Differences in epidemiology of enteropathogens in children pre- and post-rotavirus vaccine introduction in Kilifi, coastal Kenya. 2022

Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, P.O. Box 230, Kilifi, 80108, Kenya. cnyaigoti@kemri-wellcome.org.

BACKGROUND Kenya introduced Rotarix® (GlaxoSmithKline Biologicals, Rixensart, Belgium) vaccination into its national immunization programme beginning July 2014. The impact of this vaccination program on the local epidemiology of various known enteropathogens is not fully understood. METHODS We used a custom TaqMan Array Card (TAC) to screen for 28 different enteropathogens in 718 stools from children aged less than 13 years admitted to Kilifi County Hospital, coastal Kenya, following presentation with diarrhea in 2013 (before vaccine introduction) and in 2016-2018 (after vaccine introduction). Pathogen positivity rate differences between pre- and post-Rotarix® vaccination introduction were examined using both univariate and multivariable logistic regression models. RESULTS In 665 specimens (92.6%), one or more enteropathogen was detected, while in 323 specimens (48.6%) three or more enteropathogens were detected. The top six detected enteropathogens were: enteroaggregative Escherichia coli (EAggEC; 42.1%), enteropathogenic Escherichia coli (EPEC; 30.2%), enterovirus (26.9%), rotavirus group A (RVA; 24.8%), parechovirus (16.6%) and norovirus GI/GII (14.4%). Post-rotavirus vaccine introduction, there was a significant increase in the proportion of samples testing positive for EAggEC (35.7% vs. 45.3%, p = 0.014), cytomegalovirus (4.2% vs. 9.9%, p = 0.008), Vibrio cholerae (0.0% vs. 2.3%, p = 0.019), Strongyloides species (0.8% vs. 3.6%, p = 0.048) and Dientamoeba fragilis (2.1% vs. 7.8%, p = 0.004). Although not reaching statistical significance, the positivity rate of adenovirus 40/41 (5.8% vs. 7.3%, p = 0.444), norovirus GI/GII (11.2% vs. 15.9%, p = 0.089), Shigella species (8.7% vs. 13.0%, p = 0.092) and Cryptosporidium spp. (11.6% vs. 14.7%, p = 0.261) appeared to increase post-vaccine introduction. Conversely, the positivity rate of sapovirus decreased significantly post-vaccine introduction (7.8% vs. 4.0%, p = 0.030) while that of RVA appeared not to change (27.4% vs. 23.5%, p = 0.253). More enteropathogen coinfections were detected per child post-vaccine introduction compared to before (mean: 2.7 vs. 2.3; p = 0.0025). CONCLUSIONS In this rural Coastal Kenya setting, childhood enteropathogen infection burden was high both pre- and post-rotavirus vaccination introduction. Children who had diarrheal admissions post-vaccination showed an increase in coinfections and changes in specific enteropathogen positivity rates. This study highlights the utility of multipathogen detection platforms such as TAC in understanding etiology of childhood acute gastroenteritis in resource-limited regions.

UI MeSH Term Description Entries

Related Publications

Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
January 2023, Virus evolution,
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
August 2020, Pathogens (Basel, Switzerland),
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
November 2020, Pathogens (Basel, Switzerland),
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
May 2012, Journal of medical virology,
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
November 2018, Vaccine,
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
January 2019, The Pan African medical journal,
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
May 2017, Journal of medical virology,
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
January 2013, Jornal de pediatria,
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
March 2019, Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases,
Charles N Agoti, and Martin D Curran, and Nickson Murunga, and Moses Ngari, and Esther Muthumbi, and Arnold W Lambisia, and Simon D W Frost, and Barbara A Blacklaws, and D James Nokes, and Lydia N Drumright
January 2018, Wellcome open research,
Copied contents to your clipboard!