IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0359886.html

Prevalence and genotype distribution of norovirus and rotavirus among children under five with diarrheal infection in lower-middle-income countries after Rotavirus vaccine introduction: A systematic review and meta-analysis

Author

Listed:
  • Firayad Ayele
  • Tesfaye Assebe
  • Miheret Mandefro
  • Desalegn Admassu Ayana
  • Nega Assefa

Abstract

Background: Rotavirus and norovirus are the leading viral causes of acute diarrheal disease worldwide. Both viruses encompass multiple genotypes and subgenotypes, and this genetic diversity presents a significant challenge to rotavirus vaccine effectiveness and development. High-quality evidence on the prevalence and circulating genotypes of these enteric viruses among children under five years of age remains limited, particularly following the introduction of rotavirus vaccination in low and middle-income countries (LMICs). Therefore, this systematic review and meta-analysis aimed to synthesizes available evidence on the prevalence and genotype distribution of norovirus and rotavirus in this population. Methods: A systematic literature search was conducted across five major databases PubMed, Scopus, ScienceDirect, Embase, and Web of Science between February 20 and 28, 2026. Duplicate removal, title and abstract screening, full-text review and data extraction were performed independently by two investigators using the Rayyan web-based platform. STATA version 17 software was used for statistical analysis. A random-effects model was applied to estimate pooled prevalence and effect sizes. Heterogeneity was evaluated using Cochran’s Q statistic, the I2 statistic, forest plots, and Galbraith plots. Publication bias was assessed using both graphical (funnel plots) and statistical methods. Results: A total of 35,704 children under five years with diarrheal infection from LMICs were included across eligible studies. The overall pooled prevalence of norovirus and rotavirus combined was 18% (95% CI: 15–21%). Rotavirus had a higher pooled prevalence than norovirus, at 24% (95% CI: 19.6–28.3%) and 13% (95% CI: 11–15%), respectively. Substantial heterogeneity was observed across studies (I2 = 98.72%, p

Suggested Citation

  • Firayad Ayele & Tesfaye Assebe & Miheret Mandefro & Desalegn Admassu Ayana & Nega Assefa, 2026. "Prevalence and genotype distribution of norovirus and rotavirus among children under five with diarrheal infection in lower-middle-income countries after Rotavirus vaccine introduction: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 21(10), pages 1-24, October.
    • Handle: RePEc:plo:pone00:0359886
    DOI: 10.1371/journal.pone.0359886
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0359886
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0359886&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0359886?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0359886. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.