{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:27:31Z","timestamp":1772252851736,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-046917"],"award-info":[{"award-number":["INV-046917"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Global Health Research Group on Gastrointestinal Infections","award":["NIHR133066"],"award-info":[{"award-number":["NIHR133066"]}]},{"DOI":"10.13039\/100013986","name":"UK Government","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013986","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Rotavirus alphagastroenteritidis remains the leading cause of severe gastroenteritis in children under five years, despite widespread vaccine use. The COVID-19 pandemic disrupted healthcare and vaccination delivery, while non-pharmacological interventions may have influenced R. alphagastroenteritidis transmission. We conducted hospital-based surveillance of R. alphagastroenteritidis gastroenteritis at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, from October 2019 to October 2024. Children under five presenting with acute gastroenteritis were enrolled; 99.1% of vaccine-eligible participants had received at least one R. alphagastroenteritidis vaccine dose. Stool samples were tested for R. alphagastroenteritidis by enzyme immunoassay (EIA) and genotyped using RT-PCR. Among 1135 enrolled children, 29.1% (330\/1135) were R. alphagastroenteritidis-positive. Cases occurred year-round except for December 2020\u2013January 2021, when no R. alphagastroenteritidis infections were detected, and February\u2013March 2023, when no samples were collected. The prevalence varied significantly by age group between children greater than 23 months of age to the rest of the age groups (&lt;6 months, 6\u201311 months, and 12\u201322 months) (p = 0.0046). The most common R. alphagastroenteritidis G-genotypes were G3 (38.7%), G2 (25.4%), and G12 (17.2%), with G2 emerging as the predominant strain from June 2023. G3P[8] was the most frequent G\u2013P combination (25%). Its overall prevalence did not change during the pandemic; however, genotype distribution shifted compared to pre-COVID-19 patterns. Sustained surveillance and genomic analyses are essential to monitor evolving strain dynamics and inform vaccine policy.<\/jats:p>","DOI":"10.3390\/pathogens14111169","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T10:24:58Z","timestamp":1763375098000},"page":"1169","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distribution of Rotavirus alphagastroenteritidis Strains in Blantyre, Malawi, During and After the COVID-19 Pandemic"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2506-293X","authenticated-orcid":false,"given":"End","family":"Chinyama","sequence":"first","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre 312225, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chimwemwe","family":"Mhango","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Biomedical Sciences Department, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre 312225, Malawi"},{"name":"Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7ZX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5036-8001","authenticated-orcid":false,"given":"Rothwell","family":"Taia","sequence":"additional","affiliation":[{"name":"Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7ZX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Landilani","family":"Gauti","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Center for Clinical and Biological Sciences Research (CCBSR), Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo 310105, Malawi"},{"name":"Wits African Leadership in Vaccinology Expertise (Wits-Alive), School of Pathology, Faculty of Health Science, University of the Witwatersrand, Johannesburg 2050, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Mandolo","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Department of Clinical Sciences, University of Liverpool School of Tropical Medicine, Liverpool L35QA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flywell","family":"Kawonga","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7ZX, UK"},{"name":"Department of Medical Laboratory Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre 312225, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest","family":"Matambo","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7ZX, UK"},{"name":"Department of Pharmacy, School of Life Sciences and Health Professions, Kamuzu University of Health Sciences, Blantyre 312225, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prisca","family":"Matambo","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Center for Clinical and Biological Sciences Research (CCBSR), Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo 310105, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Innocent","family":"Chibwe","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre 312225, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Wachepa","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel A.","family":"Cunliffe","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7ZX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2304-886X","authenticated-orcid":false,"given":"Chisomo L.","family":"Msefula","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre 312225, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3376-8529","authenticated-orcid":false,"given":"Khuzwayo C.","family":"Jere","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Programme, Blantyre 312225, Malawi"},{"name":"Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7ZX, UK"},{"name":"Department of Medical Laboratory Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre 312225, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"ref_1","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 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