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Genes Review

June 2015, Volume 1, 1, pp 6-27

Evaluation of Techniques for the Diagnosis of Rotavirus Gastroenteritis in Paediatric Patients

Obi R.K, Oke, B.O, Anjorin, A.A, Bidmos, I.K, Salu, O.B, Omilabu, S.A

Obi R.K 1

Oke, B.O 2
Anjorin, A.A 3

Bidmos, I.K 4 Salu, O.B 5
Omilabu, S.A 4 

  1. Department of Microbiology, Federal University of Technology, Owerri, P.M.B. 1526 Owerri, Imo State, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria 1

  2. Clinical Sciences Division, Nigerian Institute of Medical Research, Yaba, Lagos; Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria 2

  3. Department of Microbiology, Lagos State University, Ojo, Lagos, Nigeria; Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria 3

  4. Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria 4

  5. Division of Human Virology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria 5

Pages: 6-27

DOI: 10.18488/journal.103/2015.1.1/103.1.6.27

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Abstract:

Rotavirus is the major etiology of acute gastroenteritis in infants and young children worldwide. It has been estimated that about 39% of childhood diarrhoea hospitalizations are caused by the virus and nearly half a million children die from the infections each year especially in developing countries on the Asian subcontinent, Africa, and Latin America where health care facilities are in short supply. Stool specimens collected from the first to fourth days of illness are optimal for detection of the infection. Diagnosis was originally performed using electron microscopy, which is still occasionally used in centers where it is available. Routine diagnosis is however, now performed by antigen detection on feces using commercially available, simple, rapid immunochromatographic dipstick style kits which have superseded the earlier latex agglutination and enzyme immunoassay methods whose usefulness in diagnosis is still relevant. Reverse transcription polymerase chain reaction of feces is also available in some reference and research centers, and is particularly useful for identification of outbreaks due to serogroups other than group A. Similarly viral culture and serology are also available but do not play much roles in diagnosis of acute disease. Rotavirus infection is indeed a public health problem and early, rapid, accurate and reliable diagnostic techniques are essential for effective patient management and infection control.
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Reference:

