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Rotavirus A Infections in Community Childhood Diarrhea in the Brazilian Semiarid Region During Post-Vaccination Era

Pankov, Rafaela C.*; Gondim, Rafhaella N.D.G.*; Prata, Mara M.G.*; Medeiros, Pedro H.Q.S.*; Veras, Herlice N.*; Santos, Ana K.S.*; Havt, Alexandre*; da Silva, Marcelle F.M.; Fumian, Tulio M.; Miagostovich, Marize P.; Leite, José P.G.; Lima, Aldo A.M.*

Journal of Pediatric Gastroenterology and Nutrition: June 17, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002416
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Background: Rotavirus A (RVA) is one of the leading causes of acute gastroenteritis worldwide; however, few studies assessed RVA genetics with community surveillance.

Objectives: This study aimed to investigate clinical data, genetic diversity, and coinfection patterns of RVA infections in children from 2–36 months old with or without community childhood diarrhea in the Brazilian semiarid region during post-vaccination era.

Methods: We enrolled and collected socioeconomic/clinical information using a standardized questionnaire and fecal samples from 291 children. Viral RNA samples were extracted and analyzed using RT-qPCR to establish the diagnosis of RVA. Sequencing of VP7 and VP4 (VP8*) regions and phylogenetic analysis were performed.

Results: RVA-negative diagnosis was associated with children 24–36 months old with complete vaccination schedule. Genotype G1P[8] was the most prevalent (57%), while unusual genotypes including G1P[4], G2P[8], G3P[9] were also detected. G1 and P[8] positive samples showed high degrees of similarity with the vaccine strain. RVA coinfections were frequently observed, and enteroaggregative Escherichia coli was the most prevalent copathogen.

Conclusions: These results demonstrate that Genotype G1P[8] is the most prevalent strain. VP7 and/or VP8* gene segments arising from RV1 vaccine strain were documented in these children, suggesting shedding or herd vaccination. Moreover, our study indicates full vaccination is important for protection against RVA infections.

*Institute of Biomedicine & Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.

Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

Address correspondence and reprint requests to Rafaela C. Pankov, R. Cel. Nunes de Melo, 1315, Rodolfo Teófilo, Fortaleza, CEP 60.430-270, CE, Brazil, Institute of Biomedicine, Faculty of Medicine, Federal University Of Ceará, Fortaleza, CE, Brazil (. e-mail: rafaelacpankov@gmail.com).

Received 16 January, 2019

Accepted 18 May, 2019

Conflict of Interest: The authors have no conflicts of interest to disclose.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,