{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:42:30Z","timestamp":1790358150486,"version":"4.1.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Although rotavirus vaccination has reduced the global burden of the virus, morbidity and mortality from rotavirus infection remain high in Sub-Saharan Africa. This study aimed to determine the prevalence of rotavirus and adenovirus infections in children under five years with acute gastroenteritis and to identify factors associated with rotavirus infection after the introduction of the Rotasiil<jats:sup>\u00ae<\/jats:sup> vaccine in 2019 in Kisangani, Democratic Republic of the Congo (DRC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study consisted of a cross-sectional hospital-based survey conducted from May 2022 to April 2023 in four health facilities in Kisangani, using a fecal-based test (rapid antigenic immuno-chromatographic diagnostic test, BYOSYNEX adenovirus\/rotavirus BSS, Biosynex SA, Illkirch-Graffenstaden, France) of rotavirus and adenovirus infections among children under five years of age with acute gastroenteritis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 320 children under five years of age with acute gastroenteritis were included. The prevalence of rotavirus infection was 34.4%, that of adenovirus was 6.3%, and that of both rotavirus and adenovirus coinfection was 1.3%. The prevalence of rotavirus was significantly higher in unvaccinated children than in vaccinated children (55.4% versus 23.1%; P &lt; 0.001). This difference was observed only in children who received all three vaccine doses. Multivariate logistic regression analysis shows that the rate of rotavirus infection was significantly reduced in vaccinated children (adjusted OR: 0.31 [95% confidence intervals (CI): 0.19\u20130.56]; P &lt; 0.001) and those whose mothers had an average (adjusted OR: 0.51 [95% CI: 0.25\u20130.91]; P = 0.018) or high level (adjusted OR: 0.34 [95% CI: 0.20\u20130.64]; P &lt; 0.001) of knowledge about the rotavirus vaccine.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The prevalence of rotavirus infection remains high in Kisangani despite vaccination. However, the prevalence of adenovirus infections was low in our series. Complete vaccination with three doses and mothers\u2019 average and high level of knowledge about the rotavirus vaccine significantly reduces the rate of rotavirus infection. It is, therefore, essential to strengthen the mothers\u2019 health education, continue with the Rotasiil<jats:sup>\u00ae<\/jats:sup> vaccine, and ensure epidemiological surveillance of rotavirus infection.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0297219","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T18:31:16Z","timestamp":1707762676000},"page":"e0297219","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rotavirus and adenovirus infections in children with acute gastroenteritis after introducing the Rotasiil\u00ae vaccine in Kisangani, Democratic Republic of the Congo"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9743-6617","authenticated-orcid":true,"given":"Didier Gbebangi","family":"Manzemu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Pierre Alworong\u2019a","family":"Opara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel Tebandite","family":"Kasai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mupenzi","family":"Mumbere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique Muyobela","family":"Kampunzu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibi Batoko","family":"Likele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naura Apio","family":"Uvoya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hortense Malikidogo","family":"Vanzwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaspard Mande","family":"Bukaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falay Sadiki","family":"Dady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor Ngbonda","family":"Dauly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Belec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7734-7729","authenticated-orcid":true,"given":"Serge","family":"Tonen-Wolyec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"issue":"Suppl 1","key":"pone.0297219.ref001","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1136\/archdischild-2013-305429","article-title":"Ending