Rotavirus genotypes in Malaysia and Universal rotavirus vaccination

Figures & data

Table 1. Hospitalizations due to rotavirus gastroenteritis among children in Malaysia

Year of study	Authors	Refs.	Site(s)	Location of study center	N	% +ve for RV	Mortality due to RV (n)
1981/82	Yap KL, et al.	15	Kuala Lumpur	Urban	587	46%	0
1996	Lee WS, et al.	16	Kuala Lumpur	Urban	297	29%	0
1996–99	Lee WS, et al.	10	Kuala Lumpur	Urban	1724	24%	0
2002	Lee WS, et al.	12	Kuala Lumpur	Both urban	475	23%	0
			Johor Bharu		1367	18%	0
2002–03	Hung LC et al.	11	Kuala Lumpur and Kuching	Urban	1756 912	35% 46%	0 0
2004	Poo MI and Lee WS	17	Kuala Lumpur	Urban	393	22%	0
2005–06	Tan ADK	19	Penang	Urban	142	54%	0
2005–06	Goh CT et al.	18	Kota Kinabalu	Urban	167	16%	0
2006–07	Chai PF and Lee WS	14	Kuala Lumpur	Urban	260	26%	0
2008–10	Present study		Kuala Lumpur and Kuala Trengganu	Urban and rural	822	34%	0
Overall					8902	30.3%	0

Table 2. Common stereotypes of rotavirus isolated in various sites in Malaysia, 1977 to 2010

Year of study	Authors	Reference	Site(s)	No. tested	Common rotavirus strains isolated (%)
1977–99	Rasool et al.	20	Kuala Lumpur	360	G4P[8] (71%), G1P[8] (14%), G^UTP[8] (11%), G3P[8] (3%)
2000–01	Zuraidah et al.	21	Peninsular Malaysia and Sarawak	157	G4P[8] (65%), G^UTP[8] (19%), G1P[8] (6.5%), others (6.5%)
1996, 2007	Zuraidah et al.	22	Kuala Lumpur and Batu Pahat	108	G1P[8] (81%), G^UTP[8] (9%), G1P^UT (7%), others (3%)
2001–03	Hung LC et al.	11	Kuala Lumpur and Kuching	157	G9P[8] (73.3%), G^UTP[8] (10%), G2P[4] (4.5%), G1P[8] (3.8%), Other (P4, P8, G1, G2, G9) (7%)
2008–10	Present study		Kuala Lumpur and Kuala Trengganu	251	G1P[8] (82%), G2P[4] (7.6%), G9P[8] (6.3%), Others (G12P[8], G3P9, G9P9, G3P8) (4%)
1977–2010	Overall			1033	G1P[8] (34.7%), G4P[8] (34.6%), G9P[8] (12.7%), G2P[4] (2.5%), G3P[8] (1.1%), others and untypeable 14.4%

Table 3. Modeled projected effectiveness of two RV vaccines against RVGE-related hospitalizations in Malaysia

Serotypes	Proportion of total serotypes in Malaysia (%)	Serotype-specific of pentavalent RV vaccine (RV5) ^A	Attributable effectiveness: Base case scenario for RV5 (%)^B	Attributable effectiveness: sensitivity analysis for RV5 (%)^C	Serotype-specific of monovalent RV vaccine (RV1) ^D	Attributable effectiveness: Base case scenario for RV1 (%)^B	Attributable effectiveness: sensitivity analysis for RV1 (%)^C
G1	34.7	0.95	33.0	33.0	1.0	34.7	34.7
G2	2.5	0.88	2.2	2.2	1.0	2.5	2.5
G3	1.1	0.93	1.0	1.0	0.95	1.0	1.0
G4	34.6	0.89	30.8	30.8	0.94^E	32.5	32.5
G9	12.7	1.0	12.7	12.7	0.92	11.7	11.7
Mixed / untypeable	14.4	-	13.0	0	-	13.0	0
Overall weighted effectiveness			92.7	79.7		95.4	82.8
Overall vaccine effectiveness based on 95% coverage			88.1	75.7		90.6	78.7

Note: RV, rotavirus. (A) Pentavalent human-bovine reassortant RV vaccine (Rotateq®, Merck Co.; ref. 3) (B) Base case scenario assumes 90% efficacy against mixed and untypeable serotypes. (C) Sensitivity analysis assumes 0% efficacy against mixed and untypeable serotypes. (D) Monovalent attenuated human RV vaccine (Rotarix®, GlaxoSmithKline Biologicals; ref. 5). The efficacy data for RV1 are for prevention of severe RV gastroenteritis based on a score of 11 using the 20-point Vesikari scale. (E) No efficacy figure for G4 was available, so efficacy for non-G1 was taken

Vesikari T, Matson DO, Dennehy P, Van Damme P, Santosham M, Rodriguez Z, et al, Rotavirus Efficacy and Safety Trial (REST) Study Team. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med 2006; 354:23 - 33; http://dx.doi.org/10.1056/NEJMoa052664; PMID: 16394299

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Phua KB, Lim FS, Lau YL, Nelson EA, Huang LM, Quak SH, et al. Safety and efficacy of human rotavirus vaccine during the first 2 years of life in Asian infants: randomised, double-blind, controlled study. Vaccine 2009; 27:5936 - 41; http://dx.doi.org/10.1016/j.vaccine.2009.07.098; PMID: 19679216

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