{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:13:19Z","timestamp":1785507199242,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Rotavirus remains a major cause of acute gastroenteritis among children under five years of age, particularly in regions with heterogeneous vaccine implementation. In Central Asia, differences in the timing and coverage of rotavirus vaccination may influence circulating genotype patterns, yet regional evidence remains fragmented. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251274198). Electronic databases (PubMed, Web of Science, ScienceDirect, and Google Scholar) were searched without date restrictions. Studies reporting laboratory-confirmed rotavirus infection and genotype distribution among children under five years in Central Asia were included. Random-effects meta-analysis of proportions was performed to estimate the pooled genotype proportions among rotavirus-positive children, with subgroup analyses comparing the before and after vaccine introduction periods. Results: Six studies (ten before vaccine introduction strata and four after vaccine introduction strata; N = 1713 rotavirus-positive children) were included. A significant decline in the G1P[8] genotype was observed following vaccine introduction, with pooled prevalence decreasing from 0.468 (95% CI: 0.363\u20130.577) to 0.068 (95% CI: 0.034\u20130.133) (p &lt; 0.001). In contrast, G2P[4] increased from 0.134 to 0.485 (p &lt; 0.001), while G9P[4] and G9P[8] also increased significantly. G3P[8] and mixed genotypes declined, whereas G4P[8], G12P[8], and untypable strains showed no statistically significant subgroup differences. Substantial heterogeneity was observed (I2 &gt; 90%), and evidence certainty was very low for all genotype outcomes. Conclusions: The available evidence suggests that rotavirus genotype distribution among children under five in Central Asia may have changed after vaccine introduction, with lower pooled proportions of G1P[8] and higher proportions of selected heterotypic genotypes in after vaccine introduction strata. Strengthened molecular surveillance using standardized genotyping protocols is needed to determine whether these patterns represent sustained genotype replacement or temporal fluctuation. These estimates are based on a small, heterogeneous evidence base with very low certainty and should be considered hypothesis-generating rather than confirmatory of a causal vaccine effect.<\/jats:p>","DOI":"10.3390\/vaccines14080668","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:23:20Z","timestamp":1785504200000},"page":"668","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Rotavirus Genotypes Among Children Under Five in Central Asia: A Systematic Review and Meta-Analysis of Available Evidence"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5543-8635","authenticated-orcid":false,"given":"Yerke","family":"Suleimenova","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1796-2604","authenticated-orcid":false,"given":"Indira","family":"Karibayeva","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4546-1452","authenticated-orcid":false,"given":"Shnara","family":"Svetlanova","sequence":"additional","affiliation":[{"name":"Department of Nursing, Kazakhstan Medical University \u201cKSPH\u201d, Almaty 050004, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8829-1281","authenticated-orcid":false,"given":"Nurzhamal","family":"Akhmadyar","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinagul","family":"Bayesheva","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulbanu","family":"Boranbayeva","sequence":"additional","affiliation":[{"name":"Research Institute of Preventive Medicine Named After Academician E.D. Dalenov, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainur","family":"Ikhambayeva","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saule","family":"Burkitbayeva","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Bolatbek","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/S1473-3099(12)70029-4","article-title":"Fulfilling the promise of rotavirus vaccines: How far have we come since licensure?","volume":"12","author":"Patel","year":"2012","journal-title":"Lancet Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa052434","article-title":"Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis","volume":"354","author":"Abate","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_3","first-page":"S96","article-title":"Global impact of rotavirus vaccination on childhood hospitalizations and mortality","volume":"62","author":"Burnett","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1086\/605032","article-title":"Rotavirus gastroenteritis in Uzbekistan: Implications for vaccine policy in Central Asia","volume":"200","author":"Flem","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e464","DOI":"10.1016\/j.ijid.2011.03.014","article-title":"Epidemiology and burden of rotavirus disease in Central Asia","volume":"15","author":"Latipov","year":"2011","journal-title":"Int. J. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.meegid.2014.08.017","article-title":"Review of global rotavirus strain prevalence data from six years post vaccine licensure surveillance: Is there evidence of strain selection from vaccine pressure?","volume":"28","author":"Martella","year":"2014","journal-title":"Infect. Genet. Evol."},{"key":"ref_7","unstructured":"Estes, M.K., and Greenberg, H.B. (2013). Rotaviruses. Fields Virology, Lippincott Williams & Wilkins. [6th ed.]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.2217\/fmb.09.96","article-title":"Rotavirus disease and vaccination: Impact on genotype diversity","volume":"4","author":"Matthijnssens","year":"2009","journal-title":"Future Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"A122","DOI":"10.1016\/j.vaccine.2011.09.111","article-title":"Systematic review of regional and temporal trends in global rotavirus strain diversity in the pre-rotavirus vaccine era: Insights for understanding the impact of rotavirus vaccination programs","volume":"30","author":"Duque","year":"2012","journal-title":"Vaccine"},{"key":"ref_10","unstructured":"World Health Organization (2026, July 15). Introduction of Rotavirus Vaccine. WHO Immunization Data Portal. Available online: https:\/\/immunizationdata.who.int\/global\/wiise-detail-page\/introduction-of-rotavirus-vaccine."