  1. L. Sai, J. Sun, L. Shao, S. Chen, H. Liu, and M. Lixian, "Epidemiology and clinical features of rotavirus and norovirus infection among children in Ji’nan, China," Virology. Journal, vol. 10, p. 302, 2013.
  2. U. Parashar, A. Burton, C. Lanata, C. Boschi-Pinto, K. Shibuya, D. Steele, M. Birmingham, and R. Glass, "Global mortality associated with rotavirus disease among children in 2004," J. Infect. Dis., vol. 200, pp. S9-S15, 2009.
  3. D. Bernstein, "Rotavirus overview," Pediatric Infectious Disease Journal, vol. 28, pp. S50–3, 2009.
  4. M. Aminu, N. Page, A. Ahmad, J. Umoh, J. Dewar, and A. Steele, "Diversity of rotavirus VP7 and VP4 genotypes in Northwestern Nigeria," J. Infect. Dis., vol. 202, pp. S198-S204, 2010.
  5. M. Estes, Rotaviruses and their replication. In: Fields BN, Knipe RM, Chanock MS  (Eds). Virology. Philadelphia: Lippincott-Raven, 2001.
  6. S. Paesi, C. Rosa, and P. Dornelles, "Evaluation of a latex agglutination kit for detecting rotavirus in piglets," Acta Scientiae Veterinariae, vol. 40, p. 1014, 2012.
  7. K. Grimwood and J. Buttery, "Clinical update: Rotavirus gastroenteritis and its prevention," Lancet, vol. 370, pp. 302–4, 2007.
  8. N. Santos and Y. Hoshino, "Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine," Rev. Med. Virol., vol. 15, pp. 29-56, 2005.
  9. A. Meneghetti, A. Bolognini, F. Lauretti, R. Linhares, N. Santos, and C. Nozawa, "Incidence of group a rotavirus in urban and rural areas of the city of Londrina - Brazil, from 1995 to 1997," Braz. Arch. Biol. Technol., vol. 44, pp. 257-61, 2001.
  10. Z. Fang, Q. Ye, and M. Ho, "Investigation of an outbreak of adult diarrhea rotavirus in China," J. Infect. Dis., vol. 160, pp. 948–53, 1989.
  11. M. Kuzuya, M. Hamano, M. Nishijima, R. Fujii, H. Ogura, and M. Tanaka, "An outbreak of acute gastroenteritis caused by human group c rotavirus in a welfare institution in Okayama prefecture," Jpn. J. Infect Dis., vol. 58, pp. 255-7, 2005.
  12. M. K. Estes, Rotaviruses and their replication. In: Fields B N, Knipe D M, Howley P M, Eds. Fields virology, 3rd ed. Philadelphia, Pa: Lippincott-Raven Publishers, 1996.
  13. J. Carlson, P. Middleton, M. Szymanski, J. Huber, and M. Petric, "Fatal rotavirus gastroenteritis. An analysis of 21 cases," Am. J. Dis. Child, vol. 132, pp. 477-479, 1978.
  14. P. Dennehy, "Transmission of rotavirus and other enteric pathogens in the home," Pediatr. Infect. Dis. J., vol. 19, pp. S103-5, 2000.
  15. N. Barro, L. Sangaré, M. Tahita, O. Traoré, C. De Souza, and A. Traoré, Risk associated with practices, procedures and processes of street-vended foods that lead to foodborne viral contamination: Critical review. In: Hygiene and its role in health. Patrick, L.A. and J.P. Lachan (Eds). ISBN: 978-1-60456-195-1. Hauppauge, NY 11788, USA: Nova Science Publishers Inc, 2008.
  16. C. Bass and K. Dorsey, Rotavirus and other agents of viral gastroenteritis. In Nelson textbook of pediatrics. Edited by Richard E and Behrman F. Philadelphia: Raven Press, 2004.
  17. J. Chin, "Control of communicable disease manual. Wash. DC: American Public Health Association," J. Clin. Microbiol., vol. 125, pp. 910-7, 2000.
  18. T. Fischer and J. Gentsch, "Rotavirus typing methods and algorithms," Rev. Med. Virol., vol. 14, pp. 71-82, 2004.
  19. The Department of Health, "Rotavirus laboratory case definition," vol. 44, pp. 3189-3195, 2006.
  20. H. Ushijima, K. Xin, S. Nishimura, S. Morikawa, and T. Abe, "Detection and sequencing of rotavirus VP7 gene from human materials (Stools, Sera, Cerebrospinal Fluids, and Throat Swabs) by reverse transcription and PCR," Journal of Clinical Mmicrobiology, vol. 32, pp. 2893-2897, 1994.
  21. C. Atchison, B. Lopman, C. Harris, C. Tam, M. Gómara, and J. Gray, "Clinical laboratory practices for the detection of rotavirus in England and wales: Can surveillance based on routine laboratory testing data be used to evaluate the impact of vaccination," Euro. Surveill, vol. 14, p. 19217, 2009.
  22. S. Junaid, U. Umeh, A. Olabode, and J. Banda, "Incidence of rotavirus infection in children with gastroenteritis attending Jos University teaching hospita., Nigeria," Virology Journal, vol. 8, p. 233, 2011.
