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. 1998;76(5):525–537.

Epidemiology of rotavirus diarrhoea in Africa: a review to assess the need for rotavirus immunization.

N A Cunliffe 1, P E Kilgore 1, J S Bresee 1, A D Steele 1, N Luo 1, C A Hart 1, R I Glass 1
PMCID: PMC2305791  PMID: 9868844

Abstract

Rapid progress towards the development of rotavirus vaccines has prompted a reassessment of the disease burden of rotavirus diarrhoea in developing countries and the possible impact of these vaccines in reducing diarrhoeal morbidity and mortality among infants and young children. We examined the epidemiology and disease burden of rotavirus diarrhoea among hospitalized and clinic patients in African countries through a review of 43 published studies of the etiology of diarrhoea. The studies were carried out from 1975 through 1992, and only those in which a sample of more than 100 patients with diarrhoea were specifically screened for rotavirus by using an established diagnostic test were included. Rotavirus was detected in a median of 24% of children hospitalized for diarrhoea and in 23% who were treated as outpatients; 38% of the hospitalized patients with rotavirus were < 6 months and 81% were < 1 year of age. Rotavirus was detected year-round in nearly every country and generally exhibited distinct seasonal peaks during the dry months. In 5 countries where rotavirus strains had been G-typed, 74% of strains were of one of the four common serotypes (G1 to G4), G1 was the predominant serotype, and 26% were non-typeable. This cumulative experience from 15 African countries suggests that rotavirus is the most important cause of severe diarrhoea in African children and that most strains in circulation today belong to common G types that are included in reassortant vaccines. Wherever large numbers of cases of rotavirus diarrhoea occur early in infancy, immunization at birth may protect the children before their first symptomatic infection.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abiodun P. O., Omoigberale A. Prevalence of nosocomial rotavirus infection in hospitalized children in Benin City, Nigeria. Ann Trop Paediatr. 1994;14(1):85–88. doi: 10.1080/02724936.1994.11747698. [DOI] [PubMed] [Google Scholar]
  2. Anagonou S. Y., Koumakpai S., Josse R., Massougbodji A., Sadeler B. C., Martet G. Gastro-entérites à rotavirus en pédiatrie hospitalière au Centre National Hospitalier et Universitaire de Cotonou (Bénin). Med Trop (Mars) 1993 Jan-Mar;53(1):105–107. [PubMed] [Google Scholar]
  3. Avery R. M., Shelton A. P., Beards G. M., Omotade O. O., Oyejide O. C., Olaleye D. O. Viral agents associated with infantile gastroenteritis in Nigeria: relative prevalence of adenovirus serotypes 40 and 41, astrovirus, and rotavirus serotypes 1 to 4. J Diarrhoeal Dis Res. 1992 Jun;10(2):105–108. [PubMed] [Google Scholar]
  4. Bern C., Martines J., de Zoysa I., Glass R. I. The magnitude of the global problem of diarrhoeal disease: a ten-year update. Bull World Health Organ. 1992;70(6):705–714. [PMC free article] [PubMed] [Google Scholar]
  5. Besselaar T. G., Rosenblatt A., Kidd A. H. Atypical rotavirus from South African neonates. Brief report. Arch Virol. 1986;87(3-4):327–330. doi: 10.1007/BF01315311. [DOI] [PubMed] [Google Scholar]
  6. Black R. E., Merson M. H., Huq I., Alim A. R., Yunus M. Incidence and severity of rotavirus and Escherichia coli diarrhoea in rural Bangladesh. Implications for vaccine development. Lancet. 1981 Jan 17;1(8212):141–143. doi: 10.1016/s0140-6736(81)90719-4. [DOI] [PubMed] [Google Scholar]
