ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India.
Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Vaccine. 2020 Dec 3;38(51):8154-8160. doi: 10.1016/j.vaccine.2020.10.084. Epub 2020 Nov 7.
Rotavirus is an important cause of severe diarrhea requiring hospitalization, accounting for approximately 78,000 deaths annually in Indian children below 5 years of age. We present epidemiological data on severe rotavirus disease collected during hospital-based surveillance in India before the introduction of the oral rotavirus vaccine into the national immunization schedule.
The National Rotavirus Surveillance Network was created involving 28 hospital sites and 11 laboratories across the four geographical regions of India. From September 2012 to August 2016 children less than 5 years of age hospitalized for diarrhea for at least 6 h, were enrolled. After recording clinical details, a stool sample was collected from each enrolled child, which was tested for rotavirus antigen using enzyme immunoassay (EIA). Nearly 2/3rd of EIA positive samples were genotyped using reverse transcription polymerase chain reaction to identify the G and P types.
Of the 21,421 children enrolled during the 4 years surveillance, 36.3% were positive for rotavirus. The eastern region had the highest proportion of rotavirus associated diarrhea (39.8%), while the southern region had the lowest (33.8%). Rotavirus detection rates were the highest in children aged 6-23 months (41.8%), and 24.7% in children aged < 6 months. Although rotavirus associated diarrhea was seen throughout the year, the highest positivity was documented between December and February across all the regions. The most common rotavirus genotype was G1P[8] (52.9%), followed by G9P4 (8.7%) and G2P4 (8.4%).
There is high burden of rotavirus gastroenteritis among Indian children below 5 years of age hospitalized for acute diarrhea thereby highlighting the need for introduction of rotavirus vaccine into the national immunization program and also for monitoring circulating genotypes.
轮状病毒是导致严重腹泻并需要住院治疗的重要原因，在印度，每年约有 7.8 万名 5 岁以下儿童因此死亡。本研究报告了在口服轮状病毒疫苗纳入国家免疫计划之前，通过在印度医院进行的基于监测收集的严重轮状病毒疾病的流行病学数据。
创建了国家轮状病毒监测网络，涉及印度四个地理区域的 28 个医院点和 11 个实验室。2012 年 9 月至 2016 年 8 月，年龄在 5 岁以下、因腹泻住院至少 6 小时的儿童纳入研究。记录临床详细信息后，从每个入组儿童采集粪便样本，使用酶联免疫吸附试验（EIA）检测轮状病毒抗原。使用逆转录聚合酶链反应（RT-PCR）对近 2/3 的 EIA 阳性样本进行基因分型，以确定 G 和 P 型。
在 4 年的监测中，共有 21421 名儿童入组，其中 36.3%轮状病毒检测阳性。东部地区轮状病毒相关腹泻的比例最高（39.8%），而南部地区最低（33.8%）。6-23 月龄儿童的轮状病毒检出率最高（41.8%），6 月龄以下儿童的检出率为 24.7%。虽然轮状病毒相关腹泻全年均可见，但所有地区 12 月至 2 月的阳性率最高。最常见的轮状病毒基因型是 G1P[8]（52.9%），其次是 G9P4（8.7%）和 G2P4（8.4%）。
印度 5 岁以下急性腹泻住院儿童轮状病毒胃肠炎负担沉重，这突出表明需要将轮状病毒疫苗纳入国家免疫规划，并监测循环基因型。
