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Multicenter Study
. 2017 Aug 1;216(3):305-316.
doi: 10.1093/infdis/jix199.

Rotavirus Infection and Disease in a Multisite Birth Cohort: Results From the MAL-ED Study

Venkata Raghava Mohan  1 , Ramanujam Karthikeyan  2 , Sudhir Babji  2 , Monica McGrath  3 , Sanjaya Shrestha  4   5 , Jasmin Shrestha  4   5 , Estomih Mdumah  6 , Caroline Amour  6 , Amidou Samie  7 , Emanuel Nyathi  7 , Rashidul Haque  8 , Shahida Qureshi  9 , Pablo Peñataro Yori  10   11 , Aldo A M Lima  12 , Ladaporn Bodhidatta  4   5 , Erling Svensen  6 , Pascal Bessong  7 , Tahmeed Ahmed  8 , Jessica C Seidman  3 , Anita K M Zaidi  9 , Margaret N Kosek  10   11 , Richard L Guerrant  13 , Jean Gratz  13 , James A Platts-Mills  13 , Dennis R Lang  14 , Michael Gottlieb  14 , Eric R Houpt  13 , Gagandeep Kang  2 ; Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) Network Investigators
Affiliations
Multicenter Study

Rotavirus Infection and Disease in a Multisite Birth Cohort: Results From the MAL-ED Study

Venkata Raghava Mohan et al. J Infect Dis. .

Abstract

Background: In a multicountry birth cohort study, we describe rotavirus infection in the first 2 years of life in sites with and without rotavirus vaccination programs.

Methods: Children were recruited by 17 days of age and followed to 24 months with collection of monthly surveillance and diarrheal stools. Data on sociodemographics, feeding, and illness were collected at defined intervals. Stools were tested for rotavirus and sera for antirotavirus immunoglobulins by enzyme immunoassays.

Results: A total of 1737 children contributed 22646 surveillance and 7440 diarrheal specimens. Overall, rotavirus was detected in 5.5% (408/7440) of diarrheal stools, and 344 (19.8%) children ever had rotavirus gastroenteritis. Household overcrowding and a high pathogen load were consistent risk factors for infection and disease. Three prior infections conferred 74% (P < .001) protection against subsequent infection in sites not using vaccine. In Peru, incidence of rotavirus disease was relatively higher during the second year of life despite high vaccination coverage.

Conclusions: Rotavirus infection and disease were common, but with significant heterogeneity by site. Protection by vaccination may not be sustained in the second year of life in settings with high burdens of transmission and poor response to oral vaccines.

Keywords: children; efficacy; gastroenteritis; rotavirus; vaccine.

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Figures

Figure 1.
Figure 1.
Survival curves for age at first rotavirus infection across the MAL-ED sites. Abbreviations: BGD, Dhaka, Bangladesh; BRF, Fortaleza, Brazil; INV, Vellore, India; NEB, Bhaktapur, Nepal; PEL, Loreto, Peru; PKN, Naushero Feroze, Pakistan; RV, rotavirus; SAV, Venda, South Africa; TZH, Haydom, Tanzania.
Figure 2.
Figure 2.
Incidence rates of subsequent rotavirus infection and diarrhea in the MAL-ED cohort. Abbreviations: BGD, Dhaka, Bangladesh; BRF, Fortaleza, Brazil; INV, Vellore, India; NEB, Bhaktapur, Nepal; PEL, Loreto, Peru; PKN, Naushero Feroze, Pakistan; SAV, Venda, South Africa; TZH, Haydom, Tanzania.
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