  7. Bos P., Kirsten M., Cronje R. E., Steele A. D. Monitoring of rotavirus infection in a paediatric hospital by RNA electrophoresis. S Afr Med J. 1995 Sep;85(9):887–891. [PubMed] [Google Scholar]
  8. Bos P., Mnisi Y. N., Steele A. D. The molecular epidemiology of rotavirus infection in Ga-Rankuwa, southern Africa. Cent Afr J Med. 1992 Jul;38(7):286–290. [PubMed] [Google Scholar]
  9. Casalino M., Yusuf M. W., Nicoletti M., Bazzicalupo P., Coppo A., Colonna B., Cappelli C., Bianchini C., Falbo V., Ahmed H. J. A two-year study of enteric infections associated with diarrhoeal diseases in children in urban Somalia. Trans R Soc Trop Med Hyg. 1988;82(4):637–641. doi: 10.1016/0035-9203(88)90542-1. [DOI] [PubMed] [Google Scholar]
  10. Cassel-Beraud A. M., Michel P., Garbarg-Chenon A. Epidemiological study of infantile rotavirus diarrhoea in Tananarive (Madagascar). J Diarrhoeal Dis Res. 1993 Jun;11(2):82–87. [PubMed] [Google Scholar]
  11. Chiba Y., Miyazaki C., Makino Y., Mutanda L. N., Kibue A., Lichenga E. O., Tukei P. M. Rotavirus infection of young children in two districts of Kenya from 1982 to 1983 as analyzed by electrophoresis of genomic RNA. J Clin Microbiol. 1984 May;19(5):579–582. doi: 10.1128/jcm.19.5.579-582.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Chunge R. N., Simwa J. M., Karumba P. N., Kenya P. R., Kinoti S. N., Muttunga J., Nagelkerke N. Comparative aetiology of childhood diarrhoea in Kakamega and Kiambu Districts, Kenya. East Afr Med J. 1992 Aug;69(8):437–441. [PubMed] [Google Scholar]
  13. Chunge R. N., Wamola I. A., Kinoti S. N., Muttunga J., Mutanda L. N., Nagelkerke N., Muthami L., Muniu E., Simwa J. M., Karumba P. N. Mixed infections in childhood diarrhoea: results of a community study in Kiambu District, Kenya. East Afr Med J. 1989 Nov;66(11):715–723. [PubMed] [Google Scholar]
  14. Cisse M. F., Leguenno B., Sourabie S., Gaye A., Boye C. S., Mboup S., Samb A. Electrophorétypes de génome de rotavirus isolés chez des enfants Sénégalais. Bull Soc Pathol Exot Filiales. 1989;82(5):637–644. [PubMed] [Google Scholar]
  15. Cisse M. F., Ouangre R. A., Gaye A., Boye C. S., Sow A. I., Mboup S., Samb A., Fall M. Causes des gastro-entérites infectieuses de l'enfant à Dakar. Presse Med. 1989 Nov 11;18(37):1827–1830. [PubMed] [Google Scholar]
  16. Clark H. F., Offit P. A., Ellis R. W., Eiden J. J., Krah D., Shaw A. R., Pichichero M., Treanor J. J., Borian F. E., Bell L. M. The development of multivalent bovine rotavirus (strain WC3) reassortant vaccine for infants. J Infect Dis. 1996 Sep;174 (Suppl 1):S73–S80. doi: 10.1093/infdis/174.supplement_1.s73. [DOI] [PubMed] [Google Scholar]
  17. Coker A. O., Dosunmu-Ogunbi O., Odugbemi T., Alabi S. A., Macaulay S. A. A study on the prevalence of rotavirus diarrhoeas in Ohaozara local government area, Imo State, Nigeria and the Lagos University Teaching Hospital, Lagos, Nigeria. East Afr Med J. 1987 Sep;64(9):586–589. [PubMed] [Google Scholar]
  18. Cook S. M., Glass R. I., LeBaron C. W., Ho M. S. Global seasonality of rotavirus infections. Bull World Health Organ. 1990;68(2):171–177. [PMC free article] [PubMed] [Google Scholar]
  19. Cruickshank J. G., Zilberg G. Winter diarrhoea and rotaviruses in Rhodesia. S Afr Med J. 1976 Nov 6;50(47):1895–1896. [PubMed] [Google Scholar]
  20. De Mol P., Zissis G., Butzler J. P., Mutwewingabo A., André F. E. Failure of live, attenuated oral rotavirus vaccine. Lancet. 1986 Jul 12;2(8498):108–108. doi: 10.1016/s0140-6736(86)91643-0. [DOI] [PubMed] [Google Scholar]
