title: Sentinel hospital surveillance for rotavirus in latin american and Caribbean countries.
abstract: The burden of rotavirus disease in the Latin American region has been poorly understood despite the promise of effective vaccines. We describe here the implementation and results of a rotavirus surveillance network in the Latin American and Caribbean region. From 2005 through 2007, stool specimens and epidemiologic information were gathered from children <5 years of age who were hospitalized for acute diarrhea (3 looser-than-normal stools within <24 h) lasting <14 days with use of a standardized generic protocol. Stool samples were tested for rotavirus, and a proportion of detected strains were typed. The proportion of samples positive for rotavirus was applied to World Health Organization diarrhea-related mortality estimates to calculate rotavirus-associated mortality. In 2007, the network comprised 54 sites in 11 countries. During 2006-2007, specimens were collected from 19,817 children; 8141 of these specimens were positive for rotavirus. The median percentage of positive specimens in the country was 31.5% (range, 24%-47%). The risk of death from rotavirus diarrhea by age 5 years was 1 of 2874. Strong rotavirus winter seasonality was apparent, even in tropical Central America. Globally common strains (P[8] G1, P[8] G9, and P[4] G2) accounted for >75% of strains, although unusual strains, including G12, were detected at low levels. As rotavirus vaccines continue to be introduced in Latin America, maintenance of surveillance will provide robust pre-introduction data and a platform for estimating vaccine effectiveness and other measures of impact.
authors.affiliation: Immunization Unit, Pan American Health Organization, Washington, DC 20037, USA. oliveirl@paho.org
authors.forename: Lucia Helena
authors.initials: LH
authors.lastname: de Oliveira
authors.forename: M Carolina
authors.initials: MC
authors.lastname: Danovaro-Holliday
authors.forename: Jon Kim
authors.initials: JK
authors.lastname: Andrus
authors.forename: Ana Maria Bispo
authors.initials: AM
authors.lastname: de Fillipis
authors.forename: Jon
authors.initials: J
authors.lastname: Gentsch
authors.forename: Cuauhtemoc Ruiz
authors.initials: CR
authors.lastname: Matus
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
mesh_terms: D017691:Caribbean Region / Q000453:epidemiology; D002675:Child, Preschool; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000401:mortality; D022243:Rotavirus Vaccines / Q000276:immunology; D013997:Time Factors; D014611:Vaccination
chemical_list: D022243:Rotavirus Vaccines