Abstract
BackgroundRotavirus is considered the main causal factor of severe gastroenteritis among infants and children globally. The association with severe rotavirus infection is mostly worse among the least developed countries, mainly due to inadequate access to medical care and poverty. This study was conducted to determine the seasonal effects in respect of diarrhea cases in children, the association between diarrhea cases and Rota2 vaccine in the Fanteakwa District of the Eastern Region of Ghana.MethodsThe study compares monthly diarrhea cases against children vaccinated with Rota2 extracted from DHIMS2 spanning May 2012 to December 2017 in Fanteakwa District. A univariate association between diarrhea cases and children vaccinated with Rota 2 was conducted using the R-software version 3.4.4 with the use of forecast, tseries and TSAPred. Pearson Correlation coefficient was also computed between monthly diarrhea cases and Rota 2 as well as lagged values of Rota 2 and Diarrhea cases.ResultsThe study shows that February recorded the highest average number of diarrhea cases (172) over the period 2012 to 2017 with a standard deviation of 59. However, a one-way analysis of variance shows a significant difference amongst the monthly averages with an F-statistic of 0.042 and P-value of 0.064. It is observed that the correlations between each of the Rota2 doses and the lagged cases are positive, showing higher Rota2 doses a month ago ((Xt − 1),0.346 to0.735), two months ago ((Xt − 2),0.383 to 0.746), three months ago ((Xt − 3), 0.330 to 0.737) and four months ago ((Xt − 4), 0.236 to 0.723) are associated with lower diarrhea cases. The results also show that an increase in the previous two month’s Rota2 figures by 100 is associated with a significant decrease in the currently expected diarrhea cases by approximately 36.ConclusionSeasonal variations exist in the occurrence of diarrhea in children, with January recording the highest number of diarrhea cases (172). There is a relationship between episodes of diarrhea in children and Rota2 (p-value = 0.064); thus, the more children are vaccinated with Rota2, the less diarrhea cases are recorded. Diarrhea cases in Fanteakwa district are generally low, except 2013 and 2016 where the cases are higher than the rest of the other years.
Highlights
Rotavirus is considered the main causal factor of severe gastroenteritis among infants and children globally
Seasonal variations exist in the occurrence of diarrhea in children, with January recording the highest number of diarrhea cases (172)
There is a relationship between episodes of diarrhea in children and Rota2; the more children are vaccinated with Rota2, the less diarrhea cases are recorded
Summary
Rotavirus is considered the main causal factor of severe gastroenteritis among infants and children globally. Discovered more than 40 years ago [8], rotaviruses are the major causative agents of acute gastroenteritis and diarrhea deaths among infants and children worldwide [13]. A quarter of a million African children die from the deadly, dehydrating diarrhea caused by rotavirus infection every year [26] — approximately 50% of the worldwide death toll [22]. A major reduction of severe rotavirus (RV) diarrhea is observed in countries with high RV vaccine coverage [4]. This is due to the World Health Organization (WHO) recommendations that the rotavirus vaccine for infants should be included in all national immunization programs [21]. Ghana introduced rotavirus vaccination as part of routine immunization in 2012, and it has been shown to be effective in reducing the disease burden in children under five years [25]
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