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Article ; Online: The Full Impact of Rotavirus Vaccines in Africa Has Yet to Be Realized.

Steele, A Duncan / Armah, George E / Mwenda, Jason M / Kirkwood, Carl D

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2023 Volume 76, Issue 76 Suppl 1, Page(s) S1–S4

Abstract: Africa bears the brunt of diarrheal mortality globally. Rotavirus vaccination rates are high across the continent and demonstrate impact on diarrheal disease reduction. Nevertheless, there is room for significant improvement in managing rotavirus vaccine ...

Abstract	Africa bears the brunt of diarrheal mortality globally. Rotavirus vaccination rates are high across the continent and demonstrate impact on diarrheal disease reduction. Nevertheless, there is room for significant improvement in managing rotavirus vaccine coverage, in access to recognized public services such as appropriate medical care, including oral rehydration therapy and improved water and sanitation.
MeSH term(s)	Humans ; Infant ; Rotavirus Vaccines ; Rotavirus Infections/epidemiology ; Rotavirus Infections/prevention & control ; Rotavirus ; Diarrhea/epidemiology ; Diarrhea/prevention & control ; Africa/epidemiology ; Vaccination
Chemical Substances	Rotavirus Vaccines
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciad017
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Article ; Online: Detection of Enterotoxigenic Escherichia coli in Rotavirus-Infected Ghanaian Children Diagnosed with Acute Gastroenteritis.

Dzudzor, Bartholomew / Amenyedor, Albert / Amarh, Vincent / Armah, George E

The American journal of tropical medicine and hygiene

2021 Volume 106, Issue 2, Page(s) 523–524

Abstract: Diarrhea is a notable global health problem in several developing countries, especially in children. Prior to the introduction of the rotavirus vaccination program in Ghana, a surveillance study was conducted to investigate the prevalence of the disease ... ...

Abstract	Diarrhea is a notable global health problem in several developing countries, especially in children. Prior to the introduction of the rotavirus vaccination program in Ghana, a surveillance study was conducted to investigate the prevalence of the disease caused by rotavirus in children. In this report, we re-used archival stool samples from the pre-vaccine surveillance study to provide information on prevalence of enterotoxigenic Escherichia coli in Ghanaian children. Re-analysis of the stool samples revealed co-infection of enterotoxigenic E. coli and rotavirus in 2% of the children whose samples were selected for this study. As Ghana is approaching 10 years post-implementation of the rotavirus vaccination program, the preliminary data presented in this report are a vital reference for subsequent studies aimed at ascertaining the effect of the vaccine on both rotavirus and enterotoxigenic E. coli.
MeSH term(s)	Acute Disease ; Child, Preschool ; Diarrhea/epidemiology ; Diarrhea/etiology ; Diarrhea/microbiology ; Diarrhea/virology ; Enterotoxigenic Escherichia coli/isolation & purification ; Escherichia coli Infections/complications ; Escherichia coli Infections/epidemiology ; Escherichia coli Infections/microbiology ; Female ; Gastroenteritis/diagnosis ; Gastroenteritis/epidemiology ; Gastroenteritis/etiology ; Gastroenteritis/microbiology ; Ghana/epidemiology ; Humans ; Infant ; Infant, Newborn ; Male ; Rotavirus Infections/complications ; Rotavirus Infections/epidemiology
Language	English
Publishing date	2021-11-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.21-0717
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Article: Maintaining Momentum for Rotavirus Immunization in Africa during the COVID-19 Era: Report of the 13th African Rotavirus Symposium.

Were, Frederick N / Jere, Khuzwayo C / Armah, George E / Mphahlele, M Jeffrey / Mwenda, Jason M / Steele, A Duncan

Vaccines

2022 Volume 10, Issue 9

Abstract: The 13th African Rotavirus Symposium was held as a virtual event hosted by the University of Nairobi, Kenya and The Kenya Paediatric Association on 3rd and 4th November 2021. This biennial event organized under the auspices of the African Rotavirus ... ...

