Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population

A comprehensive literature search was conducted in major databases on the epidemiology and burden of rotavirus among children less than five years old between 1999 and 2009. Data from each country was extracted and compared.The search identified 43 studies. RVGE was identified in 16-61% of all cases of acute gastroenteritis, with a peak in the winter. RVGE-related hospitalization rates ranged from 14% to 45%, compared to 14%-28% for non-RVGE. Annually, RVGE caused up to 112 fatalities per 100,000 in certain countries in the region. Hospitalization costs ranged from $1.8 to $4.6 million annually, depending on the country. The most recent literature available showed that G1P[8] was the most prevalent genotype combination in 8 countries (range 23%-56%). G2P[4] was most prevalent in 4 countries (26%-48%). G9P[8] and G4P[8] were also frequently detected.RVGE is a common disease associated with significant morbidity, mortality, and economic burden. Given the variety and diverse rotavirus types in the region, use of a vaccine with broad and consistent serotype coverage would be important to help decrease the burden of RVGE in the Middle East and North Africa.Rotavirus remains the most common cause of severe childhood diarrhea worldwide and of diarrheal mortality in developing countries [1]. The main symptoms of rotavirus gastroenteritis (RVGE) are fever, abdominal pain, lethargy, diarrhea and vomiting that may lead to hypovolemic shock and dehydration [2,3]. Severe cases may lead to death [4]. The World Health Organization (WHO) estimates that 527,000 children under the age of five years die of rotavirus disease each year [5]. Children in the poorest countries account for 82% of rotavirus deaths [6].Rotavirus is transmitted by the fecal-oral route [2]. Infection rates for rotavirus are highest in children under five years of age, with 95% of children between the age of three and five years affected [7]. There is seasonality to rotavirus infection, with the majority of case