title: Severe acute rotavirus gastroenteritis in children less than 5 years in southern Ghana: 2006-2011.
abstract: BACKGROUND
  Rotavirus is a major cause of acute gastroenteritis (AGE) globally. Local data on disease burden will guide recommendations for rotavirus vaccination and monitoring impact of the intervention.
  
  
  METHODS
  Prospective surveillance for rotavirus gastroenteritis was conducted in 3 hospitals in southern Ghana during the period August 2006 to December 2011, as part of the African Rotavirus Surveillance Network. Clinical data and stool specimens were collected from children <5 years of age and hospitalized with AGE (defined as 3 or more watery stools for up to 7 days). Stool was tested for rotavirus by enzyme immunoassay and rotavirus genotype identified by reverse-transcriptase polymerase chain reaction.
  
  
  RESULTS
  We tested 3044 stool samples from 3939 children. Rotavirus was detected in 45.6%, 51.3% and 48.5% of cases at the primary, secondary and tertiary care hospital, respectively. Both genders were equally affected; 75% (2954/3939) of the cohort were aged 3-18 months. Overall, rotavirus was detected in 49.4% (1504/3044) of cases, caused over 30% of AGE hospitalizations all year round and up to 70% of cases during peak seasons. Peak season occurred during cool dry months in 2008, 2010 and 2011 and the rainy season in 2009. Mortality from AGE occurred in 1.5% (45/3044) of cases and 48.9% (22/45) of these were rotavirus positive.
  
  
  CONCLUSIONS
  Rotavirus causes significant morbidity and mortality in young Ghanaian children. As Ghana introduced rotavirus vaccination in the national immunization program in 2012, continued surveillance is required to monitor the impact of this intervention.
authors.affiliation: From the *Department of Child Health, University of Ghana Medical School; †Korle Bu Teaching Hospital; ‡Department of Microbiology, University of Ghana Medical School, Accra, Ghana; §Africa Rotavirus Surveillance Network, WHO Regional Office for Africa, Djoue, Brazzaville, Republic of Congo; and ¶Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Christabel C
authors.initials: CC
authors.lastname: Enweronu-Laryea
authors.forename: Kwamena W C
authors.initials: KW
authors.lastname: Sagoe
authors.forename: Jason M
authors.initials: JM
authors.lastname: Mwenda
authors.forename: George E
authors.initials: GE
authors.lastname: Armah
mesh_terms: D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D005869:Ghana / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D012621:Seasons