Rotavirus Genotypes and Vaccine Effectiveness from a Sentinel, Hospital-Based, Surveillance Study for Three Consecutive Rotavirus Seasons in Lebanon

• Published in: PloS one Vol. 11; no. 8; p. e0161345
• Main Authors: Ali, Zainab, Harastani, Houda, Hammadi, Moza, Reslan, Lina, Ghanem, Soha, Hajar, Farah, Sabra, Ahmad, Haidar, Amjad, Inati, Adlette, Rajab, Mariam, Fakhouri, Hassan, Ghanem, Bassam, Baasiri, Ghassan, Gerbaka, Bernard, Zaraket, Hassan, Matar, Ghassan M., Dbaibo, Ghassan
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 29.08.2016; Public Library of Science (PLoS)
• Subjects: Age; Biochemistry; Biology and Life Sciences; Causes of; Child, Preschool; Children; Cold season; Demographics; Diarrhea; Disease control; Earth Sciences; Ecology and Environmental Sciences; Emergency medical care; Epidemiology; Female; Fever; Gastroenteritis; Genotype; Genotypes; Geographical variations; Hospitalization; Hospitals; Hospitals - statistics & numerical data; Humans; Immunology; Infant; Infant, Newborn; Infectious diseases; Lebanon; Male; Medicine; Medicine and Health Sciences; Nosocomial infections; Pediatrics; People and Places; Physiological aspects; Prevention; Prospective Studies; Proteins; Rotavirus; Rotavirus - genetics; Rotavirus - immunology; Rotavirus - pathogenicity; Rotavirus infections; Rotavirus Infections - diagnosis; Rotavirus Infections - prevention & control; Rotavirus Vaccines - therapeutic use; Seasons; Surveillance; Vaccination; Vaccine efficacy; Vaccines; Viral vaccines; Viruses; Lebanon
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0161345

Globally, rotavirus (RV) is the leading cause of gastroenteritis (GE) in children. Longitudinal data about changes in RV genotype distribution and vaccine effectiveness (VE) are scarce. This study was conducted in Lebanon over 3 consecutive RV seasons to estimate the rate of RVGE hospitalization, identify RV genotypes, determine the seasonal and geographical variations, and calculate RV VE. This prospective, multicenter, hospital-based surveillance study was conducted between 2011 and 2013 and enrolled children (<5 years) admitted for GE. Socio-demographic and clinical data about the current episode of GE at admission were collected. Genotypes were determined from stool samples testing positive for RV by PCR. Of 1,414 cases included in the final analysis, 83% were <2 years old and 55.6% were boys. Median duration of hospitalization was 4 days and 91.6% of GE cases were severe (Vesikari score ≥11). PCR testing showed that 30.3% of subjects were RV-positive of which 62.1% had fever versus 71.1% of RV-negative subjects (P = 0.001). RV was predominantly detected in the cold season from November till March (69.9%). G and P genotype pairs for all RV-positive stool specimens showed a predominance of G1P[8] in 36% (n = 154) of specimens, G9P[8] in 26.4% (n = 113), and G2P[4] in 17.8% (n = 76). RV-negative subjects were more likely to be RV-vaccinated (21%) compared to the RV-positive subjects (11.3%) (P<0.001), with a vaccine breakthrough rate of 18.8%. The ratio of RV1-vaccinated for each RV5-vaccinated subject was 7.8 and VE against RV disease was 68.4% (95%CI, 49.6%-80.2%). RV is a major cause of GE requiring hospitalization of children under 5 years of age in Lebanon. A few genotypes predominated over the three RV seasons studied. Mass RV vaccination will likely decrease the burden of hospitalization due to RV. VE is similar to what has been observed for other middle-income countries.