Human rotavirus associated diarrhea and strain diversity in Nepal.

Two new rotavirus vaccines were recently introduced to the market and have shown a tremendous impact in reducing severe diarrhea due to rotavirus in children. Diarrheal disease is a common cause of morbidity and mortality among Nepalese children. In anticipation of a rotavirus vaccine in Nepal, we systematically reviewed published articles on rotavirus infection in Nepal. Literatures were searched in health related national and international databases. Fifteen rotavirus related articles between 1978 and 2010 were identified. Of these, information from five articles were extracted and analyzed in the present study. Of 3671 participants, 864 were positive for rotavirus infection by ELISA. The prevalence ofrotavirus infection ranged from 12 to 39%. G1P[8] (25%) was the most frequent combined G and P genotype, followed by G12P[6] (23%) and G2P[4] (16%) between 2003 and 2007. Nearly 9% of analyzed rotavirus positive samples (G and P genotype) were non-typable. The data demonstrated that rotavirus is the most identifiable cause of severe diarrhea in children less than 5 years old in Nepal. The wide variety of rotavirus strains circulating in Nepal; underscore the need for continued surveillance. This will be the key to understanding the epidemiological characteristics of rotavirus disease and the impact of vaccination after introduction.