Instituto Evandro Chagas, Secretaria de Vigilância em Saúde, Virology Section. Belém, Brazil.
Rev Med Virol. 2011 Mar;21(2):89-109. doi: 10.1002/rmv.682. Epub 2011 Mar 7.
The efficacy of licensed rotavirus vaccines has only been shown against certain rotavirus group A (RV-A) types. It is critical to understand the burden of rotavirus gastroenteritis (RVGE) and its prevalent types to assess the potential impact of these vaccines in Latin America and the Caribbean (LA&C). We performed a systematic review and meta-analyses of all the available evidence reported from 1990 to 2009 on the burden of rotavirus disease and strains circulating in LA&C. Eligible studies--185 country-level reports, 174 951 faecal samples--were selected from MEDLINE, Cochrane Library, EMBASE, LILACS, regional Ministries of Health, PAHO, regional proceedings, doctoral theses, reference lists of included studies and consulting experts. Arc-sine transformations and DerSimonian-Laird random-effects model were used for meta-analyses. The proportion of gastroenteritis cases due to rotavirus was 24.3% (95%CI 22.3-26.4) and the incidence of RVGE was 170 per 1000 children-years (95%CI 130-210). We estimated a global annual mortality for 22 countries of 88.2 (95%CI 79.3-97.1) deaths per 100 000 under 5 years (47 000 deaths).The most common G type detected was G1 (34.2%), followed by G9 (14.6%), and G2 (14.4%). The most common P types detected were P[8] (56.2%), P[4] (22.1%) and P[1] 5.4%, and the most prevalent P-G type associations were P[8]G1 17.9%, P[4]G2 9.1% and P[8]G9 8.8%. In the last 10 years, G9 circulation increased remarkably and G5 almost disappeared. More recently, G12 appeared and P[4]G2 re-emerged. To our knowledge, this is the first meta-analysis of rotavirus infection and burden of disease in LA&C.
已获许可的轮状病毒疫苗的功效仅在针对某些轮状病毒 A 组（RV-A）型方面得到证实。了解轮状病毒胃肠炎（RVGE）的负担及其流行类型对于评估这些疫苗在拉丁美洲和加勒比地区（LA&C）的潜在影响至关重要。我们对 1990 年至 2009 年期间从 LA&C 地区报告的所有有关轮状病毒疾病负担和流行株的现有证据进行了系统评价和荟萃分析。从 MEDLINE、Cochrane 图书馆、EMBASE、LILACS、区域卫生部、泛美卫生组织、区域会议、博士论文、纳入研究的参考文献列表和咨询专家中选择了合格的研究 - 185 项国家级报告，174951 份粪便样本。使用反正弦变换和 DerSimonian-Laird 随机效应模型进行荟萃分析。轮状病毒引起的胃肠炎病例比例为 24.3%（95%CI 22.3-26.4），RVGE 的发病率为每 1000 名儿童年 170 例（95%CI 130-210）。我们估计，22 个国家的全球年死亡率为每 10 万名 5 岁以下儿童 88.2 例（95%CI 79.3-97.1）死亡（47000 例死亡）。检测到的最常见 G 型是 G1（34.2%），其次是 G9（14.6%）和 G2（14.4%）。检测到的最常见 P 型是 P[8]（56.2%）、P[4]（22.1%）和 P[1]5.4%，最常见的 P-G 型关联是 P[8]G1 17.9%、P[4]G2 9.1%和 P[8]G9 8.8%。在过去 10 年中，G9 的传播显着增加，G5 几乎消失。最近，G12 出现了，P[4]G2 再次出现。据我们所知，这是对 LA&C 轮状病毒感染和疾病负担的首次荟萃分析。