preventable child deaths from pneumonia and diarrhoea by 2025. Development of the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea","volume":"100","author":"S Qazi","year":"2015","journal-title":"Arch Dis Child"},{"issue":"9875","key":"pone.0297219.ref002","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/S0140-6736(13)60222-6","article-title":"Global burden of childhood pneumonia and diarrhoea","volume":"381","author":"CLF Walker","year":"2013","journal-title":"Lancet"},{"key":"pone.0297219.ref003","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1056\/NEJMoa1006261","article-title":"Protective effect of natural rotavirus infection in an Indian birth cohort","volume":"365","author":"BP Gladstone","year":"2011","journal-title":"New Engl J Med"},{"issue":"9","key":"pone.0297219.ref004","doi-asserted-by":"crossref","first-page":"e0183392","DOI":"10.1371\/journal.pone.0183392","article-title":"Global Rotavirus Surveillance Network. Estimating global, regional and national rotavirus deaths in children aged <5 years: current approaches, new analyses and proposed improvements.","volume":"12","author":"A Clark","year":"2017","journal-title":"PLoS One."},{"key":"pone.0297219.ref005","author":"World Health Organization (WHO).","journal-title":"Weekly epidemiological record. Rotavirus vaccines: WHOposition paper"},{"key":"pone.0297219.ref006","doi-asserted-by":"crossref","first-page":"565","DOI":"10.3201\/eid0905.020562","article-title":"Global illness and deaths caused by rotavirus disease in children","volume":"9","author":"UD Parashar","year":"2003","journal-title":"Emerg Infect Dis"},{"issue":"Suppl 2","key":"pone.0297219.ref007","doi-asserted-by":"crossref","first-page":"S96","DOI":"10.1093\/cid\/civ1013","article-title":"Global, regional, and national estimates of rotavirus mortality in children <5 years of age, 2000\u20132013","volume":"62","author":"JE Tate","year":"2016","journal-title":"Clin Infect Dis"},{"key":"pone.0297219.ref008","first-page":"2023","article-title":"a new dose hope against rotavirus india made vaccine","volume":"15","author":"DRC For the","journal-title":"Available from https:\/\/www.path.org\/drc.newdosehopeagaintsrotavirusindiamadevaccine.accessed August"},{"issue":"4","key":"pone.0297219.ref009","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1080\/21645515.2020.1804245","article-title":"Product review of the rotavirus vaccines ROTASIIL, ROTAVAC, and Rotavin-M1.","volume":"17","author":"A Skansberg","year":"2021","journal-title":"Hum Vaccin Immunother."},{"issue":"10","key":"pone.0297219.ref010","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1001\/jamapediatrics.2018.1960","article-title":"Rotavirus Vaccination and the Global Burden of Rotavirus Diarrhea Among Children Younger Than 5 Years.","volume":"172","author":"C Troeger","year":"2018","journal-title":"JAMA Pediatr"},{"key":"pone.0297219.ref011","article-title":"Epidemiology and pre-vaccine burden of rotavirus diarrhea in Democratic Republic of Congo (DRC): Results of sentinel surveillance, 2009\u20132019.","author":"C Luhata Lungayo","year":"2022","journal-title":"Vaccine"},{"issue":"9","key":"pone.0297219.ref012","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1097\/INF.0000000000001232","article-title":"A Systematic Review of the Effect of Rotavirus Vaccination on Diarrhea Outcomes Among Children Younger Than 5 Years.","volume":"35","author":"LM Lamberti","year":"2016","journal-title":"Pediatr Infect Dis J."},{"issue":"7624","key":"pone.0297219.ref013","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"335","author":"E Von Elm","year":"2007","journal-title":"BMJ"},{"issue":"6","key":"pone.0297219.ref014","doi-asserted-by":"crossref","first-page":"e100953","DOI":"10.1371\/journal.pone.0100953","article-title":"Rotavirus surveillance in Kisangani, the Democratic Republic of the Congo, reveals a high number of unusual genotypes and gene segments of animal origin in non-vaccinated symptomatic children","volume":"9","author":"E Heylen","year":"2014","journal-title":"PLoS One"},{"issue":"1","key":"pone.0297219.ref015","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1186\/s12887-023-04022-0","article-title":"Clinical profile of children under 5 years of age with rotavirus diarrhoea in a hospital setting in Kisangani, DRC, after the introduction of the rotavirus vaccine, a cross-sectional study","volume":"23","author":"D Gbebangi-Manzemu","year":"2023","journal-title":"BMC Pediatr"},{"key":"pone.0297219.ref016","unstructured":"BIOSYNEX\u00ae Adenovirus\/Rotavirus BSS. Available from https:\/\/rhogen.es\/biosynex-adenovirus rotavirus-bss. Accessed 10 August 2023"},{"key":"pone.0297219.ref017","author":"WHO","journal-title":"Classification of nutritional stutus of infants and children."