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The article of choice is “Rotavirus Surveillance in Urban and Rural Areas of Niger, April 2010-March 2012” by Page et al. (2014). This article indicates that severe gastroenteritis and more than 450,000 deaths among children less than 5years of age in less developed countries are attributed to rotavirus. There are four predominant genotypes of rotavirus: G1P, G2P, G3P, and G4P.
The article is a representation of surveillance data in 2 urban areas in Niger. In a country without rotavirus prevention vaccine, 30.6% of children had rotavirus. Children with rotavirus present symptoms of watery diarrhea and dehydration that last for three to7 days (Glass, Parashar, Patel, Gentsch & Jiang, 2014). The disease is mainly mild, and immunoassay is used to detect the rotaviral antigen in the stool because a specific diagnosis is rarely made.
Rotavirus enters the host’s body orally and replicates in the villous epithelium of the ileum. The gastrointestinal tract and fecal matter are the reservoirs of the rotavirus, but, in a study by Page et al. (2014), the numbers of rotavirus-positive specimens were lower in relation to rectal swab samples in comparison to stool samples (DOI: 10.3201/eid2004.131328). Rotavirus is transmitted through various channels: fecal-to-oral, person-to-person contact, and surfaces or equipment contaminated by stool, which is highly concentrated with rotavirus.
The seasonality of the rotavirus in relation to climate has not been fully established due to controversial results on the same. Some studies show no relationship between rotavirus infection and season, but most studies indicate that that rotavirus GE mainly occurs during the winter.
It is, however, important to note that the first epidemiological examination of rotavirus was observed in the temperate regions, and it was noted that most admissions due to diarrhea were distinct during the winter as opposed to the summer and fall. Rotavirus has a higher prevalence among children less than five years, with a peak in children between 6 months and two years (Glass, Parashar, Patel, Gentsch & Jiang, 2014).
There is no cure for rotavirus, but a preventative approach is imperative. Immunization with the rotavirus vaccine is useful in the prevention of rotavirus gastroenteritis (GE). The World Health Organization has prequalified two vaccines for rotavirus: Rotarix and Rotateq. The low income and middle-income countries are worst hit by this virus; hence, the two vaccines are largely used in these countries.
Some literature suggests that high levels of hygiene and sanitation are important to avoid the contamination of food, water, and surfaces with rotavirus. On the contrary Glass, Parashar, Patel, Gentsch & Jiang (2014) are of the opinion that hygiene and sanitation have no effect on rotavirus spread since children in both low resource settings and industrialized countries suffer from the virus early in their lives (p. S10). More research is required to verify these controversial opinions.
In Africa, only 12 countries are included in the surveillance network as per the surveillance regulations derived from the WHO protocol. I believe that these protocols are applied in other regions as well, and there is a need for literature to clarify this. The criteria used to select the African Rotavirus Surveillance Network include (Mwenda et al., 2012, p. S7):
- Existence of a high-quality Expanded Program for Immunization alongside introducing novel vaccines such as those against H. influenza type b to enhance the efficacy
- National commitment to engage resources to disease surveillance by health professionals and policy-makers
- A participant in other AFRO supported disease surveillance networks such as polio and measles
- An already well-established capacity for disease surveillance, in the country
According to Mwenda et al. (2010), ten enrolled surveillance networks have initiated surveillance activities, but only 8 have data for at least one year. More efforts to enhance surveillance of the disease should be emphasized to foster successful disease monitoring.
References
Glass, R. I., Parashar, U., Patel, M., Gentsch, J., Jiang, B. (2014). Rotavirus vaccines: Successes and challenges. Journal of Infection, 68, S9-S18.
Mwenda, J. M., Ntoto, K., Abebe, A., Enweronu-Laryea, C., Amina, I., Mchomvu, J., … Steele, A. (2010). Burden and epidemiology of rotavirus diarrhea in selected African countries: Preliminary results from the African Rotavirus Surveillance Network. The Journal of Infectious Diseases, 202(Supplement 1), S5-S11.
Page, A. L., Jusot, V., Mamaty, A. A., Adamou, L., Kaplon, J., Pothier, P.,…Grais, R. F. (2014). Rotavirus surveillance in urban and rural areas of Niger, April 2010–March 2012. Emerging Infectious Diseases. doi: 10.3201/eid2004.131328
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