Abstract
Diarrhoeal disease is the second leading cause of death in children under age 5 worldwide, with rotavirus being the main etiology. In the Lao People's Democratic Republic, acute watery diarrhoea (AWD) was introduced as one of the national notifiable diseases in 2004. We retrospectively reviewed the aggregate (n = 117 277) and case-based (n = 67 755) AWD surveillance data from 2009 to 2013 reported weekly from 1115 health facilities nationwide. Rotavirus rapid test data from all eight sentinel sites in Vientiane Capital in 2013 were also collected for analysis. The incidence of AWD ranged between 215 and 476 cases per 100 000 population and increased from 2009 to 2012 when it levelled off. The most affected age group was children under 5 who were about seven to nine times more likely to have AWD than the rest of the population (P < 0.0001). In children under 5, 74.8% of the cases were aged 0–24 months and AWD was 1.28 times more common in males (P < 0.0001). Among the 230 stool specimens tested in children under 5 in 2013, 109 (47.4%) tested positive for rotavirus. The increased AWD incidence over the study period may reflect a true increase in AWD or an improved sensitivity of the system. We recommend new mothers breastfeed up to two years after birth, which is known to reduce AWD morbidity and mortality in young children. We also recommend conducting rotavirus disease burden and cost–effectiveness studies to explore the benefits of introduction of rotavirus vaccine.
Highlights
Acute watery diarrhoea (AWD), which can last several hours to several days, is defined as the passage of three or more loose or liquid stools within 24 hours.[4]
All the line lists are compiled into an overall AWD line list that is emailed to National Center for Laboratory and Epidemiology (NCLE), and a record of the aggregated AWD cases that is entered into LAOEWARN
We investigated the trends of AWD from the national indicator-based surveillance (IBS) system from 2009 to 2013
Summary
Acute watery diarrhoea (AWD), which can last several hours to several days, is defined as the passage of three or more loose or liquid stools within 24 hours.[4]. Acute watery diarrhoea in the Lao People’s Democratic Republic, 2009–2013 were established in Vientiane Capital in 2013. These sites collect stool specimens from diarrhoea patients; specimens from patients under age 5 collected during the dry winter season (from October to April) are sent to NCLE for rotavirus testing. Since the introduction of LAOEWARN, there has been no formal analysis of AWD data over time, and little is known about the geographic distribution of AWD in the Lao People’s Democratic Republic. We aim to describe the trends of AWD in the Lao People’s Democratic Republic from 2009 to 2013 with a particular focus on the prevalence of rotavirus-related morbidity in children under age 5
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