The causes of diarrhea after 10 years of rotavirus vaccination in Rwanda were investigated with real-time polymerase chain reaction in 496 children with diarrhea and 298 without. Rotavirus was detected in 11% of children with diarrhea (odds ratio, 2.48; P = .002). Comparison of population attributable fractions (PAFs) shows that Shigella (PAF, 11%) and enterotoxigenic Escherichia coli producing labile toxin (PAF, 12%) have replaced rotavirus as the main causative agents. The PAF for rotavirus had declined from 41% prevaccination to 6.5% postvaccination, indicating that rotavirus has become one among several similarly important causes of childhood diarrhea in Rwanda. A rotavirus genotype shift to G3P[8] points at the importance of continued genotype surveillance.

中文翻译：

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在接种轮状病毒疫苗 10 年后，志贺菌和产肠毒素大肠杆菌已取代轮状病毒成为卢旺达儿童腹泻的主要原因


对 496 名腹泻儿童和 298 名未腹泻儿童进行实时聚合酶链反应调查了卢旺达轮状病毒疫苗接种 10 年后腹泻的原因。在 11% 的腹泻儿童中检测到轮状病毒 （比值比，2.48;P = .002）。群体归因分数 （PAF） 的比较表明，志贺氏菌 （PAF， 11%） 和产肠毒素的大肠杆菌产生不稳定毒素 （PAF， 12%） 已取代轮状病毒成为主要病原体。轮状病毒的 PAF 已从接种疫苗前 41% 下降到接种疫苗后的 6.5%，这表明轮状病毒已成为卢旺达儿童腹泻的几个类似重要原因之一。轮状病毒基因型向 G3P[8] 的转变表明了持续基因型监测的重要性。