Characterization of Rotavirus among Children under five Years with Gastroenteritis at Kenyatta National Hospital, Kenya

Abstract

Severe diarrhea is a common occurrence among children below the age of five years worldwide, and the major cause remains infection from rotavirus. The mortality from rotaviruses stands at an estimated 215,000 annually worldwide; 200,000 of these being in Africa alone. The main objective of this study was to characterize the strains of rotavirus among children with gastroenteritis below five years at Kenyatta National Hospital Nairobi County. The research design was cross-sectional, and the sample size was 355 participants. The study participants were identified during clinical examination by clinicians in outpatient and inpatient departments. Stool samples were collected and tested for rotavirus using Enzyme Linked Immuno-assay, one step multiplex qRT-PCR genotyping assay and whole genome sequencing using next-generation sequencing. The prevalence of rotavirus was 16.34% (58/355). Rotavirus infection among males was 10.42% (37/355) as compared to those of females 5.91% (21/355). The distribution of Rotavirus between outpatient and inpatient was 9.30% (33/355) outpatient while 7.04% (25/355) inpatient. There was no statistical significance of rotavirus infection between gender, inpatient, and outpatients. The most prevalent G-type being G1 48.3% (28/58), followed by G2 22.41% (13/58), G3 15.51%% (9/58), and G9 5.17%% (3/58) with mixed infections which included G1, 2, 5.17% (3/58) and G2, 3, 1.72% (1/58). The P-type, P [8] 46.55% (27/58) was most prevalent followed by P4 24.13% (14/58) and P [6] 20.68% (12/58). There were mixed infection which includes P [4, 8] 5.17% (3/58), and P [4, 6] 1.72% (1/58). The G-P combination showed that G1 P [8] 41.37% (24/58) was more prevalent followed by G2 P [4] 22.41%, (13/55) G3 P [6] 15.51% (9/58) and G9 [P8] 5.17% (3/58). The mixed infections included G1, 2 P [4, 8] 5.17% (3/58) and G3, 2 P [4, 6] 1.72% (1/58). The study revealed the prevalence of rotavirus has decreases to 16.34% and the most prevalent genotype was G1P[8]. There was no statistical difference in rotavirus infection in regard with gender, inpatient and outpatient. Rotavirus infection affected more males than females. The recommendation of the study is to increase vaccination of rotavirus among children to reduce gastroenteritis caused by rotavirus and frequent surveillance to monitor emerging genotypes.