Human rotavirus infection was studied over a 13-month period (January 2004 to January 2005) in children< 5 years of age admitted with severe diarrhea at the Korle-Bu Teaching Hospital in Accra, Ghana. During this period, 206 hospitalizations for diarrhea were recorded, with 34.0 z (70/206) being positive for rotavirus infection. Infection occurred throughout the year, with peak rotavirus infection occurring during the month of March. Hospitalization associated with rotaviruses was most common in the 6–8 month age group. The case fatality rate of rotavirus infection was 2.9 z (2/70) and occurred in children< 12 months of age. Four rotavirus VP7 genotypes (G1, G2, G3, and G9) were detected. The predominant genotypes were G2 (22.9 z), G1 (17.1 z), G9 (17.1 z) and G3 (12.9 z). Mixed G types were also detected. The predominant VP4 genotypes (P types) were P [6](38.6 z), P [8](21.4 z), P [4](4.3 z) and P [9](1.4 z). The predominant rotavirus strains infecting children in Accra were G9P [6](10.0 z) and G1P [8](8.6 z). Strains with unusual genotypes such as G2P [8] and G (2/3) P [6] were also detected.

Rotavirus has been recognized as the single most important cause of severe diarrhea in children worldwide and an important public health problem, particularly, in developing countries (1–3). Prevention of rotavirus infection through vaccination appears to be the only effective option because rotavirus infections show a similar incidence in children throughout the world regardless of hygiene and development standards (3). Currently, there are 2 main rotavirus vaccines in use, including RotaTeq (Merck & Co., Whitehouse Station, NJ, USA) and Rotarix (GlaxoSmithKline, Rixensart, Belgium), and are based on VP7 and/or VP4 outer capsid proteins of the virus (4). The RotaTeq vaccine formulation includes G1–G4 genotypes and the human P [8] genotype, whereas the Rotarix vaccine includes G1P [8] which provides cross-protection against most other serotypes. The World Health Organization (WHO) recommends surveillance of the burden of rotavirus disease and the circulating rotavirus strains, before and after the inclusion of rotavirus vaccination in national expanded programs on immunization (5). In Ghana, there are several surveillance reports on rotavirus (6–11). However, rotavirus surveillance appears to have been focused on the northern part of the country, where the climate contrasts sharply with that of southern Ghana. Rotavirus surveillance in Ghana provides evidence of the changing pattern of genotypes,