TRENDS IN GROUP A ROTAVIRUS GENOTYPES AMONG CHILDREN ADMITTED FOR ACUTE DIARRHEA IN YAOUNDE CAMEROON

Nadesh Taku Ashukem (takuashukem@yahoo.com)
Pédiatrie, Université de Yaoundé I
June, 2013
 
Bsc Biochemistry
Bsc Clinical Biology
Master's II Infectiouus Diseases-FMBS
 

Abstract

Background: Group A rotavirus causes diarrhea in children and thus constitutes a significant burden in pediatric disease. Knowledge of the different rotavirus G and P genotypes is indispensible for the development and implementation of a rotavirus vaccine in Cameroon.
Aim: The main objective of this study was to determine the trends of circulating group A rotavirus strains in Cameroon from 1999 – 2012. Added to this, we determined the severity of rotavirus diarrheain children < 5 years in Yaounde during the first quarter of 2013, then we determined the diversity of the VP4 and VP7 genotypes of group A rotavirus among children admitted for acute diarrhea in Yaounde, during the first quarter of 2013 so as to inform policy on rotavirus infection for rotavirus vaccine introduction in Cameroon.
Method:In the first part of the study, we did a review of literature on published and accessible unpublished works since 1999 on group A rotavirus genotypes in children <5 years in Cameroon. Data was collected from the NCBI website, the registers at the rotavirus surveillance site and from resource persons based at the rotavirus surveillance site in Cameroon. The second part was a cross-sectional study describing the rotavirus G and P genotypes in the first quarter of 2013 at the rotavirus surveillance site based at the mother and child center of the Chantal Biya foundation. Stool samples were collected from 3 hospitals of Yaoundé: The mother and child center of the Chantal Biya foundation, the Gynaeco- obstetric and Pediatric hospital of Yaounde and the Biyem- Assi district hospital.Group ARotavirus was identified by enzyme-linked immunosorbent assay (ELISA), and genotypes were determined by reverse-transcription polymerase chain reaction (RT-PCR) analysis of stool samples for which ELISA results were positive.
Results: The retrospective part of this study showed that the first study on group A rotavirus genotypes was done in 1999 in the West and South-West regions of Cameroon. Other studies were done in the North-West, Far North and Centre regions of Cameroon. The predominant G genotype was G1(25.4%), followed by G3(15%) and G2(14%). The predominant P genotype was P[8](42.4%),followed by P[6](30.2%) and P[4](10.5%). A great diversity of rotavirus strains were observed among G1P[8](14.4%) and G3P[6](9.1%) were predominant. GiP[8] was predominant in the West South-West and Centre regions of Cameroon whereas G12P[8] was predominant in the North-West and Far-North regions of Cameroon.
For the cross-sectional part, a total of 260 stool samples from children <5 years hospitalized for acute gastro enteritis was collected and analyzed for group A rotavirus. The mean (±SD) age of the study participants was 9.15±6.819 months. The highest stool samples came from children in the age group of 6- 8 months. There were 126 (48.46%) males and 134 (51.54%) females. Our study showed a rotavirus prevalence of 46.53% and 72.7% of the participants positive to group A rotavirus had severe diarrhea according to the Vesikari severity scoring scale for diarrhea.G1 (40.5%) was the most predominant G genotype followed by G3 (30.6%). G12 (0.8%) was the least. The most predominant P genotype was P6 (61.2%) followed by P8 (33.1%) and the least was P4 (0.8%). G1P[8] and G3P[6] were the most predominant G/P combinations with 28.9% each. G1P[4], G1P[6]/P[8], G2P[8], G2P[NT], G12P[8], GNTP[8], G2/G4P[6], G1/G3P[6] were the least present at 0.8% each.
Conclusions: G1P[8] and G3P[6] are the most circulating group A rotavirus strains in Cameroon. The strains of rotavirus circulating in Cameroon fit into the two rotavirus vaccines recommended by the WHO to all countries for routine immunization. This study provides comprehensive up-to-date information on rotavirus strain surveillance in Cameroon and provides a useful background for the introduction of rotavirus vaccine.


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