Countries included and year of rotavirus a vaccine introduction in the entire country

Rotavirus is the most common pathogen causing pediatric diarrhea and an important cause of morbidity and mortality in low- and middle-income countries. Previous evidence suggests that the introduction of rotavirus vaccines in national immunization schedules resulted in dramatic declines in disease burden but may also be changing the rotavirus genetic landscape and driving the emergence of new genotypes. We report genotype data of more than 16,000 rotavirus isolates from 40 countries participating in the Global Rotavirus Surveillance Network. Data from a convenience sample of children under five years of age hospitalized with acute watery diarrhea who tested positive for rotavirus were included. Country results were weighted by their estimated rotavirus disease burden to estimate regional genotype distributions. Globally, the most frequent genotypes identified after weighting were G1P[8] (31%), G1P[6] (8%) and G3P[8] (8%). Genotypes varied across WHO Regions and between countries that had and had not introduced rotavirus vaccine. G1P[8] was less frequent among African (36 vs 20%) and European (33 vs 8%) countries that had introduced rotavirus vaccines as compared to countries that had not introduced. Our results describe differences in the distribution of the most common rotavirus genotypes in children with diarrhea in low- and middle-income countries. G1P[8] was less frequent in countries that had introduced the rotavirus vaccine while different strains are emerging or re-emerging in different regions.

轮状病毒（Rotavirus）是引发儿童腹泻的最常见病原体，同时也是中低收入国家儿童发病率与死亡率的重要诱因。既往研究证据表明，将轮状病毒疫苗纳入国家免疫规划后，相关疾病负担出现了显著下降，但同时也可能改变轮状病毒的遗传格局，并推动新型基因型的出现。本数据集包含来自参与全球轮状病毒监测网络（Global Rotavirus Surveillance Network）的40个国家的超过16000株轮状病毒分离株的基因型数据。纳入研究的对象为因急性水样腹泻住院治疗的5岁以下儿童，且经检测轮状病毒呈阳性，样本采用便利抽样方式选取。研究依据各国估算的轮状病毒疾病负担对国家层面的结果进行加权，以推算区域基因型分布情况。全球范围内，经加权处理后检出的最常见基因型为G1P[8]（31%）、G1P[6]（8%）与G3P[8]（8%）。不同世界卫生组织（WHO）区域之间，以及已实施轮状病毒疫苗接种与未实施该接种的国家之间，基因型分布均存在差异。与未实施轮状病毒疫苗接种的国家相比，已实施接种的非洲国家与欧洲国家中G1P[8]的检出频率更低：其中非洲已接种国家占比为20%，未接种国家占比为36%；欧洲已接种国家占比为8%，未接种国家占比为33%。本研究结果阐明了中低收入国家腹泻患儿体内最常见轮状病毒基因型的分布差异。在已实施轮状病毒疫苗接种的国家中，G1P[8]的检出频率更低，而不同区域正不断出现新型毒株或再现旧有毒株。