Update on the disease burden and circulating strains of rotavirus in China: A systematic review and meta-analysis

• Published in: Vaccine Vol. 32; no. 35; pp. 4369 - 4375
• Main Authors: Liu, Na, Xu, Ziqian, Li, Dandi, Zhang, Qing, Wang, Hong, Duan, Zhao-jun
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 31.07.2014; Elsevier; Elsevier Limited
• Subjects: Allergy and Immunology; Applied microbiology; Biological and medical sciences; burden of disease; Children; Children & youth; China; China - epidemiology; Developing countries; Diarrhea; Diarrhea - epidemiology; Diarrhea - pathology; Diarrhea - virology; Disease burden; Fundamental and applied biological sciences. Psychology; Gastroenteritis; Gastroenteritis - epidemiology; Gastroenteritis - pathology; Gastroenteritis - virology; Genotype; Humans; Immunization; LDCs; meta-analysis; Microbiology; Miscellaneous; Molecular Epidemiology; patients; Prevalence; Reviews; Rotavirus; Rotavirus - classification; Rotavirus - genetics; Rotavirus - isolation & purification; Rotavirus Infections - epidemiology; Rotavirus Infections - pathology; Rotavirus Infections - virology; Strains; Studies; systematic review; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Virology; Asia; China; Rotavirus; Strains; Disease burden; China; Virus; Taxonomy; Review; Reoviridae; Metaanalysis; Strain
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2014.06.018

•A total of 211 studies of rotavirus prevalence were included both published in English and Chinese.•We evaluate the rotavirus positive rate in inpatients, outpatients due to diarrhea and in community.•Rotavirus predominant strain has changed from G1P[8] to G3P[8] after 2000.•We assessed the 211 studies in terms of risk of bias. However, no significant impact on pooled estimation by studies with high risk of bias was observed. 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. 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. 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%). 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.