Non-rotavirus Diarrhea Research Articles

Effect of Probiotics on Rotavirus and Non-Rotavirus Diarrhea in Infants: Randomized Controlled Trial

Objective: In this trial, we have observed efficacy of two different probiotics in Rotavirus and non-Rotavirus diarrhea in infants of 6 months to 12 months. Method: The study was done to observe efficacy of two different probiotic strains in Rotavirus and non- Rotavirus diarrhea in infants. The study included the infants suffering from acute severe diarrhea. 105 infants were selected and they were divided randomly into three groups. There were 35 infants in one group. The samples of stool were sent to microbiology lab for Rotavirus testing. The treatment plan was standard treatment of diarrhea for infants in group A. The treatment plan for infants of group B and group C included same standard management of diarrhea, in addition they also received probiotics Enterococcus faecium SF68 and Saccharomyces boulardii respectively. Results: There was reduction in stool output and improvement in consistency of stool in infants of group B and C as compared to infants of group A. There was decrease in stool frequency in non-Rotavirus diarrhea in infants of group B and C while there was no significant difference between groups regarding Rotavirus diarrhea. Conclusion: Probiotics helped to decrease the stool output in non-Rotavirus diarrhea. There was not any significant difference in groups regarding Rotavirus diarrhea. How to cite: Khan FA, Irum z, Khan MZ, Yousaf N, Piracha MI, Zaheer S. Effect of Probiotics on Rotavirus and Non- Rotavirus Diarrhea in Infants: Randomized Controlled Trial. Esculapio - JSIMS 2022;18(03):248-252 Keywords: Rotavirus, Non-Rotavirus, Saccharomyces boulardii,, Enterococcus faecium Sf68

The Differences in Transaminase Enzyme Levels among Children with Acute Diarrhea due to Rotavirus and Non-rotavirus

BACKGROUND: Diarrhea is the particular disease that still affects children in Indonesia, with rotavirus being the most common etiology among children under 5 years old. Rotavirus and non-rotavirus diarrhea can spread to the extraintestinal and localized to the liver which causes liver cell damage, thus, the level of the glutamic oxaloacetic and glutamic pyruvic transaminase enzymes increases. AIM: The objective of the study was to prove that there are differences in serum levels of glutamic oxaloacetic and glutamic pyruvic transaminase in children with acute diarrhea due to rotavirus and non-rotavirus infection. METHODS: This study used a cross-sectional design, the research subjects were children aged 6 months old until 60 months old with acute diarrhea in Denpasar Public Health Center, Sanglah, and Wangaya General Hospital within the period of March 2018 until March 2021. Statistical analysis used the Mann–Whitney. RESULTS: A total of 70 subjects were analyzed in this study. There were 24.28% of subjects with rotavirus. Each group had nearly the same degree of severity of 29.4% for rotavirus and 30.2% for non-rotavirus, with a median of serum levels of glutamic oxaloacetic transaminase (SGOT) 47 (19–261) and glutamic pyruvic transaminase (SGPT) 25 (7–217). The results of this study showed that the median difference in aspartate aminotransferase and alanine aminotransferase levels was not significant in rotavirus and non-rotavirus diarrhea (SGOT 45 [16–168], 32 [11–261], p = 0.077; (SGPT 22 [14–91], 18 [5–217], p = 0.12). CONCLUSION: This study concluded that there is a higher median level of SGOT and SGPT in children with acute diarrhea due to rotavirus infection compared to non-rotavirus infection, although it is not statistically significant.

Economic burden of rotavirus diarrhea in Thailand: Report from a pilot study on rotavirus vaccination

BackgroundRotavirus diarrhea is the leading cause of morbidity and mortality in young children in both developed and developing countries. Hospitalization costs are a significant burden of both governments and households. The objective of this study was to estimate the economic burden associated with the hospitalization of children with non-rotavirus and rotavirus diarrhea in two provinces in Thailand. MethodA prospective incidence-based cost-of-illness study was conducted on children under five years old with acute diarrhea who had been admitted to public hospitals in two provinces during October 2012 and June 2013. Caregivers were interviewed to estimate costs from a societal perspective at 2014 values. Stool samples were examined for rotavirus antigens. Multivariate regression analysis was used to assess the relationship of predictor variables to costs. Annual economic burden of rotavirus hospitalization was estimated by multiplying the number of hospitalized children and the hospitalization cost per episode. The costs were converted to international dollars (I$) using purchasing power parity (PPP) (1 USD = 12.36 baht for the year 2014). ResultsSeven hundred and eighty-eight cases of acute diarrhea were included in the analysis. Of the total, one hundred and ninety-seven (25%) were detected as being rotavirus positive. Total societal costs of inpatient care per episode were 822.68 USD (10,165 Baht). The average costs of children with and without rotavirus were 903.39 USD (11,162 Baht) and 795.40 USD (9,827 Baht), respectively. Based on the multiple regression analysis, rotavirus infection, severity, and younger age were significantly associated with the higher costs. ConclusionDiarrhea, rotavirus diarrhea in particular, represents of a substantial economic burden in the society in Thailand. The accurate estimates that societal costs of the rotavirus diarrhea hospitalizations provide valuable input for considering a preventive program.

