BACKGROUND: Established in 2006 with four countries conducting hospital-based 
rotavirus surveillance, the African rotavirus surveillance network has expanded 
over subsequent years. By 2015, 14 countries in the World Health Organization 
(WHO) East and Southern Africa sub-region (Eritrea, Ethiopia, Kenya, Lesotho, 
Madagascar, Mauritius, Namibia, Rwanda, Seychelles, Swaziland, Tanzania, Uganda, 
Zambia and Zimbabwe) were participating in the rotavirus surveillance network 
coordinated by WHO. We monitored the proportion of rotavirus diarrhoea among 
children under five years of age who were hospitalized for diarrhoea in the 
sentinel hospitals from 2010 to 2015 among countries that introduced rotavirus 
vaccine during or before 2013 (Rwanda, Tanzania, Zambia and Ethiopia) and 
compared with the other countries in the network.
METHODS: Children under the age of five years hospitalized due to acute 
diarrhoea were enrolled into the sentinel surveillance system and had stool 
samples collected and tested for rotavirus antigens by enzyme immunoassay. We 
described trends in rotavirus positivity among tested stool samples before and 
after rotavirus vaccine introduction.
RESULTS: In countries that introduced rotavirus vaccine by 2013 (Rwanda, 
Tanzania, Zambia and Ethiopia), average rotavirus vaccine coverage from 2010 to 
2015 improved from 0% in 2010 and 2011, 13% in 2012, 46% in 2013, 83% in 2014 to 
90% in 2015. Annual average rotavirus positivity from 2010 to 2015 was 35%, 33%, 
38%, 28%, 27%, and 19%, respectively. In countries that introduced rotavirus 
vaccine after 2013 or had not introduced by 2015, average rotavirus vaccine 
coverage was 0% in 2010-2013, 13% in 2014 and 51% in 2015. In these countries, 
rotavirus positivity was 44% in 2010, 32% in 2011, 33% in 2012, 41% in 2013, 40% 
in 2014 and 25% in 2015.
CONCLUSION: Countries that introduced rotavirus vaccine by 2013 had a lower 
proportion of rotavirus positive hospitalizations in 2013-2015 as compared to 
those that had not introduced rotavirus vaccine by 2013. The decrease in 
rotavirus positivity was inversely related to increase in rotavirus vaccine 
coverage showing impact of rotavirus vaccines.