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CC BY 4.0 · Journal of Child Science 2020; 10(01): e110-e118
DOI: 10.1055/s-0040-1716374
Original Article

Group A Rotavirus G1P[6] Associated Fatalities in Diarrheic Nigerian Infants, Possible Impact of Enterovirus Environmental Enteric Dysfunction, and Implications for Rota-Vaccinology

Michael Oluyemi Babalola 
1   Infectious Diseases Epidemiology, Virology and Special Pathogens Research. Department of Microbiology, Adekunle Ajasin University, Ondo State, Nigeria
2   Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan Nigeria
› Author Affiliations Funding None.
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Abstract

Group A rotavirus (RVA) diarrhea disease and mortality are yet unabated, particularly in developing countries. As global knowledge of specific strains associated with infant mortality is crucial for successful vaccination efforts, candidate RVA strains detected in mortality and fatal cases of severely diarrheic hospitalized infants in Akure, Nigeria were investigated.

Fecal samples from comatose patients were tested for RVAs, other diarrhea viruses, and enteric bacterial pathogens. Genomic dsRNA was extracted from 10% rotavirus positive stool suspension, the VP4 and VP7 genes were reverse transcribed and amplified by one-step reverse transcription polymerase chain reaction (PCR) and genotyped by seminested multiplex PCR. Amplicons were sequenced, aligned by ClustalW, and phylogenetic analyses were conducted in MEGA6. Sequences data were deposited to GenBank and DDBJ.

Medical examination and microbiological analyses upheld viral diarrhea. EIA revealed RVA and enterovirus. PCR identified virulent RVA strain GIP[6] whose VP7 nucleotide sequences shared a common cluster with Cuban isolate G1P[6], while the VP4 P[6] sequences were related to Asian strains. Reassortant RVA G1P[6] was found in fatal diarrhea cases and mortality of a Nigerian child. RVA coinfection with enterovirus and associated biomarkers of environmental enteric dysfunction in infantile diarrhea should henceforth be evaluated. Current rotavirus vaccines may fare badly against the prevailing virulent strains. The disease severity and outcome necessitates a wider epidemiological study, a review and inclusion of the P[6] genotype in future rotavirus vaccines.

