Abstract
BackgroundDiarrhea caused by viruses is a global problem among young children. We investigated two of the most important agents, rotavirus and adenovirus, to provide epidemiological evidence for a better understanding of their role among children with acute diarrhea.MethodsA total of 3147 hospitalized children were enrolled in the study during 2010 ~ 2014. Antigen testing for rotavirus and DNA testing for adenovirus were performed on stool specimens collected from participants.ResultsThere were 1985 cases of community-acquired diarrhea (CAD) and 1162 cases of hospital-acquired diarrhea (HAD). A total of 692 cases (22.0 %) were positive for rotavirus. Rotavirus was detected in more children with HAD than in those with CAD (24.6 %; 286/1162 vs. 20.5 %; 406/1985). A total of 324 cases (10.3 %) were adenovirus positive. There was a significant difference between the CAD group and HAD group (9.5 %; 188/1985 vs. 11.7 %; 136/1162: χ2 = 3.957, p = 0.047). Co-infection was found in only 35 children (1.11 %), and the co-infection rate was similar between the CAD and HAD groups (χ2 = 1.174, p = 0.279). There was no association between sex and the detection rate of these viruses. The positive rate was significantly different for rotavirus among CAD cases (χ2 = 27.979, p < 0.001) and for adenovirus (χ2 = 34.362, p < 0.001) in the five age groups. Compared with the other four age groups (15.8–19.8 %), the prevalence of rotaviruses was highest among children aged 12–24 months (28.6 %). Adenovirus was detected in 3.6 % of neonates compared with 5.8 % of infants from 1 to 6 months old; this increased to 12.0–13.8 % in children over 6 months of age. In HAD cases, age differences were not found for rotavirus and adenovirus. Seasonal variation of rotavirus was observed, with peaks in November and December and with through in July and August; however, no clear seasonal pattern was found for adenovirus.ConclusionDetection rates for rotavirus and adenovirus were significantly higher in children with HAD than those with CAD, but co-infection was very low. A high prevalence of rotavirus was identified in neonates with diarrhea. Vaccination for rotavirus gastroenteritis should be considered in neonates.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1829-z) contains supplementary material, which is available to authorized users.
Highlights
Diarrhea caused by viruses is a global problem among young children
There was a significant difference between the community-acquired diarrhea (CAD) group and hospital-acquired diarrhea (HAD) group for rotavirus (χ2 = 7.392, p = 0.007)
The difference for adenovirus was yet significant between infants with CAD and with HAD (χ2 = 3.957, p = 0.047), and there was a higher prevalence (11.7 %, 136/1162) found among children with HAD compared with CAD (9.5 %, 188/1985)
Summary
Diarrhea caused by viruses is a global problem among young children. We investigated two of the most important agents, rotavirus and adenovirus, to provide epidemiological evidence for a better understanding of their role among children with acute diarrhea. Diarrhea remains the leading infectious cause of death in children under the age of 5 years. Rotavirus is the main cause of severe diarrhea in children below 5 years of age worldwide. The virus is associated with considerable hospitalizations and deaths among children and is responsible. Liu et al BMC Infectious Diseases (2016) 16:508. Adenovirus is another important etiological agent of serious gastroenteritis among infants and young children. Infection with adenovirus can cause severe disease, increased mortality, and prolonged length of hospital stay [8]
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