title: Molecular epidemiology of Rotavirus causing diarrhea among children less than five years of age visiting national level children hospitals, Nepal.
abstract: Rotaviruses are the major cause of diarrhea among the infants and young children all over the world causing over 500,000 deaths and 2.4 million hospitalizations each year. In Nepal Rotavirus infection positivity rates ranges from 17.0 to 39.0% among children less than 5 years. However, little is known about the molecular genotypes of Rotavirus prevailing. The objective of this study was to estimate the burden of Rotavirus gastroenteritis and determine the genotypes of Rotavirus among children less than 5 years.
  
  
  
  The cross sectional study was conducted from January to November 2014 among children less than 5 years old visiting Kanti Children's Hospital and Tribhuvan University Teaching Hospital. Rotavirus antigen detection was performed by Enzyme Linked Immunosorbent Assay (ELISA) using ProSpecT Rotavirus Microplate Assay. Among the Rotavirus antigen positive samples, 59 samples were used for Rotavirus RNA extraction. Multiplex PCR was performed to identify G type comprising G1-G4, G8-G10 and G12 and P type comprising P[4], P[6], P[8], P[9], P[10], and P[11].
  
  
  
  A total of 717 diarrheal stool samples were collected from patients ranging from 10 days to 59 months of age. Rotavirus antigen positive was found among (N = 164)22.9% of patients. The highest number of the diarrhea was seen in January. Molecular analysis of Rotavirus genotypes revealed that the predominant G-Type was G12 (36%) followed by G9 (31%), G1 (21%), G2 (8.6%). The predominant P- type was P6 (32.8%) followed by P8 (31%), P10 (14.8%), P4 (14.8%). A total of seven G/P type combinations were identified the most common being G12P [6] (35.8%), G1P [8] (15.1%), G9P [8] (15.1%).
  
  
  
  Rotavirus diarrhea is, mostly affecting children from 7 to 24 months in Nepal, mostly occurring in winter. The circulating genotypes in the country are found to be primarily unusual genotypes and predominance of G12P[6]. It is recommended to conduct genotyping of Rotavirus on large samples before starting vaccination in the country.
authors.affiliation: National Public Health Laboratory, HIV Reference Unit, Kathmandu, Nepal. dhital.subhash@iom.edu.np.
authors.forename: Subhash
authors.identifier: 0000-0003-3432-9085
authors.initials: S
authors.lastname: Dhital
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Jeevan Bahadur
authors.initials: JB
authors.lastname: Sherchand
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Bharat Mani
authors.initials: BM
authors.lastname: Pokhrel
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Keshab
authors.initials: K
authors.lastname: Parajuli
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Shah
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Shyam Kumar
authors.initials: SK
authors.lastname: Mishra
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Sangita
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Hari Prasad
authors.initials: HP
authors.lastname: Kattel
authors.affiliation: National Public Health Laboratory, HIV Reference Unit, Kathmandu, Nepal.
authors.forename: Sundar
authors.initials: S
authors.lastname: Khadka
authors.affiliation: Department of Microbiology, Universal Medical College, Bhairahawa, Nepal.
authors.forename: Sulochana
authors.initials: S
authors.lastname: Khatiwada
authors.affiliation: Department of Microbiology, ManMohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
authors.forename: Narayan
authors.initials: N
authors.lastname: Parajuli
authors.affiliation: Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Basistha
authors.initials: B
authors.lastname: Rijal
mesh_terms: D000956:Antigens, Viral / Q000097:blood; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000821:virology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005838:Genotype; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017720:Molecular Epidemiology; D060885:Multiplex Polymerase Chain Reaction; D009390:Nepal / Q000453:epidemiology; D012367:RNA, Viral / Q000097:blood; D012401:Rotavirus / Q000235:genetics* / Q000276:immunology; D012400:Rotavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D012621:Seasons
chemical_list: D000956:Antigens, Viral; D012367:RNA, Viral
keywords: Diarrhea; Nepal; Rotavirus