title: Prevalence of severe acute rotavirus gastroenteritis and intussusceptions in Ghanaian children under 5 years of age.
abstract: BACKGROUND
  Vaccination is the most effective preventive strategy against rotavirus disease. Regional differences in prevalent rotavirus genotypes may affect vaccine efficacy. Pre-vaccine surveillance for burden of rotavirus disease, prevalent rotavirus genotypes, and association between rotavirus disease and intussusceptions helps in monitoring the impact of vaccination.
  
  
  METHODS
  A prospective study was conducted from January 2008 to December 2009 in children younger than five years hospitalized for longer than 24 hours with acute gastroenteritis. Data on confirmed cases of intussusception were collected retrospectively. Stools were tested by enzyme immunoassay, reverse-transcriptase polymerase chain reaction and nucleotide sequencing.
  
  
  RESULTS
  Acute gastroenteritis (AGE) caused 13.1% (2,147/16,348) of hospitalizations among children under five years. Stools were tested for 50.2% (1077/2147) of AGE cases. Of these, 49% (528/1077) were rotavirus positive. Rotavirus gastroenteritis, non-rotavirus gastroenteritis, and intussusceptions were most prevalent in children under 15 months [80.3%, 74% and 91% respectively]. Rotavirus was detected from more than 60% of acute gastroenteritis cases during peak months. The prevalence of intussusception showed no seasonal pattern. The peak ages of six to twelve months for acute gastroenteritis and five to eight months for intussusception overlapped. G1, G2 and mixed G/P genotypes were common in the isolated rotaviruses.
  
  
  CONCLUSIONS
  Rotavirus gastroenteritis causes significant morbidity in children younger than five years of age in Ghana. Although the peak age of rotavirus gastroenteritis and intussusceptions overlapped, there was no seasonal correlation between them. The high prevalence of mixed G/P genotypes in Ghanaian children may affect the effectiveness of vaccination.
authors.affiliation: Department of Child Health, University of Ghana Medical School, Accra, Ghana. chikalaryea@gmail.com
authors.forename: Christabel C
authors.initials: CC
authors.lastname: Enweronu-Laryea
authors.forename: Kwamena W C
authors.initials: KW
authors.lastname: Sagoe
authors.forename: Hope
authors.initials: H
authors.lastname: Glover-Addy
authors.forename: Richard H
authors.initials: RH
authors.lastname: Asmah
authors.forename: Julius A
authors.initials: JA
authors.lastname: Mingle
authors.forename: George E
authors.initials: GE
authors.lastname: Armah
mesh_terms: D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D017422:Sequence Analysis, DNA