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3201\/eid2001.130019","article-title":"Dynamic modeling of cost-effectiveness of rotavirus vaccination in Kazakhstan","volume":"20","author":"Flem","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.vhri.2023.06.003","article-title":"Critical analysis of economic evaluation of childhood rotavirus vaccination in low- and lower-middle-income countries: A systematic review","volume":"38","author":"Ray","year":"2023","journal-title":"Value Health Reg. Issues"},{"key":"ref_13","unstructured":"Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.J.H.W. (2022). Cochrane Handbook for Systematic Reviews of Interventions, Version 6, Cochrane."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: An emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1097\/XEB.0000000000000054","article-title":"Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data","volume":"13","author":"Munn","year":"2015","journal-title":"Int. J. Evid. Based Healthc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"F35","DOI":"10.1016\/j.vaccine.2009.08.087","article-title":"Rotavirus infection in hospitalized children and estimates of disease burden in Kyrgyzstan, 2005\u20132007","volume":"27","author":"Flem","year":"2009","journal-title":"Vaccine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/apm.12014","article-title":"Rotavirus genotype distribution in Kyrgyzstan and Kazakhstan, 2007\u20132009","volume":"121","author":"Vainio","year":"2013","journal-title":"APMIS"},{"key":"ref_19","first-page":"601","article-title":"Rotavirus hospitalizations among children <5 years of age\u2014Tajikistan, 2013\u20132014","volume":"35","author":"Nazurdinov","year":"2017","journal-title":"Vaccine"},{"key":"ref_20","first-page":"419","article-title":"Prevalence of rotavirus genotypes after introduction of monovalent rotavirus vaccine in Uzbekistan during 2014\u20132016","volume":"11","author":"Ibadullaeva","year":"2020","journal-title":"J. Vaccines Vaccin."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/21645515.2020.1776034","article-title":"Rotavirus vaccine effectiveness and impact in Uzbekistan, the first country to introduce in Central Asia","volume":"17","author":"Eraliev","year":"2021","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_22","unstructured":"R Core Team (2024). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to Perform a Meta-Analysis with R: A Practical Tutorial","volume":"22","author":"Balduzzi","year":"2019","journal-title":"Evid. Based Ment. Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting Meta-Analyses in R with the metafor Package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J. Stat. Softw."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s44197-023-00126-z","article-title":"Assessment of the impact of the rotavirus vaccine against rotavirus-associated gastroenteritis in Uzbekistan","volume":"13","author":"Musabaev","year":"2023","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_26","unstructured":"World Health Organization, and United Nations Children\u2019s Fund (UNICEF) (2026, July 14). WHO\/UNICEF Estimates of National Immunization Coverage (WUENIC). Available online: https:\/\/www.who.int\/teams\/immunization-vaccines-and-biologicals\/immunization-analysis-and-insights\/global-monitoring\/immunization-coverage\/who-unicef-estimates-of-national-immunization-coverage."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1093\/infdis\/jiad403","article-title":"Rotavirus genotypes in the postvaccine era: A systematic review and meta-analysis of global, regional, and temporal trends by rotavirus vaccine introduction","volume":"229","author":"Amin","year":"2024","journal-title":"J. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s40272-018-0283-3","article-title":"Rotavirus vaccines: Effectiveness, safety, and future directions","volume":"20","author":"Burnett","year":"2018","journal-title":"Pediatr. Drugs"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S1473-3099(14)70832-1","article-title":"Distribution of rotavirus strains and strain-specific effectiveness of the rotavirus vaccine after its introduction: A systematic review and meta-analysis","volume":"14","author":"Leshem","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2500261","DOI":"10.1080\/21645515.2025.2500261","article-title":"Systematic literature review and meta-analysis on the prevalence of rotavirus genotypes in Asia from 2015 to 2021","volume":"21","author":"Jesudason","year":"2025","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1128\/JCM.05590-11","article-title":"Genetic analyses reveal differences in the VP7 and VP4 antigenic epitopes between human rotaviruses circulating in Belgium and rotaviruses in Rotarix and RotaTeq","volume":"50","author":"Zeller","year":"2012","journal-title":"J. Clin. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Bonura, F., Mangiaracina, L., Filizzolo, C., Bonura, C., Martella, V., Ciarlet, M., and De Grazia, S. (2022). Impact of vaccination on rotavirus genotype diversity: A nearly two-decade-long epidemiological study before and after rotavirus vaccine introduction in Sicily, Italy. Pathogens, 11.","DOI":"10.3390\/pathogens11040424"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2400798","DOI":"10.2807\/1560-7917.ES.2025.30.38.2400798","article-title":"Contribution of the EuroRotaNet surveillance network to rotavirus strain surveillance in Europe","volume":"30","author":"Vaselli","year":"2025","journal-title":"Eurosurveillance"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1093\/cid\/cix369","article-title":"Effectiveness of rotavirus vaccination: A systematic review of the first decade of global postlicensure data","volume":"65","author":"Jonesteller","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Antoni, S., Nakamura, T., Cohen, A.L., Mwenda, J.M., Weldegebriel, G., Biey, J.N., and Serhan, F. (2023). Rotavirus genotypes in children under five years hospitalized with diarrhea in low and middle-income countries: Results from the WHO-coordinated Global Rotavirus Surveillance Network. PLoS Glob. Public Health, 3.","DOI":"10.1371\/journal.pgph.0001358"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1080\/14760584.2020.1775079","article-title":"An overview of rotavirus vaccination programs in developing countries","volume":"19","author":"Hallowell","year":"2020","journal-title":"Expert Rev. Vaccines"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sadiq, A., and Khan, J. (2024). Rotavirus in developing countries: Molecular diversity, epidemiological insights, and strategies for effective vaccination. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1297269"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/8\/668\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:36:46Z","timestamp":1785505006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/8\/668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["vaccines14080668"],"URL":"https:\/\/doi.org\/10.3390\/vaccines14080668","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}