Epidemiology of rotavirus gastroenteritis among children <5 years of age in Morocco during 1 year of sentinel hospital surveillance, June 2006-May 2007.

BACKGROUND In anticipation of vaccine introduction, we assessed the epidemiology, burden, and genotype of infecting strains of rotavirus disease among Moroccan children hospitalized for acute gastroenteritis. METHODS From June 2006 through May 2007, 345 children <5 years of age who had acute gastroenteritis and were admitted to 4 sentinel hospitals in different regions of Morocco were enrolled in this surveillance study, and stool specimens were tested for the presence of rotavirus with use of enzyme immunoassay. RNA from positive samples was genotyped by reverse-transcriptase polymerase chain reaction. RESULTS Overall, 314 children had complete data available, and among these, 138 (44%) tested positive for rotavirus. Rotavirus infection was most common among children <24 months of age (95% of all hospitalizations for rotavirus infection). Rotavirus infection was detected year-round at all 4 sites but was most prevalent from September through January. Genotype analysis demonstrated that 30.6% of samples were G1[P8], 26% were G9[P8], 7.5% were G2[P6], 3.7% were G1[P6], and 0.7% were G2[P8]. Nucleotide sequencing analysis of G- or P-untypeable strains showed that 4.5% were G9[P8], 2.2% were G1[8], 2.2% were G2[P6], and 1.5% were G2[P4]. A high frequency of mixed infection (21%) was found, of which G1G2[P8] accounted for the majority (16.4%). CONCLUSIONS Rotavirus was responsible for 44% of all hospitalizations for diarrhea among young children at these 4 separate sites in Morocco. These data will help inform a decision on the introduction of rotavirus vaccine in Morocco. Continued and extended surveillance in Morocco will be important to monitor changes in the epidemiology of rotavirus disease and the impact of vaccination after introduction.