Rotavirus A, a significant cause of infant diarrhea in Mozambique

Abstract

Introduction: Rotavirus A (RVA) is a leading cause of acute infant gastroenteritis in Mozambique, responsible for approximately 13,000 annual infant deaths in peri-urban and other areas. Aim: the present review aimed summarize the most relevant and recent literature regarding RVA infection in Mozambique. Methods: the documents were obtained from electronic databases such as PubMed, Google Scholar, Scinapse, Scilit, and Microsoft Academic to find the leading scientific publications related to Mozambique's RVA.Findings: The search allowed us to find 20 peer-reviewed journal articles, three official reports, eight abstracts from national conferences, one thesis, and other documents to supplement the information. Rotavirus frequency ranged between 24 to 42.4%, 34.8% attributable to Mozambique. Most data are hospital-based from Maputo, Sofala, Zambézia, and Nampula provinces. Nampula province shows the highest number of cases. Thus, there might be some bias on the geographical distribution of the virus. The prevalence is high in children less than one year. Regarding the control, the Expanded Program on Immunization (EPI) introduced a monovalent vaccine in September 2015 (Rotarix), which positively impacted the reduction of RVA cases. After vaccine introduction, a high diversity of RVA genotypes was observed, with the predominance of G1P[8] and the emergence of G9P[4], G9P[6], G3P[4]. However, only the whole genome sequence can confirm if it is due to the natural genotypes fluctuation. RVA infection was detected in swine, and a recent analysis reported an RVA strain from children clustered with different animal strains.Conclusion: The scarce yet highly reliable research resources allowed scientists to detect RVA G1P[8] and other genotypes, potential animal reservoirs, and to find that RVA is more prevalent during the transition dry-rainy season, and the virus becomes more frequent when children approach the 11th month, to then decline as they age. It is essential to develop studies providing a broad view of RVA reservoirs as part of the strategy to control its dissemination.Keywords: Rotavirus infections; Children; Diarrhea; Mozambique