title: Rotavirus Genotypes and Vaccine Effectiveness from a Sentinel, Hospital-Based, Surveillance Study for Three Consecutive Rotavirus Seasons in Lebanon.
abstract: BACKGROUND
  Globally, rotavirus (RV) is the leading cause of gastroenteritis (GE) in children. Longitudinal data about changes in RV genotype distribution and vaccine effectiveness (VE) are scarce. This study was conducted in Lebanon over 3 consecutive RV seasons to estimate the rate of RVGE hospitalization, identify RV genotypes, determine the seasonal and geographical variations, and calculate RV VE.
  
  
  METHODS
  This prospective, multicenter, hospital-based surveillance study was conducted between 2011 and 2013 and enrolled children (<5 years) admitted for GE. Socio-demographic and clinical data about the current episode of GE at admission were collected. Genotypes were determined from stool samples testing positive for RV by PCR.
  
  
  RESULTS
  Of 1,414 cases included in the final analysis, 83% were <2 years old and 55.6% were boys. Median duration of hospitalization was 4 days and 91.6% of GE cases were severe (Vesikari score ≥11). PCR testing showed that 30.3% of subjects were RV-positive of which 62.1% had fever versus 71.1% of RV-negative subjects (P = 0.001). RV was predominantly detected in the cold season from November till March (69.9%). G and P genotype pairs for all RV-positive stool specimens showed a predominance of G1P[8] in 36% (n = 154) of specimens, G9P[8] in 26.4% (n = 113), and G2P[4] in 17.8% (n = 76). RV-negative subjects were more likely to be RV-vaccinated (21%) compared to the RV-positive subjects (11.3%) (P<0.001), with a vaccine breakthrough rate of 18.8%. The ratio of RV1-vaccinated for each RV5-vaccinated subject was 7.8 and VE against RV disease was 68.4% (95%CI, 49.6%-80.2%).
  
  
  CONCLUSIONS
  RV is a major cause of GE requiring hospitalization of children under 5 years of age in Lebanon. A few genotypes predominated over the three RV seasons studied. Mass RV vaccination will likely decrease the burden of hospitalization due to RV. VE is similar to what has been observed for other middle-income countries.
authors: Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Zainab
authors: Z
authors: Ali
authors: Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Houda
authors: H
authors: Harastani
authors: Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Moza
authors: M
authors: Hammadi
authors: Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Lina
authors: L
authors: Reslan
authors: Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Soha
authors: S
authors: Ghanem
authors: Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Farah
authors: F
authors: Hajar
authors: Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Ahmad
authors: A
authors: Sabra
authors: Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Amjad
authors: A
authors: Haidar
authors: Department of Pediatrics, Nini Hospital, Tripoli, Lebanon.
authors: Adlette
authors: A
authors: Inati
authors: Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
authors: Mariam
authors: M
authors: Rajab
authors: Department of Pediatrics, Rafic Hariri University Hospital, Beirut, Lebanon.
authors: Hassan
authors: H
authors: Fakhouri
authors: Department of Pediatrics, Nabatieh Governmental Hospital, Nabatieh, Lebanon.
authors: Bassam
authors: B
authors: Ghanem
authors: Department of Pediatrics, Hammoud Hospital, Saida, Lebanon.
authors: Ghassan
authors: G
authors: Baasiri
authors: Department of Pediatrics, Hôtel-Dieu de France University Hospital, Beirut, Lebanon.
authors: Bernard
authors: B
authors: Gerbaka
authors: Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
authors: Hassan
authors: H
authors: Zaraket
authors: Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
authors: Ghassan M
authors: GM
authors: Matar
authors: Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.|Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon.
authors: Ghassan
authors: G
authors: Dbaibo
mesh_terms: D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007861:Lebanon; D008297:Male; D011446:Prospective Studies; D012401:Rotavirus / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity; D012400:Rotavirus Infections / Q000175:diagnosis* / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000627:therapeutic use*; D012621:Seasons
chemical_list: D022243:Rotavirus Vaccines