Journal of Medical Virology 80:1790–1798 (2008) Molecular Characterization of Enteric Viral Agents From Children in Northern Region of Ghana Paula Andreia Silva, 1 Klaus Stark, 1 Frank P. Mockenhaupt, 2 Klaus Reither, 2,3 Thomas Weitzel, 2 Ralf Ignatius, 4 Eiman Saad, 2 Andrew Seidu-Korkor, 5 Ulrich Bienzle, 2 and Eckart Schreier 1 * 1 Robert Koch Institute, Berlin, Germany 2 Institute of Tropical Medicine and International Health, Charite´-University Medicine Berlin, Germany 3 Department of Infectious Diseases and Tropical Medicine, University of Munich, Germany 4 Institute of Microbiology and Hygiene, Charite´-University Medicine Berlin, Berlin, Germany 5 Regional Health Administration, Ministry of Health, Tamale, Ghana Viral gastrointestinal infections are among the most important causes of childhood morbidity and mortality, especially in non-industrializ- ed countries. The objective of this study was the molecular characterization of rotaviruses, nor- oviruses, adenoviruses, astroviruses, and enter- oviruses obtained from 367 children in the Northern Region of Ghana. One hundred and forty-two rotavirus-positive stool samples were examined. The most frequent type identified was G1P[8] occurring in 80% of the cases. Of 27 norovirus positive samples, 5 isolates belonged to genogroup I and 22 to genogroup II. Adenovi- ruses were detected in 73 samples; 23.3% of these belonged to genogroup F, 31.5% to D, 17.8% to A, 15.1% to C, and 12.3% to B. Astrovirus typing of 12 positive samples displayed a distribution into four different genotypes: five sequences clustered with AstV-8, four with AstV-2, two with AstV-5, and one with AstV-6. Twenty-three different enter- ovirus types were identified in 45 positive samples, coxsackievirus A24 being the most frequent patho- gen (18%). This first, comprehensive molecular characterization of enteric viruses in northern Ghana provides baseline data for the molecular epidemiology of these pathogens and immunisa- tion strategies. The available rotavirus vaccines cover the predominant G1P[8] type and would reduce substantially disease burden in that area. J. Med. Virol. 80:1790–1798, 2008. ß 2008 Wiley-Liss, Inc. KEY WORDS: rotavirus; norovirus; adeno- virus; astrovirus; enterovirus; gastroenteritis INTRODUCTION Diarrhoeal diseases are a major cause of morbidity and mortality among young children in non-industrialized countries [Basu et al., 2003; Okitsu-Negishi et al., 2004]. Every year, more than 1 billion diarrhoea episodes and approximately 2.5 million deaths occur among children under 5 years of age [Kosek et al., 2003; Bryce et al., 2005; O’Ryan et al., 2005]. Enteric viruses have been recognized as the main cause of childhood diarrhoea, and four groups of viruses are considered relevant: rotaviruses (RoV), adenoviruses (AdV), noroviruses (NV) and astroviruses (AstV). Enteroviruses (EV) show a wide spectrum of clinical manifestation, and have been also associated with acute gastroenteritis [Phan et al., 2005; Nyangao et al., 2006]. Rotaviruses are the most common etiologic agents of acute gastroenteritis world-wide. They have a double strand RNA genome with 11 segmented genes. Based on the characteristics of VP6—the major structural pro- tein—rotaviruses are divided into seven groups (A–G). Only groups A – C infect humans, with group A being the major cause of childhood diarrhoea [Franco et al., 2006]. The outer viral capsid proteins, VP4 (protease sensitive) and VP7 (glycoprotein), have been found to induce protective immunity, and play an important role in the molecular characterization of rotaviruses. Based on their characteristics, 15 types of VP7 (termed G types) and approximately 26 of VP4 (termed P types) have been identified [Rahman et al., 2005; Martella et al., 2006]. Human noroviruses have a single strand RNA genome and are classified into three genogroups (GI, GII and GIV) containing at least 8 different genotypes in GI and 19 in GII [Wang et al., 2005; Zheng et al., 2006]. The Grant sponsor: German Rotary Volunteer Doctors; Grant sponsor: Bayer Vital GmbH; Grant sponsor: Robert Koch Institute Berlin; Grant sponsor: Institute of Tropical Medicine; Grant sponsor: International Health Berlin. *Correspondence to: Prof. Dr. Eckart Schreier, Department of Molecular Epidemiology of Viral Pathogens, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany. E-mail: schreiere@rki.de Accepted 6 May 2008 DOI 10.1002/jmv.21231 Published online in Wiley InterScience (www.interscience.wiley.com) ß 2008 WILEY-LISS, INC.