Equipa Multidisciplinar de Profissionais de Saúde, Docentes e Investigadores Nacionais
A narrative review on Rotavirus A in Mozambique
Assucênio
ABSTRACTIntroduction : Rotavirus A (RVA) is a leading cause of acute infant gastroenteritis in Mozambique, responsible for approximately13,000 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, andMicrosoft 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 nationalconferences, 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 thevirus. 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 vaccineintroduction, 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. RVAinfection 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 becomesmore frequent when children approach the 11 th month, to then decline as they age. It is essential to develop studies providing abroad view of RVA reservoirs as part of the strategy to control its dissemination. Keywords : Rotavirus infections; Children; Diarrhea; Mozambique
INTRODUCTION Diarrhea remains a tremendous public health problem globally and is associated with 446,000 deaths amongchildren under five years old in 2016 1 . In Mozambique, even with the strategies implemented to reduce diarrheacases in the last two decades (improving hygiene, sanitation, and access to clean water) 2 , diarrhea remains theleading cause of mortality of children under five years old, with 4383 deaths annually 1 .Rotavirus, particularly group A (RVA) 3 , is among the significant causes of acute infant gastroenteritis globally 1,4 . Data from the global burden of annual RVA mortality shows that in 2016, about 128,500 children under fiveyears old died, of which 104,733 in sub-Saharan Africa 1 . The World Health Organization 5 (WHO) recommendedintroducing the rotavirus vaccine in countries with high prevalence and countrywide continuous surveillance beforeand after the vaccine's introduction.The global enteric multicenter study (GEMS) showed RVA as the leading cause of diarrheic diseases inMozambique with an attributable factor of 34.8% and reported a prevalence ranging from 24 - 42.4% 6.Nevertheless, there is very little published literature on Mozambique's RVA and its impact on human or animalhealth, particularly in the northern and central regions of the country 2,7-10 . Thus, there is a need to expand
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1- Faculdade de Ciências de Saúde, Universidade Aberta do ISCED (UnISCED), Mozambique. Orcid: 0000-0002-0592-7812 - Autor correspondente. Email: ecambaza@isced.ac.mz 2 - Centro de Investigação e Treino em Saúde da Polana Caniço (CISPOC), Maputo, Mozambique 3 - Consultora independente, Maputo, Moçambique 4 - Consultora independente, Beira, Moçambique 5 - Instituto Nacional da Saúde, Maputo, Mozambique 6 - Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal 7 - Departamento de Ciências Biológicas, Universidade Eduardo Mondlane, Maputo, MoçambiqueDOI: https://doi.org/10.54283/RACSaude.v2n2.2021.p4-9 Recebido : Março de 2021 / Aceite : 06 de Julho de 2021 / Publicado : Dezembro de 2021
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