Keywords

Nigerian - infant - G1P[6] - mortality - group A rotavirus - enterovirus EED


Publication History

Received: 11 October 2019

Accepted: 10 July 2020

Article published online:
23 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 WHO. Under-five mortality. Global Health Observatory (GHO) data. Available at https://www.who.int/gho/child_health/mortality/mortality_under_five/en/ . Accessed 2017
    PubMedGoogle Scholar
  • 2 Platts-Mills JA, Liu J, Rogawski ET. et al. MAL-ED Network Investigators. Use of quantitative molecular diagnostic methods to assess the aetiology, burden, and clinical characteristics of diarrhoea in children in low-resource settings: a reanalysis of the MAL-ED cohort study. Lancet Glob Health 2018; 6 (12) e1309-e1318
    CrossrefPubMedGoogle Scholar
  • 3 Troeger C, Khalil IA, Rao PC. et al. Rotavirus vaccination and the global burden of rotavirus diarrhea among children younger than 5 years. JAMA Pediatr 2018; 172 (10) 958-965
    CrossrefPubMedGoogle Scholar
  • 4 Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD. WHO-coordinated Global Rotavirus Surveillance Network. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis 2012; 12 (02) 136-141
    CrossrefPubMedGoogle Scholar
  • 5 Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis 2003; 9 (05) 565-572
    CrossrefPubMedGoogle Scholar
  • 6 Parashar UD, Gibson CJ, Bresee JS, Glass RI. Rotavirus and severe childhood diarrhea. Emerg Infect Dis 2006; 12 (02) 304-306
    CrossrefPubMedGoogle Scholar
  • 7 Taniguchi M, Platts-Mills JA, Begum S. et al. Impact of enterovirus and other enteric pathogens on oral polio and rotavirus vaccine performance in Bangladeshi infants. Vaccine 2016; 34 (27) 3068-3075
    CrossrefPubMedGoogle Scholar
  • 8 Parker EPK, Ramani S, Lopman BA. et al. Causes of impaired oral vaccine efficacy in developing countries. Future Microbiol 2018; 13: 97-118
    CrossrefPubMedGoogle Scholar
  • 9 Ramakrishnan G, Ma JZ, Haque R, Petri Jr WA. Rotavirus vaccine protection in low-income and middle-income countries. Lancet Infect Dis 2019; 19 (07) 673-674
    CrossrefPubMedGoogle Scholar
  • 10 Tate JE, Burton AH, Bosch-Pinto C, Parashar UD. World Health Organization- coordinated global rotavirus surveillance network: global, regional, and national estimates of rotavirus mortality in children. Clin Infect Dis 2016; 62 (S2): S96-S105
    CrossrefPubMedGoogle Scholar
  • 11 Abiodun PO. Incidence of Rotavirus in acute childhood diarrhea in University of Benin Teaching Hospital. Nig J of Ped 1989; 16: 31-34
    PubMedGoogle Scholar
  • 12 Tagbo BN, Chukwubike C, Mwenda JM. , et al , ICH UNTH Enugu Rotavirus Group. Molecular characterization of rotavirus strains circulating in enugu Nigeria: 2011 to 2016. World Journal of Vaccines 2019; 9: 22-36
    CrossrefPubMedGoogle Scholar
  • 13 Pennap G, Peenze I, De Beer M. et al. Kwaga JKP. VP6 subgroup and VP7 serotype of human rotavirus in Zaria, northern Nigeria. J Trop Pediatr 2000; 46 (06) 344-347
    CrossrefPubMedGoogle Scholar
  • 14 Audu R, Omilabu SA, de Beer M, Peenze I, Steele AD. Diversity of human rotavirus VP6, VP7, and VP4 in Lagos State, Nigeria. J Health Popul Nutr 2002; 20 (01) 59-64
    PubMedGoogle Scholar
  • 15 Steele AD, Nimzing L, Peenze I. et al. Circulation of the novel G9 and G8 rotavirus strains in Nigeria in 1998/1999. J Med Virol 2002; 67 (04) 608-612
    CrossrefPubMedGoogle Scholar
  • 16 Japhet MO, Adesina AO, Famurewa O, Svensson L, Nordgren J. Molecular epidemiology of rotavirus and norovirus in Ile-Ife, Nigeria: high prevalence of G12P[8] rotavirus strains and detection of a rare norovirus genotype. J Med Virol 2012; 84 (09) 1489-1496
    CrossrefPubMedGoogle Scholar
  • 17 Alkali BR, Daneji AI, Magaji AA, Bilbis LS. Clinical symptoms of human rotavirus infection observed in children in Sokoto, Nigeria. Adv Virol 2015; 2015: 890957
    CrossrefPubMedGoogle Scholar
  • 18 Ayolabi CI. Genetic diversity of rotavirus strains in children with diarrhea in Lagos, Nigeria. Asian Pac J Trop Dis 2016; 6 (07) 517-520
    CrossrefPubMedGoogle Scholar
  • 19 Uzoma EB, Chukwubuikem C, Omoyibo E, Tagbo O. Rota virus genotypes and the clinical severity of diarrhoea among children under 5 years of age. Niger Postgrad Med J 2016; 23 (01) 1-5
    CrossrefPubMedGoogle Scholar
  • 20 Babalola MO, Odaibo GN, Olaleye OD, Alonge AO. Enteric adenovirus and norovirus gastroenteritis among under-5 years children in Owo, Ondo State, Nigeria. Br J Med Med Res 2015; 9 (08) 1-9
    CrossrefPubMedGoogle Scholar
  • 21 Durmaz R, Kalaycioglu AT, Acar S. et al. Turkish Rotavirus Surveillance Network. Prevalence of rotavirus genotypes in children younger than 5 years of age before the introduction of a universal rotavirus vaccination program: report of rotavirus surveillance in Turkey. PLoS ONE 2014; 9 (12) e113674
    CrossrefPubMedGoogle Scholar
  • 22 World Health Organization. Manual of rotavirus detection and characterization methods. WHO Document Production Services; Geneva, Switzerland: ; WHO/IVB/ 08.17. 1–147. Available at: www.who.int/vaccines-documents/ (PMID: . Accessed 2009)
    Google Scholar
  • 23 Fischer TK, Gentsch JR. Rotavirus typing methods and algorithms. Rev Med Virol 2004; 14 (02) 71-82
    CrossrefPubMedGoogle Scholar
  • 24 Gouvea V, Glass RI, Woods P. et al. Polymerase chain reaction amplification and typing of rotavirus nucleic acid from stool specimens. J Clin Microbiol 1990; 28 (02) 276-282
    CrossrefPubMedGoogle Scholar
  • 25 Iturriza Gómara M, Kang G, Mammen A. et al. Characterization of G10P[11] rotaviruses causing acute gastroenteritis in neonates and infants in Vellore, India. J Clin Microbiol 2004; 42 (06) 2541-2547
    CrossrefPubMedGoogle Scholar
  • 26 Gentsch JR, Glass RI, Woods P. et al. Identification of group A rotavirus gene 4 types by polymerase chain reaction. J Clin Microbiol 1992; 30 (06) 1365-1373
    CrossrefPubMedGoogle Scholar
  • 27 Tamura K, Stecher G, Peterson D, Filipski A, Kumar S. MEGA6: molecular evolutionary genetics analysis version 6.0. Mol Biol Evol 2013; 30 (12) 2725-2729
    CrossrefPubMedGoogle Scholar
  • 28 Kawamura Y, Miura H, Mori Y. et al. Three infants with rotavirus gastroenteritis complicated by severe gastrointestinal bleeding. J Med Virol 2016; 88 (01) 171-174
    CrossrefPubMedGoogle Scholar
  • 29 Vesikari T, Karvonen A, Prymula R. et al. Efficacy of human rotavirus vaccine against rotavirus gastroenteritis during the first 2 years of life in European infants: randomised, double-blind controlled study. Lancet 2007; 370 (9601): 1757-1763
    CrossrefPubMedGoogle Scholar
  • 30 Iturriza-Gómara M, Dallman T, Bányai K. et al. Rotavirus surveillance in europe, 2005-2008: web-enabled reporting and real-time analysis of genotyping and epidemiological data. J Infect Dis 2009; 200 (Suppl. 01) S215-S221
    CrossrefPubMedGoogle Scholar
  • 31 Ruiz-Palacios GM, Pérez-Schael I, Velázquez FR. et al. Human Rotavirus Vaccine Study Group. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med 2006; 354 (01) 11-22
    CrossrefPubMedGoogle Scholar