Diarrhoea in north Karnataka: Rotavirus versus non-rotavirus

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

A comparison of the test-negative and traditional case-control study designs with respect to the bias of estimates of rotavirus vaccine effectiveness

Estimation of the effectiveness of rotavirus vaccines via the test-negative control study design has gained popularity over the past few years. In this study design, children with severe diarrhea who test positive for rotavirus infection are considered as cases, while children who test negative serve as controls. We use a simple probability model to evaluate and compare the test-negative control and the traditional case-control designs with respect to the bias of resulting estimates of rotavirus vaccine effectiveness (VE). Comparisons are performed under two scenarios, corresponding to studies performed in high-income and low-income countries. We consider two potential sources of bias: (a) misclassification bias resulting from imperfect sensitivity and specificity of the test used to diagnose rotavirus infection, and (b) selection bias associated with possible effect of rotavirus vaccination on the probability of contracting severe non-rotavirus diarrhea.Our results suggest that both sources of bias may produce VE estimates with substantial bias. Particularly, lack of perfect specificity is associated with severe negative bias. For example, if the specificity of the diagnostic test is 90% then VE estimates from both types of case-control studies may under-estimate the true VE by more than 20%. If the vaccine protects children against non-rotavirus diarrhea then VE estimates from test-negative control studies may be close to zero even though the true VE is 50%. However, the sensitivity and specificity of the enzyme immunoassay test currently used to diagnose rotavirus infections are both over 99%, and there is no solid evidence that the existing rotavirus vaccines affect the rates of non-rotavirus diarrhea. We therefore conclude that the test-negative control study design is a convenient and reliable alternative for estimation of rotavirus VE.

Serum Zinc Levels as a Predictor of Severity of Acute Diarrhea.

To determine relationship between serum zinc levels and severity of diarrhea as determined by hydration status, duration of diarrhea and requirement for hospitalization. Also, to compare serum zinc levels in relation to rotavirus status. A prospective observational study which included 254 children aged 6 mo to 5 y with diarrhea was conducted. Serum zinc levels could be estimated in 198 children. Median (IQR) serum zinc levels of study population were 73.5 (59.11-92.86)μg/dl. Median (IQR) of serum zinc levels in children with dehydration and without dehydration were 69.64 (54.57-81.62) and 82.86 (64.1-103.48) μg/dl respectively (p<0.001). Median (IQR) of serum zinc levels in hospitalised and non-hospitalished children were 63.28 (51.81-85.37) and 74.86 (61.75-95.78) μg/dl, respectively (p 0.013). Median (IQR) of total duration of diarrhea was 4.8 (3.5-6.0) d and it did not correlate with serum zinc levels. Median (IQR) of serum zinc levels in children, with rotavirus diarrhea was 66.8 (49.7-82.48) and non-rotavirus diarrhea was 80.0 (62.42-100.12) μg/dl (p<0.001). Children with dehydration and those with rotavirus diarrhea tend to have significantly lower serum zinc levels. Hospitalized children also have lower serum zinc levels than non-hospitalized children. Duration of diarrhea does not relate with serum zinc levels.

Health related quality of life impact from rotavirus diarrhea on children and their family caregivers in Thailand

ABSTRACTBackground: Rotavirus diarrhea is a major health problem among young children worldwide with potential negative impacts on health-related quality of life (HRQoL). This study assessed the impact of rotavirus diarrhea on HRQoL of children and their caregivers.Methods: We performed a cross-sectional study among 460 hospitalized children with diarrhea aged under 5 years and their family caregivers at three hospitals in Phetchabun province, Thailand during May 2013 and February 2014. The severity of diarrhea was assessed using the Vesikari severity scoring system while the HRQoL was assessed using the EQ-5D-3L.Results: The mean EQ-5D utility of children with all-causes diarrhea was 0.604. The utility of the rotavirus diarrhea group was significantly lower than that of the non-rotavirus diarrhea group (0.593 vs. 0.612; p-value = 0.040). The family caregiver’s utility was 0.964 at baseline and significantly decreased to 0.620 (p-value = 0.041) when their children were hospitalized with diarrhea. In multiple regression analyses, severity but not rotavirus infection had significant negative impacts on the utility of both the children and their caregivers.Conclusion: Diarrhea, either caused by rotavirus or non-rotavirus infection, resulted in substantial negative impacts on the quality of life of both the children and their caregivers.

