Incidence and aetiology of diarrhoeal disease among children under five years in the post-rotavirus vaccine introduction era in Manhiça District, Mozambique.
18 affiliations
- 1Centro de Investigação em Saúde de Manhiça (CISM), 1929, Maputo, Mozambique. [email protected].
- 2ISGlobal, 08036, Barcelona, Spain.
- 3Centro de Investigação em Saúde de Manhiça (CISM), 1929, Maputo, Mozambique.
- 4Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08036, Barcelona, Spain.
- 5Instituto Nacional de Saúde (INS), 1120, Marracuene, Maputo, Mozambique.
- 6ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain.
- 7Institut Clínic de Medicina I Dermatologia, Hospital Clínic de Barcelona, Barcelona, Spain.
- 8Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.
- 9CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.
- 10World Health Organization, Intercountry Support Team, East and Southern Africa, Harare, Zimbabwe.
- 11Centers for Disease Control and Prevention (CDC), Atlanta, GA, 30333, USA.
- 12Diarrhea Pathogens Research Unit, Department of Virology, Sefako Makgatho University of Pretoria, Pretoria, South Africa.
- 13Kenya Primate Research Institute, Nairobi, Kenya.
- 14Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal.
- 15Centro de Investigação em Saúde de Manhiça (CISM), 1929, Maputo, Mozambique. [email protected].
- 16ISGlobal, 08036, Barcelona, Spain. [email protected].
- 17Instituto Nacional de Saúde (INS), 1120, Marracuene, Maputo, Mozambique. [email protected].
- 18Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal. [email protected].
Abstract
Background
Diarrhoea remains a major cause of death in children under five, despite the global decline in hospitalisations following the widespread introduction of rotavirus vaccines . As rotavirus-associated disease declines, it is important to identify other diarrhoea associated pathogens, although post-vaccine data remain limited in Mozambique. This study aimed to estimate the incidence and determine the aetiology of Moderate-to-Severe Diarrhoea (MSD) and Less Severe Diarrhoea (LSD) among children under five, post-rotavirus vaccine introduction in Manhiça District, a rural setting in Mozambique.Methods
We estimated the incidence of diarrhoea using data from the morbidity surveillance and pathogen-attributable fractions based on analysis of stool specimens collected in a case-control study.Results
The overall incidence of MSD was 5.6 cases per 1,000 child-years at risk (CYAR), with the highest rate observed among infants aged 0-11 months (15.5 per 1,000 CYAR) with a declining trend over time. LSD incidence was approximately 20 times higher than MSD incidence (119.7 per 1,000 CYAR), peaking among children aged 12-23 months (232.9 per 1,000 CYAR). Rotavirus remained the leading cause of both MSD and LSD among infants aged 0-11 months, while other important pathogens associated with LSD in this age group included sapovirus and Cryptosporidium spp. Among children aged 12-23 months, enteroaggregative Escherichia coli and adenovirus 40/41 were the major contributors to MSD.Conclusions
Our findings highlight that rotavirus remains an important diarrhoea aetiology among infants and demonstrate changes on diarrhoea aetiologies post-rotavirus vaccine introduction; reinforcing the need for continued surveillance to better inform control and prevention strategies.
Related
- Incidence of and household responses to paediatric diarrhoeal disease and acute respiratory infection in Chitwan, Nepal: protocol for a prospective cohort study
- 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
- Preliminary Analysis of the Impact of Malaria Vaccine Introduction on Severe Malaria Incidence in Children Under 5 Years in the Health Districts of Edea, Japoma, and Mbanga (2020–2024)
- Migration, attrition and internal validity in longitudinal study of chronic kidney disease of unknown aetiology in Nicaragua
- Global burden of enteric infectious diseases, diarrhoeal diseases, and corresponding aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
BibTeX
@article{chirinda2026incidence,
title = {{Incidence and aetiology of diarrhoeal disease among children under five years in the post-rotavirus vaccine introduction era in Manhiça District, Mozambique.}},
author = {Percina Chirinda and Llorenç Quintó and Corssino Tchavana and Augusto Messa and Arsénio Nhacolo and Sozinho Acacio and Tacilta Nhampossa and Quique Bassat and Goitom G Weldegebriel and Jacqueline E Tate and Umesh Parashar and Jason M Mwenda and Filomena Manjate and Inacio Mandomando},
journal = {Tropical medicine and health},
year = {2026},
month = oct,
doi = {10.1186/s41182-026-01095-2},
url = {https://europepmc.org/article/MED/42897682},
note = {CC BY},
}
RIS
TY - JOUR
TI - Incidence and aetiology of diarrhoeal disease among children under five years in the post-rotavirus vaccine introduction era in Manhiça District, Mozambique.
AU - Percina Chirinda
AU - Llorenç Quintó
AU - Corssino Tchavana
AU - Augusto Messa
AU - Arsénio Nhacolo
AU - Sozinho Acacio
AU - Tacilta Nhampossa
AU - Quique Bassat
AU - Goitom G Weldegebriel
AU - Jacqueline E Tate
AU - Umesh Parashar
AU - Jason M Mwenda
AU - Filomena Manjate
AU - Inacio Mandomando
PY - 2026
DA - 2026/10/19
JO - Tropical medicine and health
DO - 10.1186/s41182-026-01095-2
UR - https://europepmc.org/article/MED/42897682
AB - Background Diarrhoea remains a major cause of death in children under five, despite the global decline in hospitalisations following the widespread introduction of rotavirus vaccines . As rotavirus-associated disease declines, it is important to identify other diarrhoea associated pathogens, although post-vaccine data remain limited in Mozambique. This study aimed to estimate the incidence and determine the aetiology of Moderate-to-Severe Diarrhoea (MSD) and Less Severe Diarrhoea (LSD) among children under five, post-rotavirus vaccine introduction in Manhiça District, a rural setting in Mozambique.Methods We estimated the incidence of diarrhoea using data from the morbidity surveillance and pathogen-attributable fractions based on analysis of stool specimens collected in a case-control study.Results The overall incidence of MSD was 5.6 cases per 1,000 child-years at risk (CYAR), with the highest rate observed among infants aged 0-11 months (15.5 per 1,000 CYAR) with a declining trend over time. LSD incidence was approximately 20 times higher than MSD incidence (119.7 per 1,000 CYAR), peaking among children aged 12-23 months (232.9 per 1,000 CYAR). Rotavirus remained the leading cause of both MSD and LSD among infants aged 0-11 months, while other important pathogens associated with LSD in this age group included sapovirus and Cryptosporidium spp. Among children aged 12-23 months, enteroaggregative Escherichia coli and adenovirus 40/41 were the major contributors to MSD.Conclusions Our findings highlight that rotavirus remains an important diarrhoea aetiology among infants and demonstrate changes on diarrhoea aetiologies post-rotavirus vaccine introduction; reinforcing the need for continued surveillance to better inform control and prevention strategies.
SN - 1348-8945
SN - 1349-4147
ER -