  21. Dossetor J. F., Chrystie I. L., Totterdell B. M. Rotavirus gastro-enteritis in northern Nigeria. Trans R Soc Trop Med Hyg. 1979;73(1):115–116. doi: 10.1016/0035-9203(79)90144-5. [DOI] [PubMed] [Google Scholar]
  22. Dowling J. M., Wynne H. Role of enteric adenoviruses and rotaviruses in infantile gastroenteritis. Lancet. 1981 Aug 8;2(8241):305–306. doi: 10.1016/s0140-6736(81)90549-3. [DOI] [PubMed] [Google Scholar]
  23. Fagbami A. H., Johnson O. A., David-West T. S. Rotavirus infection in children presenting with acute gastroenteritis Ibadan, Nigeria. Trans R Soc Trop Med Hyg. 1985;79(1):114–115. doi: 10.1016/0035-9203(85)90251-2. [DOI] [PubMed] [Google Scholar]
  24. Fagbami A. H., Oyejide C. O., Enahoro F. Neonatal rotavirus infection in urban and rural communities in Nigeria. Trop Geogr Med. 1987 Oct;39(4):341–344. [PubMed] [Google Scholar]
  25. Gatheru Z., Kobayashi N., Adachi N., Chiba S., Muli J., Ogaja P., Nyangao J., Kiplagat E., Tukei P. M. Characterization of human rotavirus strains causing gastroenteritis in Kenya. Epidemiol Infect. 1993 Apr;110(2):419–423. doi: 10.1017/s0950268800068357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Georges-Courbot M. C., Baya C., Abdul-Wahid S., Meunier D., Georges A. J. Rôle des rotavirus dans l'étiologie des diarrhées infantiles en République Centrafricaine. Bull Soc Pathol Exot Filiales. 1984 Jan-Feb;77(1):32–38. [PubMed] [Google Scholar]
  27. Georges-Courbot M. C., Beraud A. M., Beards G. M., Campbell A. D., Gonzalez J. P., Georges A. J., Flewett T. H. Subgroups, serotypes, and electrophoretypes of rotavirus isolated from children in Bangui, Central African Republic. J Clin Microbiol. 1988 Apr;26(4):668–671. doi: 10.1128/jcm.26.4.668-671.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Georges-Courbot M. C., Monges J., Beraud-Cassel A. M., Gouandjika I., Georges A. J. Prospective longitudinal study of rotavirus infections in children from birth to two years of age in Central Africa. Ann Inst Pasteur Virol. 1988 Oct-Dec;139(4):421–428. doi: 10.1016/s0769-2617(88)80077-7. [DOI] [PubMed] [Google Scholar]
  29. Georges-Courbot M. C., Monges J., Siopathis M. R., Roungou J. B., Gresenguet G., Bellec L., Bouquety J. C., Lanckriet C., Cadoz M., Hessel L. Evaluation of the efficacy of a low-passage bovine rotavirus (strain WC3) vaccine in children in Central Africa. Res Virol. 1991 Sep-Oct;142(5):405–411. doi: 10.1016/0923-2516(91)90008-q. [DOI] [PubMed] [Google Scholar]
  30. Georges M. C., Roure C., Tauxe R. V., Meunier D. M., Merlin M., Testa J., Baya C., Limbassa J., Georges A. J. Diarrheal morbidity and mortality in children in the Central African Republic. Am J Trop Med Hyg. 1987 May;36(3):598–602. doi: 10.4269/ajtmh.1987.36.598. [DOI] [PubMed] [Google Scholar]
  31. Georges M. C., Wachsmuth I. K., Meunier D. M., Nebout N., Didier F., Siopathis M. R., Georges A. J. Parasitic, bacterial, and viral enteric pathogens associated with diarrhea in the Central African Republic. J Clin Microbiol. 1984 May;19(5):571–575. doi: 10.1128/jcm.19.5.571-575.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Geyer A., Crewe-Brown H. H., Greeff A. S., Fripp P. J., Steele A. D., Van Schalkwyk T. V., Clay C. G. The microbial aetiology of summer paediatric gastroenteritis at Ga-Rankuwa Hospital in South Africa. East Afr Med J. 1993 Feb;70(2):78–81. [PubMed] [Google Scholar]
