Clinical profile and seasonality of rotavirus infection in children of Bangladesh

Abstract

Rotavirus (RV) is the single most important causative agent for severe dehydrating childhood diarrhea worldwide. RV diarrhea is a tremendous social and economic burden upon the people in developing countries. In Bangladesh, the proportion of RV diarrhea in children is increasing compared to other infectious diarrheal agents primarily because of improvements in water sanitation. This hospital-based cross sectional study was carried out in a children’s hospital of Bangladesh to highlight the clinical presentations and seasonal predilection of RV diarrhea. A total of 601 children under the age of 5 years presenting with acute watery diarrhea were enrolled, with collected stools tested for presence or absence of RV antigen by enzyme linked immunosorbent assay (ELISA). Forty-two percent of the samples were ELISA positive for RV antigen; 72% of those RV+ children were under 12 months of age and 92% were under 24 months. Nausea, vomiting and large families (≥ 5 members) showed significant association with RV+ diarrhea compared to RV- diarrhea (P = 0.004, 0.001 and P = 00.006 respectively). In RV+ diarrhea, the purging rate was also significantly higher (P = 0.043). Mild to moderate fever and dehydration were noted in 82% and 84% cases of RV+ diarrhea respectively. RV+ diarrhea peaked during winter months (January through March). The vulnerable age group, seasonality and clinical presentations of childhood RV diarrhea observed in our study are expected to assist the Bangladeshi health care professionals confidently dealing with this health problem; even if there is little or no laboratory support.