The Role of Rotavirus Genotype in the Severity of Acute Diarrhea in Children Under 5 Years Old at Surabaya, Indonesia

Abstract

Background: Rotavirus infection is a major cause of diarrhea in children under five years of age in both the developed and developing countries. Rotavirus is often associated with acute infection with high severity level that causes death. The rotavirus genotype, patient immunity, and environmental condition are thought to be related to the severity of the incidence of acute diarrhea due to rotavirus infection in infants and young children. Objective: To correlate the rotavirus genotypes and the severity degree of acute diarrhea in children under 5 years. Methods: Cross sectional study was conducted in children aged 1-60 months with acute diarrhea that hospitalized at Gastroenterology ward Dr. Soetomo General Hospital, Surabaya between January to June 2014. Rotavirus examination in stool specimen made from bed-side examination using BD-Rota/Adeno Examine kit, while Rotavirus genotypes examined by molecular methods, namely Reserve Transcription-Polymerase Chain Reaction (RT-PCR) two-steps at the Institute of Tropical Disease (ITD) University of Airlangga. The severity of diarrhea was measured by using a scoring system: Ruuska and Vesikari scores (1990). Results: A total of 88 children were met the criteria of the study. Of the sample 80.7% were aged 6-24 months. Average value of the total score of severity of diarrhea was 10.21 (SD±2.12). Most Rotavirus genotype G2P(4) (19.3%) to group common genotype and genotype G1P(4) and G9P(4) for group genotyping uncommon with a prevalence of respectively 4.5%. There are significant differences between the types of common genotype and uncommon genotype to the total score of the severity degree of diarrhea (p< 0.05). Conclusion: The severity degree of acute diarrhea in children with genotype G2P(4) is the highest prevalence genotype of Rotavirus infection in Dr. Soetomo General Hospital.