  33. Goh Rowland S. G., Lloyd-Evans N., Williams K., Rowland M. G. The etiology of diarrhoea studied in the community in young urban Gambian children. J Diarrhoeal Dis Res. 1985 Mar;3(1):7–13. [PubMed] [Google Scholar]
  34. Gomwalk N. E., Gosham L. T., Umoh U. J. Rotavirus gastroenteritis in pediatric diarrhoea in Jos, Nigeria. J Trop Pediatr. 1990 Apr;36(2):52–55. doi: 10.1093/tropej/36.2.52. [DOI] [PubMed] [Google Scholar]
  35. Gomwalk N. E., Umoh U. J., Gosham L. T., Ahmad A. A. Influence of climatic factors on rotavirus infection among children with acute gastroenteritis in Zaria, northern Nigeria. J Trop Pediatr. 1993 Oct;39(5):293–297. doi: 10.1093/tropej/39.5.293. [DOI] [PubMed] [Google Scholar]
  36. Griffiths F. H., Steele A. D., Alexander J. J. The molecular epidemiology of rotavirus-associated gastro-enteritis in the Transkei, southern Africa. Ann Trop Paediatr. 1992;12(3):259–264. doi: 10.1080/02724936.1992.11747582. [DOI] [PubMed] [Google Scholar]
  37. Haffejee I. E., Moosa A. Rotavirus studies in Indian (Asian) South African infants with acute gastro-enteritis: I. Microbiological and epidemiological aspects. Ann Trop Paediatr. 1990;10(2):165–172. doi: 10.1080/02724936.1990.11747425. [DOI] [PubMed] [Google Scholar]
  38. Haffejee I. E., Moosa A. Rotavirus studies in Indian (Asian) South African infants with acute gastro-enteritis: II. Clinical aspects and outcome. Ann Trop Paediatr. 1990;10(3):245–254. doi: 10.1080/02724936.1990.11747438. [DOI] [PubMed] [Google Scholar]
  39. Haffejee I. E., Moosa A., Windsor I. Circulating and breast-milk anti-rotaviral antibodies and neonatal rotavirus infections: a maternal-neonatal study. Ann Trop Paediatr. 1990 Mar;10(1):3–14. doi: 10.1080/02724936.1990.11747401. [DOI] [PubMed] [Google Scholar]
  40. Haffejee I. E., Windsor I., Moosa A. Asymptomatic rotavirus infections among normal Indian children in Chatsworth, Durban. S Afr Med J. 1989 Dec 2;76(11):599–601. [PubMed] [Google Scholar]
  41. Hanlon P., Hanlon L., Marsh V., Byass P., Shenton F., Hassan-King M., Jobe O., Sillah H., Hayes R., M'Boge B. H. Trial of an attenuated bovine rotavirus vaccine (RIT 4237) in Gambian infants. Lancet. 1987 Jun 13;1(8546):1342–1345. doi: 10.1016/s0140-6736(87)90649-0. [DOI] [PubMed] [Google Scholar]
  42. Hanlon P., Hanlon L., Marsh V., Byass P., Shenton F., Sanders R. C., Hassan-King M., Greenwood B. M. Epidemiology of rotavirus in a periurban Gambian community. Ann Trop Paediatr. 1987 Dec;7(4):238–243. doi: 10.1080/02724936.1987.11748515. [DOI] [PubMed] [Google Scholar]
  43. Hassan E. M., el-Meneza S. A., el-Rashidy Z., Rashad R., Rabie S., Fahmy S. A. Detection of enteropathogens in diarrhoeal diseases among malnourished Egyptian infant and children. J Egypt Public Health Assoc. 1989;64(5-6):461–474. [PubMed] [Google Scholar]
  44. Kakai R., Wamola I. A., Bwayo J. J. Association of human rotavirus infection and intestinal rotavirus-specific immunoglobulin A in children with diarrhoea. East Afr Med J. 1995 Apr;72(4):217–219. [PubMed] [Google Scholar]
  45. Kapikian A. Z., Hoshino Y., Chanock R. M., Pérez-Schael I. Efficacy of a quadrivalent rhesus rotavirus-based human rotavirus vaccine aimed at preventing severe rotavirus diarrhea in infants and young children. J Infect Dis. 1996 Sep;174 (Suppl 1):S65–S72. doi: 10.1093/infdis/174.supplement_1.s65. [DOI] [PubMed] [Google Scholar]
  46. Kidd A. H., Rosenblatt A., Besselaar T. G., Erasmus M. J., Tiemessen C. T., Berkowitz F. E., Schoub B. D. Characterization of rotaviruses and subgroup F adenoviruses from acute summer gastroenteritis in South Africa. J Med Virol. 1986 Feb;18(2):159–168. doi: 10.1002/jmv.1890180208. [DOI] [PubMed] [Google Scholar]
