Abstract
Rotavirus is the major cause of severe diarrhea in children under 5 years old in developed and developing countries. Since improvements in sanitation and hygiene have limited impact on reducing the incidence of rotavirus diarrhea, implementation of a vaccine will be a better solution. We conducted an observational study to determine the disease burden and to identify the genotype of circulating rotavirus in Indonesia. Hospitalized children due to acute diarrhea were enrolled from four teaching hospitals in Indonesia. Stool samples were collected based on WHO protocol and were tested for the presence of group A rotavirus using enzyme immunoassay. Then, rotavirus positive samples were genotyped using RT-PCR. Fisher’s Exact tests, Chi square tests and logistic regression were performed to determine differences across hospital and year in rotavirus prevalence and genotype distribution. There were 4235 samples from hospitalized children with diarrhea during 2006, 2009 and 2010. Among them, the rotavirus positive were 2220 samples (52.42 %) and incidence rates varied between hospitals. The G1P[8], G1P[6], and G2P[4] were recognized as the dominant genotypes circulating strains in Indonesia and the proportion of predominant strains changed by year. Our study showed the high incidence of rotavirus infection in Indonesia with G1P[8], G1P[6], and G2P[4] as the dominant strains circulating in Indonesia. These results reinforce the need for a continuing surveillance of rotavirus strain in Indonesia.
Highlights
Rotavirus is a major cause of severe diarrhea in both developed and developing countries
Rotavirus test using enzyme immunoassay showed that from all stool samples collected in the study, 2220 (52 %) samples were rotavirus positive
We reported the high incidence of rotavirus infection in Indonesia that varied significantly between four teaching hospitals
Summary
Rotavirus is a major cause of severe diarrhea in both developed and developing countries. Almost 25 million cases need clinical visit, 2 million cases need hospital admission, and 440,000 death cases in children under 5 years of age. By the age of 5, nearly every child experiences an episode of rotavirus gastroenteritis, 1 in 5 will visit a clinic, 1 in 65 will be hospitalized, and approximately 1 in 293 will die. In Indonesia, rotavirus was the major causative viral infection responsible for diarrheal diseases in children (37.5 %) followed by adenovirus (3.3 %) and Norwalk-like virus (17.6 %). Bacterial infection such as Enterotoxigenic E. coli, Enterohemorrhagic E. coli and Clostridium difficile had lower incidence (Putnam et al 2007)
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