Mustafa Kiren, Faryal Rani, Alam Muhammad Masroor, Rana Suleman, Umair Massab, Shah Tawaf Ali
Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan.
Department of Microbiology, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan.
PLoS One. 2025 May 20;20(5):e0324037. doi: 10.1371/journal.pone.0324037. eCollection 2025.
Group A rotavirus (RVA) associated gastroenteritis is a major cause of infantile morbidity and mortality, globally. Pakistan had the highest rates of gastroenteritis among kids, every year. Our study aimed to assess the RVA disease burden and circulating genotypes in Rawalpindi, before the vaccine's introduction in Pakistan. Stool samples were collected from children < 5 years of age admitted at Benazir Bhutto Hospital, Rawalpindi, from November 2014 to May 2015. Of the 300 stool samples, 47% of children were found positive for RVA antigen on ELISA, with the highest prevalence (52%) in infants less than 7 months of age. Rotavirus positive cases through real-time PCR were 65.5%. Fever and diarrhea were significantly related to RVA infection when compared to RVA-negative cases (P = 0.02). It is the first report on an upsurge of G12P[6] (17.24%) along with the rise of previously declining G3 in the current epidemiological area. The other prevalent types were G1P[8] (12.07%), G1P[4] (6.90%), G1P[6] (5.17%), G3P[6] (5.17%), followed by G2P[6], G3P[4], G9P[4], and G12P[8] each found with a prevalence of (3.45%). This study reports G3P[4], G3P[6] and G12P[4] for the first time in Pakistan. Mixed genotype infections were found in 21% of cases. G12P[6], which was the predominant genotype in this study, was found to be significantly associated with fever (P = 0.03). This study provides valuable data on the significantly highest prevalence of RVA-associated gastroenteritis in kids of Rawalpindi, Pakistan, and elucidates the vast diversity of circulating RVA genotypes. The reported disease burden, genotypes, and clinical symptoms would enable public health dealers to cope with the severity of the disease. It also provides an evolutionary trend of changing genotypes in the country.
全球范围内，A组轮状病毒（RVA）相关的肠胃炎是婴幼儿发病和死亡的主要原因。巴基斯坦每年儿童肠胃炎发病率最高。我们的研究旨在评估在巴基斯坦引入轮状病毒疫苗之前，拉瓦尔品第的RVA疾病负担和流行基因型。2014年11月至2015年5月期间，从拉瓦尔品第贝娜齐尔·布托医院收治的5岁以下儿童中采集粪便样本。在300份粪便样本中，酶联免疫吸附测定（ELISA）显示47%的儿童RVA抗原呈阳性，其中7个月以下婴儿的患病率最高（52%）。通过实时聚合酶链反应（PCR）检测，轮状病毒阳性病例占65.5%。与RVA阴性病例相比，发热和腹泻与RVA感染显著相关（P = 0.02）。这是关于当前流行地区G12P[6]（17.24%）激增以及先前下降的G3上升的首份报告。其他流行类型为G1P[8]（12.07%）、G1P[4]（6.90%）、G1P[6]（5.17%）、G3P[6]（5.17%），其次是G2P[6]、G3P[4]、G9P[4]和G12P[8]，每种的患病率均为（3.45%）。本研究首次在巴基斯坦报告了G3P[4]、G3P[6]和G12P[4]。21%的病例发现有混合基因型感染。本研究中占主导地位的基因型G12P[6]被发现与发热显著相关（P = 0.03）。本研究提供了关于巴基斯坦拉瓦尔品第儿童中RVA相关肠胃炎显著高发的宝贵数据，并阐明了流行的RVA基因型的巨大多样性。报告的疾病负担、基因型和临床症状将使公共卫生工作者能够应对该疾病的严重性。它还提供了该国基因型变化的进化趋势。
