title: Update on the disease burden and circulating strains of rotavirus in China: a systematic review and meta-analysis.
abstract: BACKGROUND
  Rotavirus is the most common cause of severe diarrhea in children, and most associated deaths occur in developing countries. Two new internationally licensed vaccines are expected to be launched in the near future in China. We performed a systematic review and meta-analysis of rotavirus studies to update information on the burden of rotavirus disease in China.
  
  
  METHODS
  Eligible studies published before 2011 were identified using PubMed/Medline, Embase, Cochrane Library, LILACS, WHOLIS, and two Chinese literature databases, CNKI, and WANFANG. Arc-sine transformations and the DerSimonian-Laird random-effects or fixed-effects models were used for meta-analysis.
  
  
  RESULTS
  A total of 211 studies were included in this review, of which 63 (29.9%) were inpatient studies, 26 (12.3%) were outpatient, 122 (57.8%) were combined. Community subjects were investigated in two combined studies. Rates of gastroenteritis caused by rotavirus in inpatients, outpatients, and community children were 42.6%, 32.5% and 9.3%, respectively. The most common G type was G3 (39.3%), followed by G1 (30.3%), G2 (7.2%), and G9 (3.3%). The most common P types were P[8] (50.2%), P[4] (18.2%), and P[6] (7.2%). The most prevalent G-P combinations were G3P[8] (32.1%), G1P[8] (23.0%), and G2P[4] (7.9%).
  
  
  CONCLUSIONS
  Rotavirus is an important cause of both severe and mild diarrheal disease in children <5 years of age in China; G3P[8] is the most prevalent strain. The introduction of an effective rotavirus vaccine to Chinese pediatric immunization programs is necessary.
authors: Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Na
authors: N
authors: Liu
authors: Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Ziqian
authors: Z
authors: Xu
authors: Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Dandi
authors: D
authors: Li
authors: Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Qing
authors: Q
authors: Zhang
authors: Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Hong
authors: H
authors: Wang
authors: Department of Viral Diarrhea, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: zhaojund@126.com.
authors: Zhao-Jun
authors: ZJ
authors: Duan
mesh_terms: D002681:China / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D005838:Genotype; D006801:Humans; D017720:Molecular Epidemiology; D015995:Prevalence; D012401:Rotavirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*
keywords: China; Disease burden; Rotavirus; Strains