{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:01:29Z","timestamp":1791241289970,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T00:00:00Z","timestamp":1602201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["091909\/Z\/10\/Z"],"award-info":[{"award-number":["091909\/Z\/10\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"International Training Fellowship","award":["201945\/Z\/16\/Z"],"award-info":[{"award-number":["201945\/Z\/16\/Z"]}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1180432"],"award-info":[{"award-number":["OPP1180432"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["2018\/815189-0"],"award-info":[{"award-number":["2018\/815189-0"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["2020\/1004857-0"],"award-info":[{"award-number":["2020\/1004857-0"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI112970"],"award-info":[{"award-number":["R01AI112970"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Postdoctoral Fellowship","award":["PDF-2018-11-ST2-006"],"award-info":[{"award-number":["PDF-2018-11-ST2-006"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rotavirus vaccine (Rotarix [RV1]) has reduced diarrhea-associated hospitalizations and deaths in Malawi. We examined the trends in circulating rotavirus genotypes in Malawi over a 22-year period to assess the impact of RV1 introduction on strain distribution.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on rotavirus-positive stool specimens among children aged &amp;lt;5 years hospitalized with diarrhea in Blantyre, Malawi before (July 1997\u2013October 2012, n = 1765) and after (November 2012\u2013October 2019, n = 934) RV1 introduction were analyzed. Rotavirus G and P genotypes were assigned using reverse-transcription polymerase chain reaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A rich rotavirus strain diversity circulated throughout the 22-year period; Shannon (H\u2032) and Simpson diversity (D\u2032) indices did not differ between the pre- and postvaccine periods (H\u2032 P &amp;lt; .149; D\u2032 P &amp;lt; .287). Overall, G1 (n = 268\/924 [28.7%]), G2 (n = 308\/924 [33.0%]), G3 (n = 72\/924 [7.7%]), and G12 (n = 109\/924 [11.8%]) were the most prevalent genotypes identified following RV1 introduction. The prevalence of G1P[8] and G2P[4] genotypes declined each successive year following RV1 introduction, and were not detected after 2018. Genotype G3 reemerged and became the predominant genotype from 2017 onward. No evidence of genotype selection was observed 7 years post\u2013RV1 introduction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Rotavirus strain diversity and genotype variation in Malawi are likely driven by natural mechanisms rather than vaccine pressure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaa616","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T19:15:24Z","timestamp":1601320524000},"page":"2127-2136","source":"Crossref","is-referenced-by-count":27,"title":["Rotavirus Genotypes in Hospitalized Children With Acute Gastroenteritis Before and After Rotavirus Vaccine Introduction in Blantyre, Malawi, 1997\u20132019"],"prefix":"10.1093","volume":"225","author":[{"given":"Chimwemwe","family":"Mhango","sequence":"first","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"},{"name":"Department of Medical Laboratory Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"},{"name":"Department of Biomedical Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J","family":"Mandolo","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"},{"name":"Department of Medical Laboratory Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"},{"name":"Department of Biomedical Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"End","family":"Chinyama","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Wachepa","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Kanjerwa","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikondi","family":"Malamba-Banda","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"},{"name":"Department of Medical Laboratory Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"},{"name":"Centre for Global Vaccine Research, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca B","family":"Matambo","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"},{"name":"Department of Medical Laboratory Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"},{"name":"Centre for Global Vaccine Research, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla G","family":"Barnes","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases, T. H. Chan School of Public Health, Harvard University , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrispin","family":"Chaguza","sequence":"additional","affiliation":[{"name":"Genomics of Pneumonia and Meningitis, Wellcome Sanger Institute, Wellcome Genome Campus , Hinxton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac T","family":"Shawa","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"},{"name":"Department of Medical Laboratory Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M","family":"Nyaga","sequence":"additional","affiliation":[{"name":"Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State , Bloemfontein, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9770-0163","authenticated-orcid":false,"given":"Daniel","family":"Hungerford","sequence":"additional","affiliation":[{"name":"Centre for Global Vaccine Research, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool, United Kingdom"},{"name":"National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh D","family":"Parashar","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia E","family":"Pitzer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University , New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arox W","family":"Kamng\u2019ona","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre, Malawi"},{"name":"Department of Biomedical Sciences, College of Medicine, University of Malawi , Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miren","family":"Iturriza-Gomara","sequence":"additional","affiliation":[{"name":"Centre for Global Vaccine Research, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool, United Kingdom"},{"name":"National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool , United 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