review · Journal of Infection
Enteropathogenic viruses are the leading cause of diarrhoea in children worldwide, contributing substantially to paediatric mortality across Africa. An analysis of 33 studies published between 2003 and 2023 assessed the prevalence of these viruses among African children under five years of age requiring healthcare visits or hospitalisation. Rotavirus emerged as the most widespread cause, with an estimated pooled prevalence of 31.0 per cent, followed by norovirus at 15.0 per cent, adenovirus at 10.0 per cent, sapovirus at 4.0 per cent, astrovirus at 4.0 per cent, and aichivirus at 2.3 per cent. Among rotavirus cases, the G1P[8] genotype was most frequent, alongside several unusual strains. For norovirus, genogroup II predominated, led by the GII.4 genotype. The findings confirm rotavirus as the primary driver of severe viral diarrhoea in this cohort, underlining the necessity of stronger vaccination programmes and continuous viral surveillance.
Severe diarrhoea remains a major cause of illness and death among young children in Africa. By mapping the exact viruses and circulating strains responsible for hospitalisations and clinic visits, healthcare systems can better target prevention strategies. This evidence helps public health authorities evaluate the impact of existing interventions and identify which specific viral strains require priority attention.
The epidemiological and genomic baseline provided can inform vaccine developers, diagnostic manufacturers, and public health agencies designing targeted immunisation programmes and diagnostic panels. Because this research synthesises observational data rather than testing a specific tool or product, it sits at an early, foundational stage, providing essential guidance for future clinical developments rather than representing a near-market solution.
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Gastroenteritis viruses are the leading etiologic agents of diarrhea in children worldwide. We present data from thirty-three (33) eligible studies published between 2003 and 2023 from African countries bearing the brunt of the virus-associated diarrheal mortality. Random effects meta-analysis with proportion, subgroups, and meta-regression analyses were employed. Overall, rotavirus with estimated pooled prevalence of 31.0 % (95 % CI 24.0-39.0) predominated in all primary care visits and hospitalizations, followed by norovirus, adenovirus, sapovirus, astrovirus, and aichivirus with pooled prevalence estimated at 15.0 % (95 % CI 12.0-20.0), 10 % (95 % CI 6-15), 4.0 % (95 % CI 2.0-6.0), 4 % (95 % CI 3-6), and 2.3 % (95 % CI 1-3), respectively. Predominant rotavirus genotype was G1P[8] (39 %), followed by G3P[8] (11.7 %), G9P[8] (8.7 %), and G2P[4] (7.1 %); although, unusual genotypes were also observed, including G3P[6] (2.7 %), G8P[6] (1.7 %), G1P[6] (1.5 %), G10P[8] (0.9 %), G8P[4] (0.5 %), and G4P[8] (0.4 %). The genogroup II norovirus predominated over the genogroup I-associated infections (84.6 %, 613/725 vs 14.9 %, 108/725), with the GII.4 (79.3 %) being the most prevalent circulating genotype. In conclusion, this review showed that rotavirus remains the leading driver of viral diarrhea requiring health care visits and hospitalization among under-five years children in Africa. Thus, improved rotavirus vaccination in the region and surveillance to determine the residual burden of rotavirus and the evolving trend of other enteric viruses are needed for effective control and management of cases.
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DOI: 10.1016/j.jinf.2024.106169
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