Peer-reviewed article
Epidemiological characteristics of rotavirus gastroenteritis in China: A systematic review of studies published from 2014 to 2023.
Yanwei Wu, Xinling Liu, Qingmei Leng, Xiaopeng Song, Jinyuan Wu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined rotavirus gastroenteritis in children under five across China from 2014 to 2023, analyzing data from 320 studies. The disease remains a significant public health burden, with infection rates varying by region and genotype patterns shifting over time. G9 and P[8] genotypes became increasingly dominant after 2018, with G8 also emerging among children. The findings highlight the need for continued disease surveillance to inform vaccine development strategies.
Key points
- Rotavirus positive rates in children under 5 were highest in Jilin (48.59%), Shanxi (40.89%), and Xinjiang (37.65%)
- Infection rates were higher in inpatient settings (32.85%) compared to outpatient/emergency departments (26.46%)
- G9 and P[8] genotypes shifted to dominance after 2018, with G9 increasing from 42.89% to 66.73% in children
- G8 genotype emerged as a notable strain among children, rising from 0.89% before 2018 to 5.08% after 2018
- Adults in Shaanxi, Inner Mongolia, and Heilongjiang showed the highest rotavirus positive rates (27.73%, 22.95%, 17.82% respectively)
Limitations
This is a systematic review of observational studies examining disease epidemiology rather than intervention effectiveness. It provides data on disease distribution and pathogenic characteristics but cannot directly evaluate which health system approaches or interventions are most effective at reducing rotavirus burden.
Abstract
Rotavirus gastroenteritis (RVGE) is a major public health concern, particularly amongst children below five-years-old. In China, the disease burden remains high owing to the absence of a comprehensive detection system. This study analyses RVGE incidence, population distribution, and pathogenic genotypes reported in studies published between 2014 and 2023, providing evidence to support vaccine and drug development. A systematic review of studies on RVGE published between 2014 and 2023 was conducted. Articles were screened using a standardized algorithm. A random-effects model was employed to analyze rotavirus positive rates and genotype variation trends. Among 320 studies, the highest rotavirus positive rates in children (≤5 y) were in Jilin (48.59%), Shanxi (40.89%), and Xinjiang (37.65%), while the highest number of infections were in Yunnan (89,128), Jiangsu (82,869), and Guangxi (36,524). Among adults (≥15 y), Shaanxi (27.73%), Inner Mongolia (22.95%), and Heilongjiang (17.82%) had the highest rotavirus positive rates, whereas Shanghai (3,170), Beijing (2,019), and Fujian (1,044) recorded the most infections. The rotavirus positive rates were 26.46% and 32.85% for children visiting the outpatient/emergency department and the inpatient department, respectively. Before 2018, the dominant G genotypes were G9 (children: 42.89%; adults: 56.13%) and G3 (children: 20.17%; adults: 14.71%), whereas the dominant P genotype was P[8] (children: 76.30%; adults: 80.78%). After 2018, G9 (children: 66.73%; adults: 67.43%) and P[8] (children: 88.62%; adults: 88.57%) became predominant in both groups, with an increase in G8 (before: 0.89%; after: 5.08%) among children. RVGE remains a significant burden in China, with evolving distributions. Continuous surveillance is essential to guide vaccine strain selection and development.