Epidemiology of rotavirus diarrhoea in Africa: a review to assess the needfor rotavirus immunization

Rapid progress towards the development of rotavirus vaccines has prompted a reassessment of the disease burden of rotavirus diarrhoea in developing co untries and the possible impact of these vaccines in reducing diarrhoeal mo rbidity and mortality among infants and young children. We examined the epi demiology and disease burden of rotavirus diarrhoea among hospitalized and clinic patients in African countries through a review of 43 published studi es of the etiology of diarrhoea. The studies were carried out from 1975 thr ough 1992, and only those in which a sample of more than 100 patients with diarrhoea were specifically screened for rotavirus by using an established diagnostic test were included. Rotavirus was detected in a median of 24% of children hospitalized for diar rhoea and in 23% who were treated as outpatients; 38% of the hospitalized p atients with rotavirus were <6 months and 81% were <1 year of age. Rotaviru s was detected year-round in nearly every country and generally exhibited d istinct seasonal peaks during the dry months. In 5 countries where rotaviru s strains had been G-typed, 74% of strains were of one of the four common s erotypes (GI to G4), GI was the predominant serotype, and 26% were non-type able This cumulative experience from 15 African countries suggests that rot avirus is the most important cause of severe diarrhoea in African children and that most strains in circulation today belong to common G types that ar e included in reassortant vaccines. Wherever large numbers of cases of rota virus diarrhoea occur early in infancy, immunization at birth may protect t he children before their first symptomatic infection.