Department of Medical Research, Ministry of Health and Sports, Myanmar.
Department of Medical Research, Ministry of Health and Sports, Myanmar.
Vaccine. 2018 Dec 14;36(51):7832-7835. doi: 10.1016/j.vaccine.2017.11.002. Epub 2017 Dec 20.
Rotavirus is the leading cause of severe acute gastroenteritis (AGE) in children <5 years of age in Myanmar. The purpose of this analysis is to report from the sentinel surveillance system for rotavirus gastroenteritis (RVGE), which collects information on the epidemiology and circulating genotypes to assess the disease burden and support vaccine introduction in Myanmar.
Prospective, active surveillance for RVGE-associated hospitalizations was conducted during 2009 -2014 at Yangon Children's Hospital. Stool samples collected from children <5 years of age admitted for AGE were screened for rotavirus antigen by ELISA (ProSpecT™ Rotavirus, OXOID-UK). G and P genotyping was performed by reverse transcription polymerase chain reaction.
Overall, 1860/3724 (49.9%) of stool samples tested positive for rotavirus, ranging from 42-56% of hospitalized AGE cases each year. RVGE was predominant in the 6-11 months age group 889/1860 (47.8%) as compared with 12-23 months 633/1860 (34.0%), 0-5 months 226/1860 (12.2 %) and 24-59 months 112/1860 (6.0%). RVGE occurred in a seasonal cycle with peak occurrence in the cold and dry months (November to February), accounting for 65.3% (1151/1763) among enrolled AGE cases. Vomiting (84.1% Vs 67.9%; P < .01), fever (84.5% Vs 75.6%; P < .01) and dehydration (78% Vs 69%; P < .01) were more frequently observed in RVGE than non-RVGE. Genotyping revealed that G1P[8] was predominant from January to June 2009, G12P[8] was predominant throughout 2009-2012 which was replaced in 2012-2013 by G2P[4] and changed again to G1P[8] in 2013-2014 and G9P[8] in late 2014.
Rotavirus is accounting for approximately half of AGE-associated hospitalizations among children <5 years of age in Myanmar. There is immense diversity of rotavirus strains similar to that reported previously for other countries in the region. Information gained from this surveillance system highlights consideration of rotavirus vaccine introduction into this target population.
轮状病毒是导致缅甸 5 岁以下儿童严重急性胃肠炎（AGE）的主要原因。本分析报告来源于轮状病毒胃肠炎（RVGE）监测系统，该系统收集有关流行病学和循环基因型的信息，以评估疾病负担并支持疫苗在缅甸的引入。
2009 年至 2014 年，仰光儿童医院对 RVGE 相关住院患者进行了前瞻性、主动监测。采集年龄<5 岁因 AGE 住院的儿童粪便样本，通过 ELISA（ProSpecT™ Rotavirus，OXOID-UK）检测轮状病毒抗原。通过逆转录聚合酶链反应进行 G 和 P 基因分型。
总体而言，3724 份粪便样本中 1860 份（49.9%）检测出轮状病毒阳性，每年住院 AGE 病例中轮状病毒阳性率在 42%-56%之间。与 12-23 月龄（34.0%）、0-5 月龄（12.2%）和 24-59 月龄（6.0%）相比，6-11 月龄（47.8%）儿童中 RVGE 更为常见。RVGE 呈季节性发病，高峰出现在寒冷干燥月份（11 月至 2 月），占纳入 AGE 病例的 65.3%（1151/1763）。呕吐（84.1%比 67.9%；P<0.01）、发热（84.5%比 75.6%；P<0.01）和脱水（78%比 69%；P<0.01）在 RVGE 中比非 RVGE 更常见。基因分型显示，2009 年 1 月至 6 月以 G1P[8]为主，2009 年全年至 2012 年以 G12P[8]为主，2012 年至 2013 年被 G2P[4]取代，2013 年至 2014 年再次变为 G1P[8]，2014 年晚期变为 G9P[8]。
轮状病毒约占缅甸 5 岁以下儿童 AGE 相关住院病例的一半。轮状病毒株的多样性很大，与该地区其他国家此前报道的相似。该监测系统提供的信息强调了在该目标人群中引入轮状病毒疫苗的考虑。
