Burden and typing of rotavirus group A in Latin America and the Caribbean: Systematic review and meta-analysis

LINHARES AC; STUPKA JA; CIAPPONI, AGUSTÍN; BARDACH, ARIEL; GLUJOVSKY, D; ARUJ, PATRICIA; MAZZONI, AGUSTINA; RODRIGUEZ JAB; REARTE A; LANZIERI TM; ORTEGA-BARRIA, EDUARDO; COLINDRES, ROMULO

REVIEWS IN MEDICAL VIROLOGY

JOHN WILEY & SONS LTD

Lugar: LOndres; Año: 2011 vol. 21 p. 89 - 109

1052-9276

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, 174951 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 100000 under 5 years (47000 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. 2011 John Wiley & Sons, Ltd.