rotavirus_genotypes_circulating_in_children_<_5_years_of_age_hospitalized_for_acute_gastroenteritis_in_India_from_2005_to_2016:_analysis_of_temporal_and_regional_genotype_variation_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05448-y DB - PRIME DP - Unbound Medicine ER -