  23. A. Momenzadeh, S. Modarres, A. Faraji, M. Motamedirad, A. Sohrabi, S. Modarres, L. Azarnoush, and H. Mirshahabi, "Comparison of enzyme immunoassay, immunochromatography, and RNA-polyacrylamide-gel electrophoresis for diagnosis of rotavirus infection in children with acute gastroenteritis," Iran J. Med. Sci., vol. 33, pp. 173-176, 2008.
  24. V. Venkatesh, H. Prashanth, K. Bhat, D. Subha, K. Sudhindra, and F. Farheen, "Rotaviral diarrhoea in children: A comparison of PAGE with ELISA," Journal of Clinical and Diagnostic Research, vol. 6, pp. 188-191, 2012.
  25. M. Arens and E. Swierkosz, "Detection of rotavirus by hybridization with a nonradioactive synthetic DNA probe and comparison with commercial enzyme immunoassays and silver-stained polyacrylamide gels," Journal of Clinical Microbiology, vol. 27, pp. 1277-1279, 1989.
  26. R. Yolken and F. Leister, "Evaluation of enzyme immunoassays for the detection of human rotavirus," J. Infect. Dis., vol. 144, p. 379, 1981.
  27. E. Cheung, S. Hnatko, H. Gunning, and J. Wilson, "Comparison of rotazyme and direct electron microscopy for detection of rotavirus in human stools," J. Clin. Microbiol., vol. 16, pp. 562-563, 1982.
  28. A. Rubenstein and M. Miller, "Comparison of an enzyme immunoassay with electron microscopic procedures for detecting rotavirus," J. Clin. Microbiol., vol. 15, pp. 938-944, 1982.
  29. B. Keswick, T. Hejkal, H. DuPont, and L. Pickering, "Evaluation of a commercial enzyme immunoassay kit for rotavirus detection," Diagn. Microbiol. Infect. Dis., vol. 1, pp. 111-115, 1983.
  30. M. Chernesky, S. Castriciano, J. Mahony, and D. DeLong, "Examination of the rotazyme II enzyme immunoassay for the diagnosis of rotavirus gastroenteritis," J. Clin. Microbiol., vol. 22, pp. 462-464, 1985.
  31. E. Thomas, M. Puterman, E. Kawano, and M. Curran, "Evaluation of seven immunoassays for detection of rotavirus in pediatric stool samples," Journal of Clinical Microbiology, vol. 26, pp. 1189-1193, 1988.
  32. G. Gerna, A. Sarasini, N. Passarani, M. Torsellini, M. Parea, and M. Battaglia, "Comparative evaluation of a commercial enzyme-linked immunoassay and solid-phase immune electron microscopy for rotavirus detection in stool specimens," J. Clin. Microbiol., vol. 25, pp. 1137-1139, 1987.
  33. S. Raboni, M. Nogueira, V. Hakim, Torrecilha, H. Lerner, and L. Tsuchiya, "Comparison of latex agglutination with enzyme immunoassay for detection of rotavirus in fecal specimens," Am. J. Clin. Pathol., vol. 117, pp. 392-394, 2002.
  34. W. Abood, "Performance of enzyme linked immunosorbent assay versus latex agglutination test in the diagnosis of acute gastroenteritis by rotavirus," Journal of Al-Nahrain University, vol. 13, pp. 107-111, 2010.
  35. C. Knisley, A. Bednarz-Prashad, and L. Pickering, "Detection of rotavirus in stool specimens with monoclonal and polyclonal antibody-based assay systems," J. Clin. Microbiol., vol. 23, pp. 897-900, 1986.
  36. G. Doern, J. Herrmann, P. Henderson, D. Stobbs-Walro, D. Perron, and N. Blacklow, "Detection of rotavirus with a new polyclonal antibody enzyme immunoassay (Rotazyme II) and a commercial latex agglutination tests (Rotalex): Comparison with a monoclonal antibody enzyme immunoassay," J. Clin. Microbiol., vol. 23, pp. 226-229, 1986.
  37. R. Cevenini, F. Rumpianesi, R. Mazzaracchio, M. Donati, E. Falcieri, and R. Lazzari, "Evaluation of a new latex agglutination test for detecting human rotavirus in faeces," J. Infect. Dis., vol. 7, pp. 130-133, 1983.
  38. M. Sambourg, A. Goudeau, C. Courant, G. Pinon, and F. Denis, "Direct appraisal of latex agglutination testing, a convenient alternative to enzyme immunoassay for the detection of rotavirus in childhood gastroenteritis, by comparison of two enzyme immunoassays and two latex tests," J. Clin. Microbiol., vol. 21, pp. 622-625, 1985.
  39. C. Brandt, C. Arndt, G. Evans, H. Kim, E. Staalings, W. Rodriguez, and R. Parrott, "Evaluation of a latex test for rotavirus detection," J. Clin. Microbiol., vol. 25, pp. 1800-802, 1987.
  40. P. Miotti, J. Eiden, and R. Yolken, "Comparative efficiency of commercial immunoassays for the diagnosis of rotavirus gastroenteritis during the course of infection," J. Clin. Microbiol., vol. 22, pp. 693-698, 1985.
