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Meta-Analysis
. 2024 May 31;24(1):547.
doi: 10.1186/s12879-024-09434-6.

Rotavirus vaccines in Africa and Norovirus genetic diversity in children aged 0 to 5 years old: a systematic review and meta-analysis : Rotavirus vaccines in Africa and Norovirus genetic diversity

Dako Dakouo  1 , Djénéba Ouermi  1   2   3 , Abdoul Karim Ouattara  4   5 , Abibou Simpore  1   6 , Tégwendé Rebecca Compaore  1   7 , Mah Alima Esther Traore  1 , Zakaria Gamsore  1 , Abdou Azaque Zoure  1   7 , Lassina Traore  1   2 , Théodora Mahoukèdè Zohoncon  1   2   8 , Albert Théophane Yonli  1   2 , P Denise Ilboudo  1 , Florencia Wendkuuni Djigma  1   2 , Jacques Simpore  1   2
Affiliations
Meta-Analysis

Rotavirus vaccines in Africa and Norovirus genetic diversity in children aged 0 to 5 years old: a systematic review and meta-analysis : Rotavirus vaccines in Africa and Norovirus genetic diversity

Dako Dakouo et al. BMC Infect Dis. .

Abstract

Noroviruses are the second leading cause of death in children under the age of 5 years old. They are responsible for 200 million cases of diarrhoea and 50,000 deaths in children through the word, mainly in low-income countries. The objective of this review was to assess how the prevalence and genetic diversity of noroviruses have been affected by the introduction of rotavirus vaccines in Africa. PubMed, Web of Science and Science Direct databases were searched for articles. All included studies were conducted in Africa in children aged 0 to 5 years old with gastroenteritis. STATA version 16.0 software was used to perform the meta-analysis. The method of Dersimonian and Laird, based on the random effects model, was used for the statistical analyses in order to estimate the pooled prevalence's at a 95% confidence interval (CI). Heterogeneity was assessed by Cochran's Q test using the I2 index. The funnel plot was used to assess study publication bias. A total of 521 studies were retrieved from the databases, and 19 were included in the meta-analysis. The pooled norovirus prevalence's for pre- and post-vaccination rotavirus studies were 15% (95 CI, 15-18) and 13% (95 CI, 09-17) respectively. GII was the predominant genogroup, with prevalence of 87.64% and 91.20% respectively for the pre- and post-vaccination studies. GII.4 was the most frequently detected genotype, with rates of 66.84% and 51.24% respectively for the pre- and post-vaccination studies. This meta-analysis indicates that rotavirus vaccination has not resulted in a decrease in norovirus infections in Africa.

Keywords: Africa; Epidemiology; Gastroenteritis; Genotypes; Meta-analysis; Norovirus.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart for the selection of studies according to the PRISMA protocol
Fig. 2
Fig. 2
Forest plot of pooled norovirus prevalence in children aged 0–5 years with gastroenteritis in Africa. Legend The size of each grey square indicates the weight of the study contributing to the pooled prevalence estimate. The line running horizontally through each grey square refers to a 95% confidence interval with the mean effect at the centre (the point estimate of prevalence for each study). The dotted blue line represents the mean estimate of the pooled prevalence of norovirus. The dark blue diamond represents the 95% confidence interval of the pooled norovirus prevalence estimate. The length of the confidence interval is proportional to the size of the study sample and therefore to the precision of the estimate
Fig. 3
Fig. 3
Distribution of norovirus infections in children aged 0–5 years by region of Africa
Fig. 4
Fig. 4
Forest representation of pooled prevalence estimates of norovirus infection before and after the introduction of rotavirus vaccines in Africa
Fig. 5
Fig. 5
Distribution of norovirus genotypes in children aged 0–5 years with gastroenteritis in Africa
Fig. 6
Fig. 6
Forest plot of the distribution of cases of rotavirus-norovirus co-infections in African children aged 0–5 years
Fig. 7
Fig. 7
Prevalence of norovirus genogroups in children aged 0–5 years no gastroenteritis in Africa
Fig. 8
Fig. 8
Distribution of norovirus genotypes in children aged 0–5 years no gastroenteritis in Africa
Fig. 9
Fig. 9
Funnel diagram for assessing study publication bias. Legend: Each point represents a study. The subjective evaluation of this diagram gives an indication of the heterogeneity of the studies. The y-axis represents the precision (inverse of the variance) expressed here at a ratio of 1/1000. The x axis represents the standardised effect transformed into a log (estimate divided by its standard error)
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