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. 2021 Aug 6;16(8):e0255720.
doi: 10.1371/journal.pone.0255720. eCollection 2021.

Rotavirus A infection in pre- and post-vaccine period: Risk factors, genotypes distribution by vaccination status and age of children in Nampula Province, Northern Mozambique (2015-2019)

Assucênio Chissaque  1   2 , Adilson Fernando Loforte Bauhofer  1   2 , Idalécia Cossa-Moiane  1   3 , Ezequias Sitoe  4 , Benilde Munlela  1   5 , Eva Dora João  1   2 , Jerónimo S Langa  1 , Jorfélia José Chilaúle  1 , Simone Salvador Boene  1   5 , Marta Cassocera  1   2 , Esperança Lourenço Guimarães  1   2 , Timothy A Kellogg  6 , Luzia Gonçalves  7   8 , Nilsa de Deus  1   9
Affiliations

Rotavirus A infection in pre- and post-vaccine period: Risk factors, genotypes distribution by vaccination status and age of children in Nampula Province, Northern Mozambique (2015-2019)

Assucênio Chissaque et al. PLoS One. .

Abstract

Mozambique introduced the monovalent rotavirus vaccine (Rotarix®, GSK Biologicals, Rixensart, Belgium) in September 2015. Previous analysis, showed that Nampula province continues reporting a high frequency of Rotavirus A (RVA) infection and the emergence of G9P[6], G9P[4] and G3P[4] genotypes. This analysis aimed to determine the RVA frequency; risk factors; genotype distribution by vaccination status and age between pre- and post-vaccine periods in children under-five years old with diarrhea in Nampula. A cross-sectional, hospital-based surveillance study was conducted in the Hospital Central de Nampula in Mozambique. Socio-demographic and clinical data were collected to assess factors related to RVA infection in both periods. Stool specimens were screened to detect RVA by ELISA, and positive samples were genotyped. Between 2015 (pre-vaccine period) and 2016-2019 (post-vaccine period), 614 stool specimens were collected and tested for RVA in which 34.9% (67/192) were positive in pre-vaccine period and 21.8% (92/422) in post-vaccine (p = 0.001). In the post-vaccine period, age, year, and contact with different animal species (chicken, duck, or multiple animals) were associated with RVA infection. RVA infection was higher in children partially vaccinated (40.7%, 11/27) followed by the fully vaccinated (29.3%, 56/191) and the unvaccinated (15.3%, 21/137) (p = 0.002). G1P[8] and G9P[4] were common in vaccinated children less than 12 months. The present analysis showed that RVA infection reduced slightly in the post-vaccine period, with a high proportion of infection and genotype diversity in children, under 12 months of age, vaccinated. Further research on factors associated with RVA infection on vaccinated compared to unvaccinated children and vaccination optimization should be done.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Frequency of RVA infection by year and their Wilson’s confidence intervals.
Fig 2
Fig 2. Frequency of RVA per year and children age groups in Hospital Central de Nampula.
Fig 3
Fig 3. RVA genotypes distribution by age groups in the pre-vaccine period; N = 60.
Fig 4
Fig 4. Genotypes distribution by age groups in the post-vaccine period; N = 92.
Fig 5
Fig 5. Monthly distribution of RVA infection between March 2015 and December 2019.
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