Saikia Kasturi, Ahmed Riya, Das Birupaksha, Paul Sourav, Ray Suvendra Kumar, Chandra Deka Ramesh, Borah Partha Pratim, Saharia Niruprabha, Namsa Nima D
Department of Molecular Biology and Biotechnology, Tezpur University, Napaam, India.
Department of Biotechnology, National Institute of Technology, Durgapur, India.
Rev Med Virol. 2025 Sep;35(5):e70066. doi: 10.1002/rmv.70066.
Rotavirus (RV) is a major aetiology of childhood gastroenteritis worldwide. It is crucial to understand the hospital-based RV disease prevalence and its spatio-temporal genotype distribution during the period pre-and post-introduction of RV vaccines in India. A systematic review and meta-analysis were performed to extract information on literature related to the impact of vaccination on rotavirus disease prevalence and the distribution of genotypes from 1986 to 2022. A search for relevant articles was carried out in public databases (PubMed, Google Scholar, and ScienceDirect) to extract specific information on RV prevalence among children less than 5 years of age and the genotype distribution from 1986 to 2022. DerSimonian-Laird random-effects model was employed to account for the heterogeneity of included studies analysed using meta-analysis and publication bias was assessed using funnel plot and Egger linear regression test. Of the 1939 records identified through screening and after removing duplicate records, the full texts of 1609 records were assessed for eligibility. After the full-text assessment, 49 records were found eligible and included in the study. The estimated pooled prevalence of RV-associated gastroenteritis during the pre-vaccine period was 33% {(95% confidence interval (CI), 28%-38%)} while the prevalence was 23% (95% CI, 18%-29%) in the post-vaccine period. Rotaviruses are classified into genotypes by their G-(glycoprotein VP7) and P-(protease-sensitive VP4) proteins. Combination of genotype G1 and P[8] that is G1P[8] predominated during the pre- and post-vaccine period, while the prevalence of G3P[8] increased after immunisation. The dominant genotypes in pre-vaccine era were G1 and G2 while G1 and G3 after vaccine inclusion, with a constant circulation of P[8] during the entire period from 1986 to 2022. Occurence of G2 increased post-vaccination in western zone of India. As observed from the meta-regression analysis, rotavirus vaccination has significantly reduced gastroenteritis associated hospitalizations and death. The spatio-temporal change in the genotype distribution in the post-vaccination era warrants the need for further surveillance studies to provide information on RV-associated hospital visits. Additionally, this will also provide information on detection of emerging strains that can assist in designing future policies for the implementation and development of new-generation vaccines against rotavirus disease.
轮状病毒（RV）是全球儿童肠胃炎的主要病因。了解印度引入RV疫苗前后基于医院的RV疾病患病率及其时空基因型分布至关重要。我们进行了一项系统综述和荟萃分析，以提取1986年至2022年期间与疫苗接种对轮状病毒疾病患病率的影响以及基因型分布相关的文献信息。我们在公共数据库（PubMed、谷歌学术和科学Direct）中搜索相关文章，以提取关于5岁以下儿童RV患病率和1986年至2022年基因型分布的具体信息。采用DerSimonian-Laird随机效应模型来解释使用荟萃分析的纳入研究的异质性，并使用漏斗图和Egger线性回归检验评估发表偏倚。在通过筛选确定并去除重复记录后的1939条记录中，对1609条记录的全文进行了资格评估。经过全文评估，发现49条记录符合资格并纳入研究。疫苗接种前时期RV相关肠胃炎的估计合并患病率为33%{（95%置信区间（CI），28%-38%）}，而疫苗接种后时期患病率为23%（95%CI，18%-29%）。轮状病毒根据其G-（糖蛋白VP7）和P-（蛋白酶敏感VP4）蛋白分为不同基因型。基因型G1和P[8]的组合即G1P[8]在疫苗接种前后时期占主导地位，而免疫后G3P[8]的患病率增加。疫苗接种前时代的主要基因型是G1和G2，而疫苗纳入后是G1和G3，在1986年至2022年的整个时期P[8]持续流行。印度西部地区接种疫苗后G2的发生率增加。从荟萃回归分析中观察到，轮状病毒疫苗接种显著减少了与肠胃炎相关的住院和死亡。疫苗接种后时代基因型分布的时空变化需要进一步的监测研究，以提供关于RV相关医院就诊的信息。此外，这也将提供关于新兴毒株检测的信息，有助于设计针对轮状病毒疾病的新一代疫苗的实施和开发的未来政策。
