Review of rotavirus studies in Africa: 1976-2006.
BACKGROUND
Rotavirus is a common cause of severe diarrheal disease in children worldwide. Ninety percent of the associated deaths occur in sub-Saharan Africa and South East Asia. Our aim was to review the prevalence of rotavirus infection in Africa over the past 30 years.


METHODS
Eligible studies were identified from 3 Medline searches. Only studies including children <5 years of age that included >50 children and had an observational period >3 months were included. The data were analyzed during 3 periods (1976-1985, 1986-1995, and 1996-2006), as a summary (1976-2006), and by different study settings (ie, hospital, outpatient department, and combined).


RESULTS
The initial search identified 206 studies from 27 countries during 1976-2006. The refined search yielded 101 studies, of which 58 (57%) were hospital based, 25 (25%) were outpatient studies, and 18 (18%) were combined. Rotavirus was detected in 25% (interquartile range, 16%-32%) of stool samples. Rotavirus was the most common agent identified in 73% of studies in which multiple diarrheal agents were determined.


CONCLUSIONS
Rotavirus is an important cause of severe diarrheal disease in children <5 years of age in Africa. Clinical trials in South Africa and Malawi have shown that severe rotavirus disease is a vaccine-preventable entity in Africa.
Waggie
Zainab
Z
Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa. Zainab.Waggie@uct.ac.za
Hawkridge
Anthony
A
Hussey
Gregory D
GD
D000349:Africa / Q000453:epidemiology; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000401:mortality / Q000821:virology*; D006801:Humans; D015994:Incidence; D007223:Infant; D012400:Rotavirus Infections / Q000453:epidemiology*; D013997:Time Factors