Abstract	The 13th African Rotavirus Symposium was held as a virtual event hosted by the University of Nairobi, Kenya and The Kenya Paediatric Association on 3rd and 4th November 2021. This biennial event organized under the auspices of the African Rotavirus Network shapes the agenda for rotavirus research and prevention on the continent, attracting key international and regional opinion leaders, researchers, and public health scientists. The African Rotavirus Network is a regional network of institutions initially established in 1999, and now encompassing much of the diarrheal disease and rotavirus related research in Africa, in collaboration with the World Health Organization African Regional Office (WHO-AFRO), Ministries of Health, and other partners. Surges in SARS-CoV2 variants and concomitant travel restrictions limited the meeting to a webinar platform with invited scientific presentations and scientific presentations from selected abstracts. The scientific program covered updates on burden of diarrheal diseases including rotavirus, the genomic characterization of rotavirus strains pre- and post-rotavirus vaccine introduction, and data from clinical evaluation of new rotavirus vaccines in Africa. Finally, 42 of the 54 African countries have fully introduced rotavirus vaccination at the time of the meeting, including the two recently WHO pre-qualified vaccines from India. Nonetheless, the full benefit of rotavirus vaccination is yet to be realized in Africa where approximately 80% of the global burden of rotavirus mortality exists.
Language	English
Publishing date	2022-09-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10091463
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Article ; Online: Sustaining rotavirus vaccination in Africa: measuring vaccine effectiveness.

Armah, George E / Binka, Fred N

The Lancet. Infectious diseases

2014 Volume 14, Issue 11, Page(s) 1031–1032

MeSH term(s)	Diarrhea/prevention & control ; Hospitalization/statistics & numerical data ; Humans ; Male ; Rotavirus Infections/prevention & control ; Rotavirus Vaccines/administration & dosage ; Rotavirus Vaccines/immunology
Chemical Substances	Rotavirus Vaccines
Language	English
Publishing date	2014-11
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(14)70961-2
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Article ; Online: Vaccine value profile for norovirus.

Armah, George / Lopman, Ben A / Vinjé, Jan / O'Ryan, Miguel / Lanata, Claudio F / Groome, Michelle / Ovitt, Jared / Marshall, Caroline / Sajewski, Elizabeth / Riddle, Mark S

Vaccine

2023 Volume 41 Suppl 2, Page(s) S134–S152

Abstract: Norovirus is attributed to nearly 1 out of every 5 episodes of diarrheal disease globally and is estimated to cause approximately 200,000 deaths annually worldwide, with 70,000 or more among children in developing countries. Noroviruses remain a leading ... ...

Abstract	Norovirus is attributed to nearly 1 out of every 5 episodes of diarrheal disease globally and is estimated to cause approximately 200,000 deaths annually worldwide, with 70,000 or more among children in developing countries. Noroviruses remain a leading cause of sporadic disease and outbreaks of acute gastroenteritis even in industrialized settings, highlighting that improved hygiene and sanitation alone may not be fully effective in controlling norovirus. Strengths in global progress towards a Norovirus vaccine include a diverse though not deep pipeline which includes multiple approaches, including some with proven technology platforms (e.g., VLP-based HPV vaccines). However, several gaps in knowledge persist, including a fulsome mechanistic understanding of how the virus attaches to human host cells, internalizes, and induces disease.
MeSH term(s)	Child ; Humans ; Norovirus ; Caliciviridae Infections ; Gastroenteritis/epidemiology ; Diarrhea/prevention & control ; Viral Vaccines
Chemical Substances	Viral Vaccines
Language	English
Publishing date	2023-10-06
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2023.03.034
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Article ; Online: Rotavirus vaccine product switch in Ghana: An assessment of service delivery costs, switching costs, and cost-effectiveness.

Owusu, Richmond / Mvundura, Mercy / Nonvignon, Justice / Armah, George / Bawa, John / Antwi-Agyei, Kwadwo Odei / Amponsa-Achiano, Kwame / Dadzie, Frederick / Bonsu, George / Clark, Andrew / Pecenka, Clint / Debellut, Frederic

PLOS global public health

2023 Volume 3, Issue 8, Page(s) e0001328

Abstract: Ghana introduced rotavirus vaccine (ROTARIX 1-dose presentation) into the routine national immunization program in 2012 and switched to a different product (ROTAVAC 5-dose presentation) in 2020. ROTAVAC has a lower price per dose (US$0.85 versus US$2.15 ... ...

