RT Journal Article SR Electronic T1 Circulating rotavirus G and P strains post rotavirus vaccination in Eastern Mediterranean Region JF Saudi Medical Journal JO Saudi Med J FD Prince Sultan Military Medical City SP 755 OP 756 DO 10.15537/smj.2018.6.21394 VO 39 IS 8 A1 Almalki, Shaia S. R. YR 2018 UL http://smj.org.sa/content/39/8/755.abstract AB Objective: To detect changes in circulating strains of rotavirus in the Eastern Mediterranean Region (EMR) post rotavirus immunization drive.Methods: We searched MEDLINE, PubMed, ScienceDirect, and the Cochrane Library and specific database website (Nutrition and Food Sciences) for relevant articles. Our search included websites of a number of relevant organizations in addition to gray. literature search. Of the 2198 articles found, we included only 35 studies after excluding irrelevant, ineligible, duplicated, and very low-quality papers.Results: Thirty pre-vaccination studies reported frequent rotavirus strains among children below 5 years of age. G1P[8] has been identified as the most dominant type prior to vaccination in EMR countries. Five post-vaccination studies conducted in 3 countries (Saudi Arabia, Morocco, and Yemen) illustrated that G1P[8] is the most prevalent strain in Saudi Arabia, and the incidence of G2P[4] has increased from 21.6% to 33.3%. In Yemen, G1P[4] is the most prevalent strain (87.5%), followed by G9P[8] (57%) and G1P[8] (18.5%). Furthermore, in Yemen, G9P[8] were the most prevalent strains accounting to 57% and 14% in G9P[4], post vaccination. Finally, in Morocco, G1P[8] was not reported 3 years post vaccination; however, incidence of G9P[8] was reported at 67% and G2P[4] at 33%.Conclusions: Rotavirus circulating strain prevalence in EMR countries has changed post vaccination, and G9P[8], G2P[4], and G9P[4] have become more dominant. Proportion of rotavirus strains in these countries after vaccination has significantly reduced. There is an increase in circulating strain G2P[4] in the post-vaccination period, which needs further monitoring. PROSPERO registration number CRD42017056887