  47. Makino Y., Matsumoto I., Chiba Y., Mohammed O. A., Ogaja P. O., Kibue A. M., Muli J. M., Nakitare G. W. Virological survey of children in Nyeri and Mombasa. Monthly survey of rotavirus in faeces. East Afr Med J. 1983 Aug;60(8):536–541. [PubMed] [Google Scholar]
  48. Mefane C., Richard-Lenoble D., Gendrel D., Engonah E. Diarrhées du jeune enfant à Libreville (Gabon). Recherches écologiques. Arch Fr Pediatr. 1986 Dec;43(10):813–816. [PubMed] [Google Scholar]
  49. Mnisi Y. N., Williams M. M., Steele A. D. Subgroup and serotype epidemiology of human rotaviruses recovered at Ga-Rankuwa, southern Africa. Cent Afr J Med. 1992 Jun;38(6):221–225. [PubMed] [Google Scholar]
  50. Mpabalwani M., Oshitani H., Kasolo F., Mizuta K., Luo N., Matsubayashi N., Bhat G., Suzuki H., Numazaki Y. Rotavirus gastro-enteritis in hospitalized children with acute diarrhoea in Zambia. Ann Trop Paediatr. 1995;15(1):39–43. doi: 10.1080/02724936.1995.11747747. [DOI] [PubMed] [Google Scholar]
  51. Murray C. J., Lopez A. D. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997 May 17;349(9063):1436–1442. doi: 10.1016/S0140-6736(96)07495-8. [DOI] [PubMed] [Google Scholar]
  52. Mutanda L. N. Epidemiology of acute gastroenteritis in early childhood in Kenya. III. Distribution of the aetiological agents. East Afr Med J. 1980 May;57(5):317–326. [PubMed] [Google Scholar]
  53. Mutanda L. N. Epidemiology of acute gastroenteritis in early childhood in Kenya. VI. Some clinical and laboratory characteristics relative to the aetiological agents. East Afr Med J. 1980 Sep;57(9):599–606. [PubMed] [Google Scholar]
  54. Mutanda L. N. Epidemiology of acute gastroenteritis in early childhood in Kenya: aetiological agents. Trop Geogr Med. 1980 Jun;32(2):138–144. [PubMed] [Google Scholar]
  55. Mutanda L. N., Kangethe S. K., Juma R., Lichenga E. O., Gathecha C. Aetiology of diarrhoea in malnourished children at Kenyatta National Hospital. East Afr Med J. 1985 Dec;62(12):835–841. [PubMed] [Google Scholar]
  56. Mutanda L. N., Kinoti S. N., Gemert W., Lichenga E. O. Age distribution and seasonal pattern of rotavirus infection in children in Kenya. J Diarrhoeal Dis Res. 1984 Sep;2(3):147–150. [PubMed] [Google Scholar]
  57. Mutanda L. N., Patel A., Masudi A. M., Maina G. Aetiology of diarrhoea in pre-term neonates at Kenyatta National Hospital nursery, Nairobi, Kenya. East Afr Med J. 1990 Apr;67(4):223–230. [PubMed] [Google Scholar]
  58. Mølbak K., Wested N., Højlyng N., Scheutz F., Gottschau A., Aaby P., da Silva A. P. The etiology of early childhood diarrhea: a community study from Guinea-Bissau. J Infect Dis. 1994 Mar;169(3):581–587. doi: 10.1093/infdis/169.3.581. [DOI] [PubMed] [Google Scholar]
  59. Naguib T., Wyatt R. G., Mohieldin M. S., Zaki A. M., Imam I. Z., DuPont H. L. Cultivation and subgroup determination of human rotaviruses from Egyptian infants and young children. J Clin Microbiol. 1984 Feb;19(2):210–212. doi: 10.1128/jcm.19.2.210-212.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Nakano T., Binka F. N., Afari E. A., Agbodaze D., Aryeetey M. E., Mingle J. A., Kamiya H., Sakurai M. Survey of enteropathogenic agents in children with and without diarrhoea in Ghana. J Trop Med Hyg. 1990 Dec;93(6):408–412. [PubMed] [Google Scholar]
