Abstract
Background: As children with diarrhoea are often prescribed antibiotics, it was decided to study the causative organisms. Rotavirus is a major cause of diarrhoea and diarrhoea related mortality in most parts of India. Rotavirus vaccine is available but expensive. According to the World Health Organisation (WHO) the vaccine should be used in areas where diarrhoea related under five mortality is around 10%. The situation in north Karnataka is not known. Objectives : To find proportions of rotavirus and non-rotavirus diarrhoea in children of north Karnataka and study the key clinical features of rotavirus diarrhoea. Study design and settings : Prospective observational study conducted in patients from the paediatric ward and outpatient department in a tertiary care hospital. Method: Children 1 to 36 months old, presenting with acute diarrhoea from July 2014 to May 2016 and fulfilling selection criteria were included. Demographic and clinical details were noted. Stools were collected within 24 hours and subjected to routine and microscopic examination, test for presence of reducing substance, bacterial culture and Rapid ELISA test for rotavirus using antigen detection micro-well ELISA kit by Premere Rotaclone. Results: A total of 168 children was recruited . Children positive for rotavirus ELISA were labelled as having rotavirus diarrhoea and comprised 52 (31%) of total, including 17 with mixed infection and 15% were bacterial culture positive. Most common age group affected was 7 to 18 months (79%).Male female ratio was same in rotavirus and non-rotavirus diarrhoea. The clinical features defining rotavirus diarrhoea were fever, vomiting, watery stools, respiratory symptoms and perianal excoriations. Moderate and severe dehydration were common. There was no mortality. Conclusions : Around one third (31%) of diarrhoea cases were positive for rotavirus and 15% were of only bacterial aetiology. Key clinical features in rotavirus infection were fever, vomiting, watery stools, respiratory symptoms and perianal excoriations. Sri Lanka Journal of Child Health , 2018; 47 : 204-209
Highlights
The proportion of rotavirus as a cause of death among causes of diarrhoea in children ranges in different states of India from 7% in Vellore to 50% in Manipur[1]
Around one third (31%) of diarrhoea cases were positive for rotavirus and 15% were of only bacterial aetiology
Children positive for rotavirus ELISA were labelled as having rotavirus diarrhoea and comprised 52 (31%) of total, including 17 with mixed infection and 15% were bacterial culture positive
Summary
The proportion of rotavirus as a cause of death among causes of diarrhoea in children ranges in different states of India from 7% in Vellore to 50% in Manipur[1]. According to the World Health Organisation (WHO), the under-five mortality has come down from 528,000 in 2000 to 215,000 in 2013 but 22% of global rotaviral deaths occurred in India[2]. The prevalence of rotavirus among all diarrhoeal causes has not been studied in Karnataka after 2002, to the best of our knowledge. Some anecdotal studies have reported 19.5% to 28% prevalence in south Karnataka[3,4]. Prevalence in North Karnataka has not been reported. As children with diarrhoea are often prescribed antibiotics, it was decided to study the causative organisms. Rotavirus is a major cause of diarrhoea and diarrhoea related mortality in most parts of India. According to the World Health Organisation (WHO) the vaccine should be used in areas where diarrhoea related under five mortality is around 10%.
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