  41. A. Abdulrazzaq, S. Aljeboory, S. Abdulkareem, and J. Klena, "Two different diagnostic methods for detection of rotavirus in Iraqi young children. Al-Anbar," J. Vet. Sci., vol. 4, pp. 1999-6527, 2011.
  42. G. Hammond, G. Ahluwalia, and P. Hazelton, "Detection of human rotavirus in fecal specimens by a commercial latex-agglutination test," J. Infect. Dis., vol. 149, p. 1021, 1984.
  43. I. Julkunen, J. Savolainen, A. Hautanen, and T. Hovi, "Detection of rotavirus in faecal specimens by enzyme immunoassay, latex agglutination and electron microscopy," Scand. J. Infect. Dis., vol. 17, pp. 245-249, 1985.
  44. C. Pai, M. Shahrabadi, and B. Ince, "Rapid diagnosis of rotavirus gastroenteritis by a commercial latex agglutination test," J. Clin. Microbiol., vol. 22, pp. 846-850, 1985.
  45. M. Altindis, S. Yavru, A. Simsek, A. Ozku, A. Ceri, and K. Hasan, "Rotavirus infection in children with acute diarrhea as detected by latex agglutination, ELISA and polyacrylamide gel electrophoresis," Indian Pediatrics, vol. 41, pp. 590-594, 2004.
  46. L. Pereira, S. Raboni, M. Nogueira, L. Vidal, S. De Almeida, C. Debur, and C. Cruz, "Rotavirus infection in a tertiary hospital: Laboratory diagnosis and impact of immunization on pediatric hospitalization," Braz. J. Infect. Dis., vol. 15, pp. 151-8, 2011.
  47. C. Cicek, T. Karatas, I. Altuglu, G. Koturoglu, Z. Kurugol, and A. Bilgic, "Comparison of  ELISA with shell vial cell culture method for the detection of human rotavirus in fecal specimens," New Microbiol., vol. 30, pp. 113-8, 2007.
  48. C. Adlhoch, M. Kaiser, M. Hoehne, A. Marques, I. Stefas, F. Veas, and H. Ellerbrok, "Highly sensitive detection of the group a rotavirus using apolipoprotein H-coated ELISA plates compared to quantitative real-time PCR," Virology Journal, vol. 8, pp. 63-68, 2011.
  49. P. Xiao-Li, J. Jaana, H. Yasutaka, A. Kapikian, and T. Vesikari, "Rotaviruses detected by reverse transcription polymerase chain reaction in acute gastroenteritis during a trial of rhesus-human reassortant rotavirus tetravalent vaccine: Implications for vaccine efficacy analysis," Journal of Clinical Virology, vol. 13, pp. 9-16, 1999.
  50. A. Yasmon, E. Harahap, P. Dwipoerwantoro, and B. Dewi, "Detection of human group A and C rotaviruses in pediatric patients with acute gastroenteritis by real time RT-PCR assay: A preliminary study," Makara, Kesehatan, vol. 14, pp. 65-69, 2010.
  51. D. Li, A. Gu, W. Yang, M. He, X. Hu, and S. Han-Chang, "An integrated cell culture and reverse transcription quantitative PCR assay for detection of infectious rotaviruses in environmental waters," Journal of Microbiological Methods, vol. 82, pp. 59–63, 2010.
  52. L. Van Doorn, B. Kleter, E. Hoefnagel, I. Stainier, A. Poliszczak, B. Colau, and W. Quint, "Detection and genotyping of human rotavirus VP4 and VP7 genes by reverse transcriptase PCR and reverse hybridization," J. Clin. Microbiol., vol. 47, pp. 2704-2712, 2009.
  53. R. Brooks, L. Brown, and R. Franklin, "Comparison of a new rapid test (Test Pack Rotavirus) with standard enzyme immunoassay and electron microscopy for the detection of rotavirus in symptomatic hospitalized children," Journal of Clinical Microbiology, vol. 27, pp. 775-777, 1989.
  54. C. Von Bonsdorff, T. Hovi, P. Makela, and A. Morttinen, "Rotavirus infections in adults in association with acute gastroenteritis," J. Med. Virol., vol. 2, pp. 21-28, 1978.
  55. P. Dennehy, M. Hartin, S. Nelson, and S. Reising, "Evaluation of the immuno card stat! Rotavirus assay for detection of group a rotavirus in fecal specimen," J. Clin. Microbiol., vol. 37, pp. 1977–1979, 1999.
  56. P. Dennehy, "Rotavirus vaccines: An overview," Clin. Microbiol. Rev. , vol. 21, pp. 198–208, 2008.
  57. S. Lee, J. Hong, S. Lee, and M. Lee, "Comparisons of latex agglutination, immunochromatography and enzyme immunoassay methods for the detection of rotavirus antigen," Korean J. Lab. Med., vol. 27, pp. 437-41, 2007.
  58. J. Dewar, M. De Beer, E. Elliott, P. Monaisa, D. Semenya, and A. Steele, "Rapid detection of rotaviruses – are laboratories underestimating infection in infants," SAM J., vol. 95, pp. 1-2, 2005.