  61. Oelofsen M. J., Venter E. H., Smith M. S. Nosocomial rotavirus infections in a South African hospital nursery for white infants. S Afr Med J. 1985 Sep 14;68(6):394–396. [PubMed] [Google Scholar]
  62. Ogunsanya T. I., Rotimi V. O., Adenuga A. A study of the aetiological agents of childhood diarrhoea in Lagos, Nigeria. J Med Microbiol. 1994 Jan;40(1):10–14. doi: 10.1099/00222615-40-1-10. [DOI] [PubMed] [Google Scholar]
  63. Olusanya O., Taiwo O. Rotavirus as an aetiological agent of acute childhood diarrhoea in Ile-Ife, Nigeria. East Afr Med J. 1989 Feb;66(2):100–104. [PubMed] [Google Scholar]
  64. Omoigberale A. I., Abiodun P. O. Nosocomial rotavirus infection in newborns. East Afr Med J. 1995 Apr;72(4):220–221. [PubMed] [Google Scholar]
  65. Oyejide C. O., Fagbami A. H. An epidemiological study of rotavirus diarrhoea in a cohort of Nigerian infants: II. Incidence of diarrhoea in the first two years of life. Int J Epidemiol. 1988 Dec;17(4):908–912. doi: 10.1093/ije/17.4.908. [DOI] [PubMed] [Google Scholar]
  66. Paul M. O., Erinle E. A. Rotavirus infection in Nigerian infants and young children with gastroenteritis. Am J Trop Med Hyg. 1982 Mar;31(2):374–375. doi: 10.4269/ajtmh.1982.31.374. [DOI] [PubMed] [Google Scholar]
  67. Paul M. O., Paul B. D. Rotavirus infection among children in hospital in Nigeria. J Infect. 1986 Jan;12(1):39–47. doi: 10.1016/s0163-4453(86)94862-0. [DOI] [PubMed] [Google Scholar]
  68. Pavone R., Schinaia N., Hart C. A., Getty B., Molyneux M., Borgstein A. Viral gastro-enteritis in children in Malawi. Ann Trop Paediatr. 1990 Mar;10(1):15–20. doi: 10.1080/02724936.1990.11747402. [DOI] [PubMed] [Google Scholar]
  69. Pazzaglia G., Bourgeois A. L., Araby I., Mikhail I., Podgore J. K., Mourad A., Riad S., Gaffar T., Ramadan A. M. Campylobacter-associated diarrhoea in Egyptian infants: epidemiology and clinical manifestations of disease and high frequency of concomitant infections. J Diarrhoeal Dis Res. 1993 Mar;11(1):6–13. [PubMed] [Google Scholar]
  70. Robins-Browne R. M., Still C. S., Miliotis M. D., Richardson N. J., Koornhof H. J., Freiman I., Schoub B. D., Lecatsas G., Hartman E. Summer diarrhoea in African infants and children. Arch Dis Child. 1980 Dec;55(12):923–928. doi: 10.1136/adc.55.12.923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Rowland M. G., Davies H., Patterson S., Dourmashkin R. R., Tyrrell D. A., Matthews T. H., Parry J., Hall J., Larson H. E. Viruses and diarrhoea in West Africa and London: A collaborative study. Trans R Soc Trop Med Hyg. 1978;72(1):95–98. doi: 10.1016/0035-9203(78)90308-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. Rowland M. G., Goh S. G., Williams K., Campbell A. D., Beards G. M., Sanders R. C., Flewett T. H. Epidemiological aspects of rotavirus infection in young Gambian children. Ann Trop Paediatr. 1985 Mar;5(1):23–28. doi: 10.1080/02724936.1985.11748354. [DOI] [PubMed] [Google Scholar]
  73. Rowland M. G., McCollum J. P. Malnutrition and gastroenteritis in The Gambia. Trans R Soc Trop Med Hyg. 1977;71(3):199–203. doi: 10.1016/0035-9203(77)90006-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  74. Sam N. E., Haukenes G., Szilvay A. M., Mhalu F. Rotavirus infection in Tanzania: a virological, epidemiological and clinical study among young children. APMIS. 1992 Sep;100(9):790–796. doi: 10.1111/j.1699-0463.1992.tb04001.x. [DOI] [PubMed] [Google Scholar]
  75. Schoub B. D., Cohen F., Thompson D., Koornhof H. J., Miliotis M. D., Still C. S., Berkowitz F. E., Miller S., Kushlick E. Variance in rotavirus infection rates in different urban population groups in South Africa. J Med Virol. 1982;10(3):171–179. doi: 10.1002/jmv.1890100303. [DOI] [PubMed] [Google Scholar]