Abstract	Ghana introduced rotavirus vaccine (ROTARIX 1-dose presentation) into the routine national immunization program in 2012 and switched to a different product (ROTAVAC 5-dose presentation) in 2020. ROTAVAC has a lower price per dose (US$0.85 versus US$2.15 for ROTARIX) and smaller cold chain footprint but requires more doses per regimen (three versus two). This study estimates the supply chain and service delivery costs associated with each product, the costs involved in switching products, and compares the cost-effectiveness of both products over the next ten years. We estimated the supply chain and service delivery costs associated with ROTARIX and ROTAVAC (evaluating both the 5-dose and 10-dose presentations) using primary data collected from health facilities in six of the 14 regions in the country. We estimated the costs of switching from ROTARIX to ROTAVAC using information collected from key informant interviews and financial records provided by the government. All costs were reported in 2020 US$. We used the UNIVAC decision-support model to evaluate the cost-effectiveness (US$ per disability-adjusted life-year (DALY) averted from government and societal perspectives) of ROTARIX and ROTAVAC (5-dose or 10-dose presentations) compared to no vaccination, and to each other, over a ten-year period (2020 to 2029). We ran probabilistic sensitivity analyses and other threshold analyses. The supply chain and service delivery economic cost per dose was $2.40 for ROTARIX, $1.81 for ROTAVAC 5-dose, and $1.76 for ROTAVAC 10-dose. The financial and economic cost of switching from ROTARIX to ROTAVAC 5-dose was $453,070 and $883,626, respectively. Compared to no vaccination, the cost per DALY averted was $360 for ROTARIX, $298 for ROTAVAC 5-dose, and $273 for ROTAVAC 10-dose. ROTAVAC 10-dose was the most cost-effective option and would be cost-effective at willingness-to-pay thresholds exceeding 0.12 times the national GDP per capita ($2,206 in the year 2020). The switch from ROTARIX to ROTAVAC 5-dose in 2020 was cost-saving. Rotavirus vaccination is highly cost-effective in Ghana. A switch from ROTAVAC 5-dose to ROTAVAC 10-dose would be cost-saving and should be considered.
Language	English
Publishing date	2023-08-09
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0001328
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Article ; Online: Emergence of Intergenogroup Reassortant G9P[4] Strains Following Rotavirus Vaccine Introduction in Ghana.

Doan, Yen Hai / Dennis, Francis Ekow / Takemae, Nobuhiro / Haga, Kei / Shimizu, Hiroyuki / Appiah, Michael Gyasi / Lartey, Belinda Larteley / Damanka, Susan Afua / Hayashi, Takaya / Suzuki, Toshihiko / Kageyama, Tsutomu / Armah, George Enyimah / Katayama, Kazuhiko

Viruses

2023 Volume 15, Issue 12

Abstract: Rotavirus (RVA) is a leading cause of childhood gastroenteritis. RVA vaccines have reduced the global disease burden; however, the emergence of intergenogroup reassortant strains is a growing concern. During surveillance in Ghana, we observed the ... ...

