Circulação dos genótipos de rotavírus antes e depois da introdução da vacina contra rotavírus no Brasil: uma revisão sistemática e meta-análise

Abstract

Objective: This article aims to describe the circulation of rotavirus genotypes before and after the introduction of rotavirus vaccine in Brazil. Methods: A systematic review was conducted to identify studies published between January 2006 and December 2015 in Portuguese, Spanish and English. There was data extraction, assessment of risk of bias and quality study, check the prevalence of diarrhea by rotavirus and genotypic distribution. Results: A total of 1,436 publications were identified (1.157 before and 279 after the introduction of the vaccine). After screening titles and abstracts, 158 articles had their texts fully assessed for eligibility and, of these, 86 (58 before and 28 after vaccination) reported that the genotypes of rotavirus have been included. Overall, 6.884 (15.2%) of 45,305 children tested were rotavirus positive. Rotavirus was detected in 3,364 (22.4%) of 15,033 stool samples before the introduction of the vaccine (1986-2006) and 3.520 (11.6%) of 30,275 collected after the introduction of the vaccine (> 2006-2015, p <0.001). Interpretation: This study confirms the current rate of children with acute diarrhea from rotavirus infection and highlights the diversity of rotavirus strains circulating in Brazil, with a predominance of G2P[4] after the introduction of monovalent vaccine. The rotavirus genotypes vary over time and by region. There must be rotavirus surveillance of maintenance for ongoing evaluation of the effectiveness of rotavirus vaccines and continuous control of the emergence of new strains of rotavirus and/or lines. So, we may distinguish if these variations in the genotype of the rotavirus occur as a result of natural fluctuations of the genotype or due to the introduction of the vaccine.