  76. Schoub B. D., Greeff A. S., Lecatsas G., Prozesky O. W., Hay I. T., Prinsloo J. G., Ballard R. C. A microbiological investigation of acute summer gastroenteritis in black South African infants. J Hyg (Lond) 1977 Jun;78(3):377–385. doi: 10.1017/s0022172400056278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  77. Schoub B. D., Koornhof H. J., Lecatsas G., Prozesky O. W., Freiman I., Hartman E., Kassel H. Letter: Viruses in acute summer gastroenteritis in black infants. Lancet. 1975 May 10;1(7915):1093–1094. doi: 10.1016/s0140-6736(75)91869-3. [DOI] [PubMed] [Google Scholar]
  78. Schoub B. D., Robins-Browne R. M., Lecatsas G., Still C. S., Miliotis M., Koornhof H. J., Prozesky O. W. Rotavirus and winter gastro-enteritis in White South African infants. S Afr Med J. 1977 Dec 10;52(25):998–999. [PubMed] [Google Scholar]
  79. Shukry S., Zaki A. M., DuPont H. L., Shoukry I., el Tagi M., Hamed Z. Detection of enteropathogens in fatal and potentially fatal diarrhea in Cairo, Egypt. J Clin Microbiol. 1986 Dec;24(6):959–962. doi: 10.1128/jcm.24.6.959-962.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  80. Sitbon M., Lecerf A., Garin Y., Ivanoff B. Rotavirus prevalence and relationships with climatological factors in Gabon, Africa. J Med Virol. 1985 Jun;16(2):177–182. doi: 10.1002/jmv.1890160210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  81. Steele A. D., Alexander J. J., Hay I. T. Rotavirus-associated gastroenteritis in black infants in South Africa. J Clin Microbiol. 1986 May;23(5):992–994. doi: 10.1128/jcm.23.5.992-994.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  82. Steele A. D., Alexander J. J. Molecular epidemiology of rotavirus in black infants in South Africa. J Clin Microbiol. 1987 Dec;25(12):2384–2387. doi: 10.1128/jcm.25.12.2384-2387.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  83. Steele A. D., Alexander J. J. The relative frequency of subgroup I and II rotaviruses in black infants in South Africa. J Med Virol. 1988 Mar;24(3):321–327. doi: 10.1002/jmv.1890240309. [DOI] [PubMed] [Google Scholar]
  84. Steele A. D., Geyer A., Alexander J. J., Crewe-Brown H. H., Fripp P. J. Enteropathogens isolated from children with gastro-enteritis at Ga-Rankuwa Hospital, South Africa. Ann Trop Paediatr. 1988 Dec;8(4):262–267. doi: 10.1080/02724936.1988.11748584. [DOI] [PubMed] [Google Scholar]
  85. Steele A. D., Mnisi Y. N., Williams M. M., Bos P., Aspinall S. Electrophoretic typing of nosocomial rotavirus infection in a general paediatric unit showing the continual introduction of community strains. J Med Virol. 1993 Jun;40(2):126–132. doi: 10.1002/jmv.1890400209. [DOI] [PubMed] [Google Scholar]
  86. Steele A. D., Sears J. F. Characterisation of rotaviruses recovered from neonates with symptomatic infection. S Afr Med J. 1996 Dec;86(12):1546–1549. [PubMed] [Google Scholar]
  87. Steele A. D. Shift in genomic RNA patterns of human rotaviruses isolated from white children in South Africa. S Afr Med J. 1991 Feb 2;79(3):143–145. [PubMed] [Google Scholar]
  88. Steele A. D., Steinhardt L. S., Alexander J. J. Viruses excreted in neonatal stools. S Afr Med J. 1987 Aug 1;72(3):198–200. [PubMed] [Google Scholar]
  89. Steele A. D., van Niekerk M. C., Geyer A., Bos P., Alexander J. J. Further characterisation of human rotaviruses isolated from asymptomatically infected neonates in South Africa. J Med Virol. 1992 Sep;38(1):22–26. doi: 10.1002/jmv.1890380106. [DOI] [PubMed] [Google Scholar]
