Post-vaccine rotavirus genotype distribution in Nairobi County, Kenya

Int J Infect Dis. 2020 Nov:100:434-440. doi: 10.1016/j.ijid.2020.09.005. Epub 2020 Sep 6.

Abstract

Background: Rotaviruses are primary etiological agents of gastroenteritis in young children. In Kenya, G1P8 monovalent vaccine (Rotarix) was introduced in July 2014 for mandatory vaccination of all newborns at 6 and 10 weeks of age. Since then, no studies have been done to identify the rotavirus genotypes circulating in Nairobi County, Kenya, following the vaccine introduction, hence the post-vaccine genotype distribution is not known.

Objectives: The aim of this study was to determine the post-vaccine occurrence of rotavirus genotypes in children <5 years of age in Nairobi County, Kenya.

Methods: Stool samples were collected from children presenting with diarrhea for whom the vaccination status was card-confirmed. Fecal samples were analyzed for rotavirus antigen using a commercial enzyme immunoassay (EIA) kit, followed by characterization by polyacrylamide gel electrophoresis, RT-PCR, and nested PCR genotyping, targeting the most medically important genotypes.

Results: The strains observed included G1P[8] (38.8%), G9P[8] (20.4%), G2P[4] (12.2%), G3[P4] (6.1%), G2P[6] (4.1%), and G9P[6] (4.1%). Mixed genotype constellations G3P[4][8] were also detected (4.1%). Remarkably, an increased prevalence of G2 genotypes was observed, revealing a change in genetic diversity of rotavirus strains. While the dominance of G1P[8] decreased after vaccination, an upsurge in G2P[4] (12.2%) and G9P[8] (20.4%) was observed. Additionally, G3[P4] (6.1%) and G2P[6] (4.1%) prevalence increased over the 3 years of study.

Conclusions: The results inform the need for robust longitudinal surveillance and epidemiological studies to assess the long-term interaction between rotavirus vaccine and strain ecology.

Keywords: Gastroenteritis; Genotypes; Rotarix; Rotavirus; Vaccine.

MeSH terms

  • Child, Preschool
  • Diarrhea / epidemiology
  • Feces / virology
  • Female
  • Gastroenteritis / epidemiology
  • Gastroenteritis / virology
  • Genotype
  • Humans
  • Infant
  • Infant, Newborn
  • Kenya / epidemiology
  • Male
  • Phylogeny
  • Prevalence
  • Rotavirus / classification
  • Rotavirus / genetics*
  • Rotavirus / immunology
  • Rotavirus / isolation & purification
  • Rotavirus Infections / epidemiology
  • Rotavirus Infections / virology*
  • Rotavirus Vaccines / administration & dosage*
  • Rotavirus Vaccines / genetics
  • Rotavirus Vaccines / immunology
  • Vaccination
  • Vaccines, Attenuated / administration & dosage
  • Vaccines, Attenuated / genetics
  • Vaccines, Attenuated / immunology

Substances

  • RIX4414 vaccine
  • Rotavirus Vaccines
  • Vaccines, Attenuated