背景:轮状病毒感染是全球5岁以下儿童严重腹泻及相关疾病和死亡的重要原因。尽管十多年前全球开始接种轮状病毒疫苗,轮状病毒感染每年仍然导致高死亡率,主要在低收入国家,包括埃塞俄比亚,需要特别注意。本系统综述和荟萃分析旨在全面探讨埃塞俄比亚5岁以下腹泻儿童在疫苗接种前后轮状病毒的阳性率和基因型分布。
方法:审查遵循系统审查和荟萃分析(PRISMA)2020指南的首选报告项目。数据库来源包括PubMed、Scopus,EMBASE,和认识论,专注于2023年11月30日之前发表的研究。在引入Rota疫苗前后,在埃塞俄比亚寻找有针对性的轮状病毒感染和基因型分布。数据使用EndNote2020软件进行管理,并存储在Excel2010表格中。随机效应模型以95%的置信区间确定了轮状病毒感染率的汇总估计值。Q和I²统计量用于评估研究异质性,并使用漏斗图(Egger检验)确定发表偏倚的可能性。
结果:分析包括在埃塞俄比亚不同地区进行的9项研究的数据。轮状病毒感染的总体患病率显着,患病率约为22.63%(1362/6039)。在Rota假期引入之前确定的最常见的基因型是G1,G2,G3,G12,P[4],P[6],P[8],P[9],P[10]同时,G3和P[8]基因型在Rota疫苗引入后特别普遍。这些发现突出了实施预防措施的重要性,如接种疫苗,以减轻该人群轮状病毒感染的负担。确定的基因型为疫苗开发和有针对性的干预措施提供了有价值的见解。
结论:本研究为埃塞俄比亚5岁以下儿童减少轮状病毒感染影响的公共卫生干预措施和策略提供了证据基础。尽管在埃塞俄比亚推出了Rota疫苗接种,轮状病毒异质性仍然很高,因此,加强疫苗接种和免疫接种至关重要。
BACKGROUND: Rotavirus infections are a significant cause of severe diarrhea and related illness and death in children under five worldwide. Despite the global introduction of vaccinations for rotavirus over a decade ago, rotavirus infections still result in high deaths annually, mainly in low-income countries, including Ethiopia, and need special attention. This system review and meta-analysis aimed to comprehensively explore the positive proportion of rotavirus at pre- and post-vaccine introduction periods and genotype distribution in children under five with diarrhea in Ethiopia.
METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Database sources included PubMed, Scopus, EMBASE, and Epistemonikos, focusing on studies published before November 30, 2023. The search targeted rotavirus infection and genotype distribution in Ethiopia before and after the introduction of the Rota vaccine. Data was managed using EndNote 2020 software and stored in an Excel 2010 sheet. A random-effects model determined the pooled estimate of the rotavirus infection rate at 95% confidence intervals. The Q-and I² statistics were used to assess the study heterogeneity, and a funnel plot (Egger test) was used to determine the possibility of publication bias.
RESULTS: The analysis included data from nine studies conducted in different regions of Ethiopia. The overall prevalence of rotavirus infection was significant, with a prevalence rate of approximately 22.63% (1362/6039). The most common genotypes identified before the Rota vacation introduction were G1, G2, G3, G12, P [4], P [6], P [8], P [9], and P [10]. Meanwhile, G3 and P [8] genotypes were particularly prevalent after the Rota vaccine introduction. These findings highlight the importance of implementing preventive measures, such as vaccination, to reduce the burden of rotavirus infection in this population. The identified genotypes provide valuable insights for vaccine development and targeted interventions.
CONCLUSIONS: This study contributes to the evidence base for public health interventions and strategies to reduce the impact of rotavirus infection in children under five in Ethiopia. Despite the rollout of the Rota vaccination in Ethiopia, rotavirus heterogeneity is still high, and thus, enhancing vaccination and immunization is essential.