  90. Steele A. D., van Niekerk M. C., Mphahlele M. J. Geographic distribution of human rotavirus VP4 genotypes and VP7 serotypes in five South African regions. J Clin Microbiol. 1995 Jun;33(6):1516–1519. doi: 10.1128/jcm.33.6.1516-1519.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  91. Stintzing G., Bäck E., Tufvesson B., Johnsson T., Wadström T., Habte D. Seasonal fluctuations in the occurrence of enterotoxigenic bacteria and rotavirus in paediatric diarrhoea in Addis Ababa. Bull World Health Organ. 1981;59(1):67–73. [PMC free article] [PubMed] [Google Scholar]
  92. Thorén A., Stintzing G., Tufvesson B., Walder M., Habte D. Aetiology and clinical features of severe infantile diarrhoea in Addis Ababa, Ethiopia. J Trop Pediatr. 1982 Jun;28(3):127–131. doi: 10.1093/tropej/28.3.127. [DOI] [PubMed] [Google Scholar]
  93. Tiemessen C. T., Wegerhoff F. O., Erasmus M. J., Kidd A. H. Infection by enteric adenoviruses, rotaviruses, and other agents in a rural African environment. J Med Virol. 1989 Jul;28(3):176–182. doi: 10.1002/jmv.1890280313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  94. Tswana S. A., Jorgensen P. H., Halliwell R. W., Kapaata R., Moyo S. R. The incidence of rotavirus infection in children from two selected study areas in Zimbabwe. Cent Afr J Med. 1990 Oct;36(10):241–246. [PubMed] [Google Scholar]
  95. Tufvesson B. Detection of a human rotavirus strain different from types 1 and 2--a new subgroup? Epidemiology of subgroups in a Swedish and an Ethiopian community. J Med Virol. 1983;12(2):111–117. doi: 10.1002/jmv.1890120205. [DOI] [PubMed] [Google Scholar]
  96. Urasawa T., Urasawa S., Chiba Y., Taniguchi K., Kobayashi N., Mutanda L. N., Tukei P. M. Antigenic characterization of rotaviruses isolated in Kenya from 1982 to 1983. J Clin Microbiol. 1987 Oct;25(10):1891–1896. doi: 10.1128/jcm.25.10.1891-1896.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  97. Vargues F., Samb A., M'Boup S., Gaye A., Sene M., David M. P., Cisse F. Etudes parasitologique, bactériologique et virologique de selles de 212 enfants diarrhéiques dakarois non hospitalisés. Application du concept d'infection opportuniste de masse. Bull Soc Pathol Exot Filiales. 1984 Jan-Feb;77(1):97–103. [PubMed] [Google Scholar]
  98. Zaki A. M., DuPont H. L., el Alamy M. A., Arafat R. R., Amin K., Awad M. M., Bassiouni L., Imam I. Z., el Malih G. S., el Marsafie A. The detection of enteropathogens in acute diarrhea in a family cohort population in rural Egypt. Am J Trop Med Hyg. 1986 Sep;35(5):1013–1022. doi: 10.4269/ajtmh.1986.35.1013. [DOI] [PubMed] [Google Scholar]
  99. de Mol P., Brasseur D., Hemelhof W., Kalala T., Butzler J. P., Vis H. L. Enteropathogenic agents in children with diarrhoea in rural Zaire. Lancet. 1983 Mar 5;1(8323):516–518. doi: 10.1016/s0140-6736(83)92202-x. [DOI] [PubMed] [Google Scholar]
  100. de Zoysa I., Feachem R. G. Interventions for the control of diarrhoeal diseases among young children: rotavirus and cholera immunization. Bull World Health Organ. 1985;63(3):569–583. [PMC free article] [PubMed] [Google Scholar]
  101. el-Mougi M., Amer A., el-Abhar A., Hughes J., el-Shafie A. Epidemiological and clinical features of rotavirus associated acute infantile diarrhoea in Cairo, Egypt. J Trop Pediatr. 1989 Oct;35(5):230–233. doi: 10.1093/tropej/35.5.230. [DOI] [PubMed] [Google Scholar]

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