key: cord-0714585-5mv9ckmo
authors: Efunshile, M.; Nwangwu, C.; Ngwu, B.
title: Enteric viruses isolates and rotavirus genotypes during the seasonal surge of acute watery childhood diarrhoea in South-Eastern Nigeria
date: 2022-03-30
journal: nan
DOI: 10.1101/2022.03.25.22272944
sha: 07acfb7064b0eea61c52760b08a6da0dedd802fc
doc_id: 714585
cord_uid: 5mv9ckmo

Diarrhoea remains one of the top three causes of death in Africa. However, data on the molecular epidemiology of enteric viruses in Nigeria is rare. Two hundred and forty three infants and children below the age of 5 years with acute watery diarrhoea were evaluated for the presence of enteric viruses in stool by real-time PCR (rtPCR) during the dry months of December to April 2017, which correspond to diarrhoea season in South-East Nigeria. At least one viral pathogen was detected in 95.1% (231/243) of the study population. Rotavirus, 231(95.1%) was the most common followed by adenovirus, 103(42.4%) and enterovirus 32(13.2%). Other viruses seen in the stool samples include astrovirus 7.3 % (11/151), parechovirus 3.5 % (4/113), sapovirus, 2.8 % (4/145), bocavirus 6.8% (5/73) and human coronavirus 13.9% (10/73). Norovirus and hepatitis A and E viruses were not detected. Children that consumed factory packaged water had the lowest prevalence of rotavirus infection (p=0.044). A significant association between the viral pathogen and home treatment of drinking water or exclusive breastfeeding was not observed. Randomly selected 46 samples were genotyped for rotavirus, which showed that G3P[6] (39.1%) was the most common, followed by G1P[8] (15.2%), G9P[8] (13.0%), G12P[8] (6.5%), G9P[6]P[8] (2.2%), and G12P[6] (2.2%). This was the highest rotavirus prevalence in any published African study, and may be a reflection of inadequate water sanitation/hygiene in the study area, a peculiar epidemiological situation and/or the sensitivity of the diagnostic method used. The present study suggests that the burden of rotavirus is bigger than previously reported; and that morbidity can be greatly reduced if rotavirus vaccine is included in Nigerian national immunization policy.

Diarrhoea caused an estimate of 1.3 million deaths globally in 2015 and it was reported to be 44 the 4 th leading cause of death among children less than 5 years old [1] . 45 Diarrhoea was reported to have killed more than 500.000 children under 5 years in 2015 46 alone, with Asia and Sub-Saharan Africa recording the highest number of incidence and Africa countries as a result of inadequate water, poor sanitation and hygiene; as well as 50 predisposition from malnutrition [2] . Rotavirus, cryptosporidium and shigella spp were the 51 major agents which accounted for more than 50% of diarrhoea deaths among children below 52 the age of 5 years in 2015 [1] . In its comprehensive assessment, the Global Burden of 53 Diseases in 2015 also listed enteric adenovirus and noroviruses as other viral agents that 54 significantly contributed to diarrhoea deaths [1] . Though, the burden of specific viral agent 55 depends on the study region and the season. Because rotavirus is the commonest diarrhoea 56 agent worldwide, the incidence and mortality of its associated diarrhoea were shown to have 57 significantly declined in countries where rotavirus vaccines were introduced [3] . The WHO 58 therefore recommends that rotavirus vaccine is included in routine immunization policy, 59 especially in developing countries [4] . Rotavirus gastroenteritis is more seasonal in temperate 60 regions compared to the tropical areas where it occurs more or less all the year round. And 61 this difference was found to be associated with socio-economic factors rather than being an 

The study was carried out at University Teaching Hospitals (Ebonyi and Enugu) in the South- 

Data collection and management 106 Questionnaires were administered to the parents/guardian of the participants to collect data 107 regarding age, frequency and duration of diarrhoea, risk factors and other relevant 108 information. This information were subsequently transferred into excel sheets for analysis.

Specimen management and preliminary examination 110 About 5 ml of watery stool were collected from the participants into wide mouth bottles.

Inactivated aliquots were shipped to the Institute of Virology, Leipzig University, Germany. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint There was no significant association between ages or sex and any of the 3 most commonly 168 encountered enteric viruses (table 3) . The present study did not establish a significant association between the three common 174 enteric viruses (i.e. rotavirus, enterovirus and adenovirus) and past history of exclusive 175 breastfeeding or the current feeding practice of the children (table 4) . is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The study did not rule out all other possible cause of diarrhoea including bacteria and 301 parasites among the study participants, so it was difficult to establish a causal relationship 302 between the viruses and the diarrhoea. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint 

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