},{"issue":"4","key":"pone.0297219.ref018","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1002\/jmv.24382","article-title":"Molecular epidemiology and surveillance of circulating rotavirus and adenovirus in Congolese children with gastroenteritis","volume":"88","author":"G Mayindou","year":"2016","journal-title":"J Med Virol"},{"key":"pone.0297219.ref019","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ijid.2015.03.009","article-title":"Molecular epidemiology of enteric viruses and genotyping of rotavirus A, adenovirus and astrovirus among children under 5 years old in Gabon","volume":"34","author":"SE Lekana-Douki","year":"2015","journal-title":"Int J Infect Dis"},{"issue":"6","key":"pone.0297219.ref020","doi-asserted-by":"crossref","first-page":"e04248","DOI":"10.1016\/j.heliyon.2020.e04248","article-title":"Prevalence, risk factors, and clinical characteristics of rotavirus and adenovirus among Lebanese hospitalized children with acute gastroenteritis.","volume":"6","author":"R Zaraket","year":"2020","journal-title":"Heliyon."},{"issue":"7","key":"pone.0297219.ref021","doi-asserted-by":"crossref","first-page":"e210347","DOI":"10.1001\/jamapediatrics.2021.0347","article-title":"Association of Rotavirus Vaccines With Reduction in Rotavirus Gastroenteritis in Children Younger Than 5 Years: A Systematic Review and Meta-analysis of Randomized Clinical Trials and Observational Studies","volume":"175","author":"ZW Sun","year":"2021","journal-title":"JAMA Pediatr"},{"key":"pone.0297219.ref022","doi-asserted-by":"crossref","first-page":"101687","DOI":"10.1016\/j.eclinm.2022.101687","article-title":"Systematic review of the effect of additional doses of oral rotavirus vaccine on immunogenicity and reduction in diarrhoeal disease among young children","volume":"54","author":"BF Middleton","year":"2022","journal-title":"EClinicalMedicine"},{"issue":"3","key":"pone.0297219.ref023","doi-asserted-by":"crossref","first-page":"243","DOI":"10.4103\/ijph.IJPH_307_18","article-title":"Epidemiology of rotavirus gastroenteritis and need of high rotavirus vaccine coverage with early completion of vaccination schedule for protection against rotavirus diarrhea in India: A narrative review.","volume":"63","author":"B Raju","year":"2019","journal-title":"Indian J Public Health"},{"issue":"3","key":"pone.0297219.ref024","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/INF.0b013e318275328f","article-title":"Effectiveness of an incomplete RotaTeq (RV5) vaccination regimen in preventing rotavirus gastroenteritis in the United States.","volume":"32","author":"FT Wang","year":"2013","journal-title":"Pediatr Infect Dis J."},{"key":"pone.0297219.ref025","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1471-2431-10-69","article-title":"Prevalence and factors associated with rotavirus infection among children admitted with acute diarrhea in Uganda","volume":"10","author":"JS Nakawesi","year":"2010","journal-title":"BMC Pediatr"},{"issue":"2","key":"pone.0297219.ref026","first-page":"127","article-title":"Analysis of factors in response to rotavirus vaccination counselling in a private paediatric clinic.","volume":"65","author":"P Kannan Kutty","year":"2010","journal-title":"Med J Malaysia."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0297219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T18:31:27Z","timestamp":1707762687000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0297219"}},"subtitle":[],"editor":[{"given":"Adriana","family":"Calderaro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,2,12]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,12]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0297219","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,12]]}}}