Artículo
Burden and typing of rotavirus group A in Latin America and the Caribbean: systematic review and meta-analysis
Autor
Linhares, Alexandre C
Stupka, Juan A.
Ciapponi, Agustin
Bardach, Ariel
Glujovsky, Demian
Aruj, Patricia
Mazzoni, Agustina
Rodriguez, Jefferson
Rearte, Analía
Lanzieri, Tatiana
Ortega-Barria, Eduardo
Colindres, Romulo
Resumen
Fil: Linhares, Alexandre C. Instituto Evandro Chagas. Secretaria de Vigilancia em Saúde. Virology Section; Brasil. Fil: Stupka, Juan A. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Virología. Laboratorio de Gastroenteritis Virales; Argentina. Fil: Ciapponi, Agustín. Instituto de Efectividad Clínica y Sanitaria; Argentina. Fil: Bardach, Ariel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Fil: Glujovsky, Demián. Instituto de Efectividad Clínica y Sanitaria; Argentina. Fil: Aruj, Patricia. Instituto de Efectividad Clínica y Sanitaria; Argentina. Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Fil: Rodriguez, Jefferson. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rearte, Analía. Instituto de Efectividad Clínica y Sanitaria; Argentina. Fil: Lanzieri, Tatiana. GlaxoSmithKline Biologicals; Brasil. Fil: Ortega-Barria, Eduardo. GlaxoSmithKline Biologicals; Brasil. Fil: Colindres, Romulo. GlaxoSmithKline Biologicals; Brasil. The efficacy of licensed rotavirus vaccines has only been shown against certain rotavirus group A (RV-A) types. It is critical to understand the burden of rotavirus gastroenteritis (RVGE) and its prevalent types to assess the potential impact of these vaccines in Latin America and the Caribbean (LA&C). We performed a systematic review and meta-analyses of all the available evidence reported from 1990 to 2009 on the burden of rotavirus disease and strains circulating in LA&C. Eligible studies--185 country-level reports, 174 951 faecal samples--were selected from MEDLINE, Cochrane Library, EMBASE, LILACS, regional Ministries of Health, PAHO, regional proceedings, doctoral theses, reference lists of included studies and consulting experts. Arc-sine transformations and DerSimonian-Laird random-effects model were used for meta-analyses. The proportion of gastroenteritis cases due to rotavirus was 24.3% (95%CI 22.3-26.4) and the incidence of RVGE was 170 per 1000 children-years (95%CI 130-210). We estimated a global annual mortality for 22 countries of 88.2 (95%CI 79.3-97.1) deaths per 100 000 under 5 years (47 000 deaths).The most common G type detected was G1 (34.2%), followed by G9 (14.6%), and G2 (14.4%). The most common P types detected were P[8] (56.2%), P[4] (22.1%) and P[1] 5.4%, and the most prevalent P-G type associations were P[8]G1 17.9%, P[4]G2 9.1% and P[8]G9 8.8%. In the last 10 years, G9 circulation increased remarkably and G5 almost disappeared. More recently, G12 appeared and P[4]G2 re-emerged. To our knowledge, this is the first meta-analysis of rotavirus infection and burden of disease in LA&C.