Abstract:
Rotavirus is a leading cause of morbidity and mortality among children under five years
old worldwide. Annually in Kenya, rotavirus infection results in 4471 deaths, 8781
hospitalizations, and 1,443,883 clinic visits among children under five years old. This
study aimed to determine the molecular epidemiology and risk factors of rotavirus
infection in children under five years old hospitalized with acute gastroenteritis in
Garissa, Kenya before rotavirus vaccine introduction into the national immunization
programme. Socio-demographic, clinical and risk factor information of each respondent
was collected using a standard questionnaire. Stool specimens were obtained from each
respondent and tested for the presence of rotavirus antigens using Prospect ELISA test
kit following the manufacturer's instruction. Phenotypic and genotypic analysis of the
detected rotaviruses was undertaken using PAGE and RT-PCR respectively. In total, 237
children with acute gastroenteritis were enrolled into the study. Overall rotavirus
prevalence was 17% (n=41). Phenotypically, long RNA electropherotypes were the
predominant rotavirus electropherotypes and genotypically, G3, G9 and P4 were the
predominant rotavirus genotypes. Of the risk factors that were evaluated, under 2 years
old, use of unboiled tap water for drinking, underweight, history of low birth weight and
lack of maternal formal education were identified as independent risk factors of
rotavirus infection. In conclusion, rotavirus is an important aetiology in children under
five years old hospitalized with acute gastroenteritis. Preventable risk factors and
genotypes protectable by Rotarix and Rotateq rotavirus vaccines are found to be
responsible for infection in this region. This study recommends the fastracking of
rotavirus vaccine introduction into the national immunization programme coupled with
supplementary feeding of malnourished infants, safe water supply and public health
education to mothers on hand hygiene during infant feeding. The study also recommends
continuous surveillance of rotavirus disease burden and changes in rotavirus strain
distribution that might impact on the effectiveness of rotavirus vaccines after its
introduction.