Abstract	Rotavirus (RVA) is a leading cause of childhood gastroenteritis. RVA vaccines have reduced the global disease burden; however, the emergence of intergenogroup reassortant strains is a growing concern. During surveillance in Ghana, we observed the emergence of G9P[4] RVA strains in the fourth year after RVA vaccine introduction. To investigate whether Ghanaian G9P[4] strains also exhibited the DS-1-like backbone, as seen in reassortant G1/G3/G8/G9 strains found in other countries in recent years, this study determined the whole genome sequences of fifteen G9P[4] and two G2P[4] RVA strains detected during 2015-2016. The results reveal that the Ghanaian G9P[4] strains exhibited a double-reassortant genotype, with G9-VP7 and E6-NSP4 genes on a DS-1-like backbone (G9-P[4]-I2-R2-C2-M2-A2-N2-T2-E6-H2). Although they shared a common ancestor with G9P[4] DS-1-like strains from other countries, further intra-reassortment events were observed among the original G9P[4] and co-circulating strains in Ghana. In the post-vaccine era, there were significant changes in the distribution of RVA genotype constellations, with unique strains emerging, indicating an impact beyond natural cyclical fluctuations. However, reassortant strains may exhibit instability and have a limited duration of appearance. Current vaccines have shown efficacy against DS-1-like strains; however, ongoing surveillance in fully vaccinated children is crucial for addressing concerns about long-term effectiveness.
MeSH term(s)	Child ; Humans ; Rotavirus Infections/epidemiology ; Rotavirus Infections/prevention & control ; Rotavirus Infections/genetics ; Ghana/epidemiology ; Rotavirus Vaccines ; Genome, Viral ; Reassortant Viruses/genetics ; Phylogeny ; Rotavirus/genetics ; Genotype
Chemical Substances	Rotavirus Vaccines
Language	English
Publishing date	2023-12-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2516098-9
ISSN	1999-4915 ; 1999-4915
ISSN (online)	1999-4915
ISSN	1999-4915
DOI	10.3390/v15122453
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Article: Next-generation sequencing of a human-animal reassortant G6P[14] rotavirus A strain from a child hospitalized with diarrhoea

Damanka, Susan Afua / Dennis, Francis Ekow / Lartey, Belinda Larteley / Nyarko, Kofi Mensah / Agbemabiese, Chantal Ama / Armah, George Enyimah

Archives of virology. 2020 Apr., v. 165, no. 4

2020

Abstract: We previously reported the VP4 and the VP7 genotypes of the first G6P[14] rotavirus strain (RVA/Human-wt/GHA/M0084/2010/G6P[14]) from the stool of an infant with diarrhoea in Ghana. In the current study, we obtained the complete genome sequences using ... ...

Abstract	We previously reported the VP4 and the VP7 genotypes of the first G6P[14] rotavirus strain (RVA/Human-wt/GHA/M0084/2010/G6P[14]) from the stool of an infant with diarrhoea in Ghana. In the current study, we obtained the complete genome sequences using Illumina MiSeq next-generation sequencing to enable us to determine the host species origin of the genes by phylogenetic analysis. The genotype constellation was G6-P[14]-I2-R2-C2-M2-A11-N2-T6-E2-H3. Phylogenetic analysis showed that M0084 was a reassortant strain from RVAs of both artiodactyl and human host species origin. The level of sequence identity of the individual genes of M0084 to other sequences in the GenBank ranged from 95.2 to 99.5%; however, there was no single strain from the GenBank database with a complete genome sequence that was highly similar to that of M0084. To help trace the source of such unique gene pools being introduced into human RVAs, it will be useful to examine RVA sequences from potential reservoirs such as sheep and goats, which are common domestic animals in this locality.
Keywords	Rotavirus A ; children ; diarrhea ; genes ; genetic databases ; genotype ; hosts ; humans ; nucleotide sequences ; phylogeny ; sheep ; virology ; Ghana
Language	English
Dates of publication	2020-04
Size	p. 1003-1005.
Publishing place	Springer Vienna
Document type	Article
Note	NAL-AP-2-clean
ZDB-ID	7491-3
ISSN	1432-8798 ; 0304-8608
ISSN (online)	1432-8798
ISSN	0304-8608
DOI	10.1007/s00705-020-04543-4
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Article ; Online: Understanding Pediatric Norovirus Epidemiology: A Decade of Study among Ghanaian Children.

Lartey, Belinda L / Quaye, Osbourne / Damanka, Susan A / Agbemabiese, Chantal A / Armachie, Joseph / Dennis, Francis E / Enweronu-Laryea, Christabel / Armah, George E

Viruses

2020 Volume 12, Issue 11

Abstract: Understanding the epidemiology of human norovirus infection in children within Ghana and the entire sub-Saharan African region, where future norovirus vaccines would have the greatest impact, is essential. We analyzed 1337 diarrheic stool samples ... ...

