Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria; Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria.
WHO African Regional Office, Brazzaville, Congo.
Vaccine. 2018 Dec 14;36(51):7759-7764. doi: 10.1016/j.vaccine.2018.03.084. Epub 2018 May 22.
The high burden of rotavirus acute gastroenteritis (AGE) is well documented among children under 5 years of age, with the majority of mortality occurring in developing countries. Nigeria ranked second worldwide in the number of rotavirus deaths in 2013. As Nigeria plans to introduce rotavirus vaccine soon, a pre-vaccine documentation of rotavirus disease burden is necessary to determine vaccine impact.
Routine rotavirus surveillance was conducted during 2011-2016 in 3 sentinel sites in Nigeria using the standard WHO protocol. Children under 5 years of age hospitalized for acute gastroenteritis were enrolled and demographic, clinical and outcome data were collected. A stool sample was subsequently obtained and tested for human rotavirus antigen using the Enzyme-linked immunosorbent assay (ELISA).
2694 children with acute gastroenteritis were enrolled during January 2011 to December 2016; of these, 1242 (46%) tested positive for rotavirus. Among the rotavirus positive cases, 66% and 94% were younger than 12 months and 24 months respectively. Marked peaks in rotavirus positivity were seen in January of each year. Vomiting, and use of oral and intravenous fluids occurred more often in rotavirus positive cases as compared to rotavirus negative cases.
The high prevalence of rotavirus disease highlights the need for urgent introduction of rotavirus vaccine in Nigeria. Additionally, this study provides pre-vaccine introduction disease-burden data that will serve as a baseline for rotavirus vaccine impact-assessment once vaccine has been introduced in the national immunization program.
轮状病毒急性肠胃炎（AGE）给 5 岁以下儿童带来了沉重负担，大部分死亡病例发生在发展中国家。2013 年，尼日利亚的轮状病毒死亡病例数居世界第二位。由于尼日利亚计划即将推出轮状病毒疫苗，因此需要在疫苗接种前评估轮状病毒疾病负担，以确定疫苗的影响。
2011 年至 2016 年期间，在尼日利亚的 3 个哨点采用世卫组织标准方案开展轮状病毒常规监测。5 岁以下因急性肠胃炎住院的儿童被纳入研究，并收集其人口统计学、临床和结局数据。随后采集粪便样本，使用酶联免疫吸附测定（ELISA）检测人轮状病毒抗原。
2011 年 1 月至 2016 年 12 月期间共纳入 2694 名患有急性肠胃炎的儿童；其中 1242 名（46%）轮状病毒检测呈阳性。在轮状病毒阳性病例中，66%和 94%的患儿分别小于 12 个月和 24 个月。每年 1 月轮状病毒阳性率显著升高。与轮状病毒阴性病例相比，轮状病毒阳性病例更常出现呕吐，且更常接受口服和静脉补液治疗。
轮状病毒疾病的高流行率突出表明尼日利亚急需引入轮状病毒疫苗。此外，本研究提供了疫苗接种前的疾病负担数据，一旦疫苗纳入国家免疫规划，这些数据将作为轮状病毒疫苗效果评估的基线。
