Browsing by Author "Moji, K."
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Item Rotavirus infections with multiple emerging genotypes in Sri Lanka(Springer-Verlag, 2010) Ahmed, K.; Batuwanthudawe, R.; Chandrasena, T.G.A.N.; Mitui, M.T.; Rajindrajith, S.; Galagoda, G.; Pun, S.B.; Uchida, R.; Kunii, O.; Moji, K.; Abeysinghe, N.; Nishizono, A.; Nakagomi, O.Rotavirus diarrhea is an important cause of child mortality in developing countries, but studies on this diarrhea are scarce in Sri Lanka. A prospective study conducted in Sri Lanka on rotavirus infection among children in a hospital setting (n = 611) versus children residing in tsunami camps (n = 52) showed that prevalence of rotavirus infection was comparable, 21.9 and 20%, respectively. The hospital and camps were located in different districts. Analysis of the genotypes of 122 rotaviruses from the hospital and 12 from the camps indicated that G9P[8] was associated with 35 and 33%; G12P[8/nt] with 14.7 and 33%; G3P[8/4/nt] with 17 and 8% and G1P[8/4] with 6.5 and 16.7%. Rotaviruses with G2P[8/4/6] and G4P[8/4] were hospital-associated only, and some rotaviruses (9 and 8% from the hospital and the camps, respectively) were G- and P-nontypable. We conclude from the present study that multiple emerging genotypes were prevalent in Sri Lanka, and children in camps were at risk of developing diarrhea due to rotavirusesItem Rotavirus surveillance at the North Colombo Teaching Hospital, Sri Lanka, 2007-2008(Sri Lanka College of Paediatricians, 2010) Chandrasena, T.G.A.N.; Rajindrajith, S.; Gunawardena, N.K.; Abayawardana, U.A.T.M.; Ranasinghe, S.L.; Nishizono, A.; Moji, K.; Ahmed, K.INTRODUCTION: Rotavirus disease is a common paediatric problem and accounts for severe dehydrating diarrhoea, a large number of hospital admissions and an annually estimated 600,000 deaths across the world. Prospective Rotavirus surveillance was initiated at the North Colombo Teaching Hospital (NCTH), Sri Lanka from April 2005. The serorype distribution in our previous study was; G9P[S] 35.2%, G12P[8] 14.7%, G3P[4] 17.2%, G2P[8/4/6] 14%, GlP[8/4] 6.5% and G4P[8/4] 3.3%. OBJECTIVE: To describe the serotype distribution of rotavirus responsible for hospitalization at the NCTH. DESIGN, SETTING AND METHOD: A prospective hospital-based study was conducted in the paediatric units of the NCTH from November 2007-October 2008. Stool samples of children admitted with diarrhoea were analyzed for Group A rotavirus antigen by enzyme linked immunosorbent assay (ELISA) (Rotaclone). Stool samples positive for rotavirus were characterized by electropherotyping (PAGE) and serotyping (reverse transcription polymasase chain reaction - RT PCR). RESULTS: Group A rotavirus was detected in 78 (33%) of 231 children less than 5 years of age admitted with diarrhoea. G9, Gl, G2, G3 and G non-typable infections were seen in 33(42%), 31 (40%) 7 (9%), 1 (1.3%) and 4 (5%) respectively. A predominance of G9 serotype (84%) was seen during the initial seven months. Dramatic transition of genotypic predominance to Gl (70%) occurred in the latter half of the year. All Gl, G3 and G9 strains assayed for P genotype contained P8 except two mixed G9 infections which were associated with P4 and PS. In contrast to the previous report, all G2 strains identified were associated with P4 and serotypes G12P [8] and G4P [8/4] were not detected. Polyacrylamide-gel-electrophoresis revealed the presence of El, E2, E3, E4 and E5 electropherotypes with a co-dominance of Eland E5 (30.7%). CONCLUSIONS: During the study period a rising trend in prevalence with a fluctuating genotypic distribution was observed at CNTH, Sri Lanka. The diversity of rotavirus serotypes requires a vaccine that confers adequate homotypic and heterorypic protection against these strains.Item Spatial epidemiology and hotspots of Rotavirus In children: an analysis and mapping using Geographic Information System(Sri Lanka College of Paediatricians, 2010) Gunawardena, N.K.; Rajindrajith, S.; Chandrasena, T.G.A.N.; Nishizono, A.; Moji, K.; Ahmed, K.INTRODUCTION: Rotavirus is a leading cause of acute gastroenteritis in Sri Lanka. Studies from the western world have assessed the seasonal variations of this infection and its association with environmental factors such as rainfall and temperature. However, little is known of its seasonal variation and geographical distribution in Sri Lanka. Areliable and updated distribution map of rotavirus infection is essential for target control strategies and policy making processes. Geographical Information. System (GIS) has previously been used to monitor spatial distribution of diseases and their transmission dynamics. For the first time we describe the spatial epidemiological patterns of rotavirus diarrhoea in Sri Lanka. OBJECTIVE: To study the spatial epidemiological distribution of rotaviral infection among children with diarrhoeal diseases admitted to the North Colombo Teaching Hospital, Ragama. DESIGN, SETTING AND METHOD: This study was carried out in two phases. Phase I, a prospective hospital-based study, was conducted in the North Colombo Teaching Hospital from January 2008 to October 2009 to detect the incidence of rotavirus infection in children with diarrhoea. Stool samples were analyzed for Group A rotavirus antigen by enzyme linked immunosorbent assay (EL1SA) (Rotaclone). During Phase II of the study, patients with rotavirus infection were mapped using geographic coordinates obtained from a hand-held GIS receiver (Trimble Juno SB). Rainfall and temperature data for the years 2008 and 2009 in the Gampaha District were obtained from the Department of Meteorology, Sri Lanka and correlated with the spatial distribution data. RESULTS: In 2008 and 2009, 71 (60.6% males) and 99 (63.6% males) had rotavirus infection respectively. Spatial distribution data showed that most rotavirus infections (78%) presenting to the Teaching Hospital, Ragama were coming from a 10 km radius of catchment area. The hot spots were clustered in and around the marshy land areas of the Gampaha District and 67% use water from their own well or from the well of a neighbour. The peak incidence in both years was between May and July which coincided with the highest rainfall to the area. There was no correlation between environmental temperature and rotavirus infection rates. CONCLUSION: Incidence of rotavirus infection is highest in children living around marshy lands and using water from private sources such as a well.