Abstract	Understanding the epidemiology of human norovirus infection in children within Ghana and the entire sub-Saharan African region, where future norovirus vaccines would have the greatest impact, is essential. We analyzed 1337 diarrheic stool samples collected from children <5 years from January 2008 to December 2017 and found 485 (36.2%) shedding the virus. GII.4 (54.1%), GII.3 (7.7%), GII.6 (5.3%), GII.17 (4.7%), and GII.5 (4.7%) were the most common norovirus genotypes. Although norovirus GII.4 remained the predominant capsid genotype throughout the study period, an increase in GII.6 and GII.3 capsid genotypes was observed in 2013 and 2014, respectively. The severity of clinical illness in children infected with GII.4 norovirus strains was similar to illness caused by non-GII.4 strains. Since the epidemiology of norovirus changes rapidly, establishment of systematic surveillance within sentinel sites across the country would enhance the monitoring of circulating norovirus strains and allow continuous understanding of norovirus infection in Ghana.
MeSH term(s)	Caliciviridae Infections/diagnosis ; Caliciviridae Infections/epidemiology ; Child, Preschool ; Feces/virology ; Female ; Gastroenteritis/epidemiology ; Gastroenteritis/virology ; Genetic Variation ; Genotype ; Ghana/epidemiology ; Humans ; Infant ; Infant, Newborn ; Male ; Norovirus/classification ; Norovirus/genetics ; Phylogeny ; Prevalence ; Sequence Analysis, DNA ; Virus Shedding
Language	English
Publishing date	2020-11-18
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2516098-9
ISSN	1999-4915 ; 1999-4915
ISSN (online)	1999-4915
ISSN	1999-4915
DOI	10.3390/v12111321
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Article ; Online: Next-generation sequencing of a human-animal reassortant G6P[14] rotavirus A strain from a child hospitalized with diarrhoea.

Damanka, Susan Afua / Dennis, Francis Ekow / Lartey, Belinda Larteley / Nyarko, Kofi Mensah / Agbemabiese, Chantal Ama / Armah, George Enyimah

Archives of virology

2020 Volume 165, Issue 4, Page(s) 1003–1005

Abstract	We previously reported the VP4 and the VP7 genotypes of the first G6P[14] rotavirus strain (RVA/Human-wt/GHA/M0084/2010/G6P[14]) from the stool of an infant with diarrhoea in Ghana. In the current study, we obtained the complete genome sequences using Illumina MiSeq next-generation sequencing to enable us to determine the host species origin of the genes by phylogenetic analysis. The genotype constellation was G6-P[14]-I2-R2-C2-M2-A11-N2-T6-E2-H3. Phylogenetic analysis showed that M0084 was a reassortant strain from RVAs of both artiodactyl and human host species origin. The level of sequence identity of the individual genes of M0084 to other sequences in the GenBank ranged from 95.2 to 99.5%; however, there was no single strain from the GenBank database with a complete genome sequence that was highly similar to that of M0084. To help trace the source of such unique gene pools being introduced into human RVAs, it will be useful to examine RVA sequences from potential reservoirs such as sheep and goats, which are common domestic animals in this locality.
MeSH term(s)	Animals ; Diarrhea/therapy ; Diarrhea/virology ; Feces/virology ; Genome, Viral ; Ghana ; Goat Diseases/virology ; Goats ; High-Throughput Nucleotide Sequencing ; Hospitalization ; Humans ; Infant ; Phylogeny ; Reassortant Viruses/classification ; Reassortant Viruses/genetics ; Reassortant Viruses/isolation & purification ; Rotavirus/classification ; Rotavirus/genetics ; Rotavirus/isolation & purification ; Rotavirus Infections/therapy ; Rotavirus Infections/veterinary ; Rotavirus Infections/virology ; Sheep ; Sheep Diseases/virology
Language	English
Publishing date	2020-02-10
Publishing country	Austria
Document type	Journal Article
ZDB-ID	7491-3
ISSN	1432-8798 ; 0304-8608
ISSN (online)	1432-8798
ISSN	0304-8608
DOI	10.1007/s00705-020-04543-4
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