Department of International Health, Johns Hopkins University, Baltimore, MD, USA.
Indian Pediatr. 2012 Jun;49(6):467-74. doi: 10.1007/s13312-012-0076-7.
With rotavirus vaccines now available globally, it will be useful to assemble the available evidence on the epidemiology and burden of rotavirus gastroenteritis in India, in order to weigh the urgency of introducing a vaccine to help control rotavirus disease.
We reviewed published studies on rotavirus infection and genotype distribution in India, as well as safety and immunogenicity studies of currently available vaccines. PubMed was searched for papers published after 1990, and several authors who are experts in the field recommended papers of known significance.
Rotavirus accounts for close to 40% of hospitalizations for diarrhea in India, with more recent studies showing an increased proportion compared with older studies. There is substantial serotype diversity in India, although there is less intra-country variation than previously thought. Two genotypes, G1P[8] and G2P[4], account for roughly 50% of symptomatic infections in non-neonates. Currently licensed vaccines are safe, and although the efficacy appears lower in developing countries, given the extremely high incidence of diarrhea these could still be cost-effective interventions.
The epidemiology and burden of rotavirus diarrhea is fairly well characterized in India. Introducing rotavirus vaccine into the UIP, along with adequate surveillance, should be an important part of efforts to reduce diarrhea mortality, the third leading cause of death among Indian children, and achieve the country's MDG goals.
随着全球范围内轮状病毒疫苗的应用，对印度轮状病毒胃肠炎的流行病学和疾病负担进行综合评估将非常有益，这有助于衡量引入疫苗以控制轮状病毒疾病的紧迫性。
我们对印度轮状病毒感染和基因型分布的已发表研究，以及目前可用疫苗的安全性和免疫原性研究进行了综述。通过 PubMed 检索了 1990 年后发表的论文，并且一些该领域的专家推荐了一些具有重要意义的论文。
轮状病毒占印度住院治疗腹泻病例的近 40%，最近的研究显示与早期研究相比，其比例有所增加。印度存在大量的血清型多样性，尽管与之前的想法相比，国内的变异较少。两种基因型 G1P[8]和 G2P[4]占非新生儿症状性感染的大约 50%。目前许可使用的疫苗是安全的，尽管在发展中国家的有效性似乎较低，但鉴于腹泻的极高发病率，这些疫苗仍然可能是具有成本效益的干预措施。
印度的轮状病毒腹泻流行病学和疾病负担特征相当明确。将轮状病毒疫苗纳入 UIP 并进行充分监测，应该是降低印度儿童第三大死因（腹泻）死亡率并实现国家千年发展目标的重要措施。