  59. I. Wilhelmi, J. Colomina, D. Martin-Rodrigo, E. Roman, and A. Sanchez-Fauquier, "New immunochromatographic method for rapid detection of rotaviruses in stool samples compared with standard enzyme immunoassay and latex agglutination techniques," Eur. J. Clin. Microbiol. Infect. Dis., vol. 20, pp. 741-3, 2001.
  60. G. Gerna, N. Passarani, M. Battaglia, and E. Percivalle, "Rapid serotyping of human rotavirus strains by solid-phase immune electron microscopy," J. Clin. Microbiol., vol. 19, pp. 273-278, 1984.
  61. R. Moosai, R. Alcock, T. Bell, F. Laidler, J. Peiris, A. Wyn-Jones, and C. Madeley, "Detection of rotavirus by a latex agglutination test rotalex: Comparison with electron microscopy, immunofluorescence, polyacrylamide gel electrophoresis, and enzyme linked immunosorbent assay," J. Clin. Pathol., vol. 38, pp. 694-700, 1985.
  62. T. Shinozaki, K. Araki, H. Ushijima, B. Kim, T. Tajima, and R. Fujii, " Comparison of five methods for detecting human rotavirus in stool specimens," Eur. J. Pediatr., vol. 144, p. 513, 1986.
  63. L. DeSilva, M. Hanlon, and J. Stanton, "Rotavirus infection," Med. J. Aust., vol. 2, pp. 602-603, 1983.
  64. B. Manuja, M. Prasad, B. Gulati, A. Manuja, and G. Prasad, "Comparative efficacy of immunological, molecular and culture assays for detection of group a rotavirus from fecal samples of pediatric patients," Tropical Animal Health and Production, vol. 42, pp. 1817-1820(4), 2010.
  65. B. Weber, F. Harms, B. Selb, and H. Doerr, "Improvement of rotavirus isolation in the cell culture by immune peroxidase staining," J. Virol. Methods, vol. 38, pp. 187-94, 1992.
  66. R. Cevenini, F. Rumpianesi, R. Mazzaracchio, M. Donati, E. Falcieri, and I. Sarov, "A simple immunoperoxidase method for detecting enteric adenovirus and rotavirus in cell culture," Journal of Infection, vol. 4453, pp. 93219-5, 1984.
  67. R. Yolken and P. Stopa, "Analysis of nonspecific reactions in enzyme-linked immunosorbent assay testing for human rotavirus," J. Clin. Microbiol., vol. 10, pp. 703-707, 1979.
  68. T. Hovi, V. Vaisanen, P. Ukkonen, and C. Von Bonsdorff, "Solid-phase enzyme immunoassay for rotavirus antigen: Faecal protease activity as a reason for false-negative results," J. Virol. Methods, vol. 5, pp. 45-53, 1982.
  69. R. Hogg and G. Davidson, "Improved specificity of ELISA for rotavirus," Aust. Paediatr. J., vol. 18, pp. 184-185, 1982.
  70. P. Krause, J. Hyams, P. Middleton, V. Herson, and J. Flores, "Unreliability of rotazyme ELISA test in neonates," J. Pediatr., vol. 103, pp. 259-262, 1983.
  71. C. Pai and D. Mayock, "Rotazyme test in neonates," J. Pediatr., vol. 106, pp. 343-344, 1985.
  72. K. Rand, H. Houck, and H. Swingle, "Rotazyme assay in neonates without diarrhea," Am. J. Clin. Pathol., vol. 84, pp. 748-751, 1985.
  73. I. Chrystie, B. Totterdell, and J. Banatvala, "False positive rotazyme tests on faecal samples from babies," Lancet, vol. 2, p. 1028, 1983.
  74. S. Ratnam, A. Tobin, J. Flemming, and P. Blaskovic, "False positive rotazyme results," Lancet, vol. 1, pp. 345-346, 1984.
  75. H. Tronen, "False positive rotazyme results," Lancet, vol. 1, p. 345, 1984.
  76. G. Beards, A. Campbell, N. Cottrell, J. Peiris, N. Rees, R. Sanders, J. Shirley, H. Wood, and T. Flewett, "Enzyme-linked immunosorbent assays based on polyclonal and monoclonal antibodies for rotavirus detection," J. Clin. Microbiol., vol. 19, pp. 248-254, 1984.
  77. P. Rudd and D. Carrington, "Clinical range of neonatal rotavirus gastroenteritis," Arch. Dis. Child, vol. 31, pp. 175-82, 1984.
  78. C. Giaquinto, G. Errico, E. Ruga, I. Naso, and R. D'Elia, "Evaluation of ELISA test for rotavirus diagnosis in neonates," J. Pediatr. , vol. 109, pp. 565-566, 1986.
  79. J. Herrmann, D. Perron, N. Blacklow, G. Cukor, P. Krause, J. Hyams, H. Barrett, and P. Ogra, "Enzyme immunoassay with monoclonal antibodies for the detection of rotavirus in stool specimens," J. Infect. Dis., vol. 152, pp. 830-832, 1985.
  80. H. Rotbart, R. Yolken, W. Nelson, D. Davis, M. Roe, and M. Levin, "Confirmatory testing of rotazyme results in neonates," J. Pediatr., vol. 107, pp. 289-292, 1985.

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