Prevalence and clinical profile of rotavirus in children ? 5 years admitted in a tertiary care Hospital in Western Maharashtra

Background: Diarrhea is the second leading cause of mortality in children less than 5 years. Rotavirus is the commonest pathogen which causes diarrhea in children. As a result of dehydration and its hazardous consequences, it causes various deleterious effects on a child resulting in growth failure and malnutrition and sometimes leading to death. Aims &amp; Objectives: To determine the prevalence and elucidate the clinical pattern of rotavirus diarrhea and differentiate it from non-rotavirus diarrhea in children ? 5 years hospitalized for acute diarrhea. Material &amp; Methods: It was a cross-sectional study carried out between October 2014 and September 2016 on a total of 189 patients admitted for acute diarrhea in a tertiary care hospital. Stool samples were processed for identification of rotavirus antigen by ELISA. Clinical characteristics along with the seasonal variation of the infection were also studied. Result: Prevalence of rotavirus in the present study was estimated to be 36.5%. Infection occurred mostly in the age group of 7 – 12 months (46.3%) followed by 1 – 6 months (31.8%). Positive cases had associated clinical features as vomiting (69.5%), fever (55%) and peri-anal redness (33.3%). Maximum no. of rotavirus cases occurred in the winter season (42%). Conclusion: Rotavirus diarrhea does not follow a specific clinical pattern and lead to substantial morbidity in the study population.

Scoring system to distinguish between rotavirus and non-rotavirus diarrhea in children

Background Distinguishing rotavirus from non-rotavirus diarrhea is helpful for managing the illness. However, definitively diagnosing rotavirus diarrhea from serology is difficult and expensive.Objectives To distinguish between the clinical manifestations of rotavirus and non-rotavirus diarrhea, and to assess the accuracy of using such clinical manifestations to predict the type of diarrhea in children.Methods A cross-sectional study was performed from April to October 2015 in all children less than five years of age who presented with acute diarrhea at the Pediatric Outpatient Clinic of the Department of Child Health and Emergency Department, Dr. Mohammad Hoesin and Bari Hospitals, Palembang, South Sumatera. Clinical manifestations were collected from history and physical examinations; stool specimens were examined by immunochromatography. Clinical parameters were analyzed by multivariate analysis, and scores given to each significant parameter. The accuracy of the scoring system based in these parameters was analyzed by means of receiver-operating characteristic (ROC) area under the curve (AUC).Results Of 184 children, 92 had rotavirus and 92 had non-rotavirus diarrhea. Multivariate analysis showed 3 clinical parameters commonly seen in the rotavirus diarrhea cases: male sex (OR 2.718; 95%CI 1.373 to 5.382), cough (OR 3.500; 95%CI 1.788 to 6.582), and yellow-greenish stool (OR 4.009; 95%CI 2.061 to 7.797). A scoring system was constructed based on the parameters: male (score of 1), cough (score of 2), and yellow-greenish stool (score of 3). From ROC analysis, the AUC was 0.755. Using a cut-off score of &gt; 3, the sensitivity was 81.5%, specificity 51.1%, and PPV 62.5%.Conclusion Cough, yellow-greenish stool, and male are significant parameters for differentiating rotavirus from non-rotavirus diarrhea. A scoring system from these parameters is sensitive for predicting rotavirus vs. non-rotavirus diarrhea in children less than five years of age.

Prevalence of Enteric Adenovirus among Non-Rotavirus Diarrhea in Assam, Northeast India

Introduction: Globally enteric adenovirus has become the second leading cause of viral diarrhea. Present investigation was undertaken to understand the adenoviral etiology of diarrhea among hospitalized children in Assam, northeast India. Materials and methods: Over a period of two years (20132015), 455 faecal samples were collected from hospitalized children aged <5 years with diarrhea from Assam, northeast India for screening of rotavirus antigen. A total of 238 samples were rotavirus antigen negative and are screened for adenovirus antigen by ELISA and followed by PCR. Results: Present investigation revealed enteric adenovirus infection in hospitalized children <5 years to be 10.9% (26/238). Prevalence was higher among infants (16.6%) and females (15.1%). Moreover, severe diarrhea (≥10 times) 14.9% (P=0.047) and restlessness 50% (P=0.002) is significantly higher in enteric adenovirus infected children. Enteric adenovirus infection was observed sporadically throughout the year; however infection was higher during warmer months (17%) than cooler months (7.3%) (P=0.0001). Adenovirus sequence analysis of the hexon gene showed adenovirus F type-41 to be the predominant serotype circulating in the study region. Analysis of the adenovirus fiber protein of the present study confirmed 15 amino acid deletions from the 15 th repeat motif of the shaft region. Conclusions: Present data demonstrated that enteric adenovirus could be considered an important viral etiological agent for acute gastroenteritis among children in northeast India along with other etiology.

Racecadotril in the Management of Rotavirus and Non-rotavirus Diarrhea in Under-five Children: Two Randomized, Double-blind, Placebo-controlled Trials.

To study the effect of racecadotril on reduction in the duration of acute rotavirus and non-rotavirus diarrhea. Two randomized double-blind placebo-controlled trials. Community-based trial in an urban area in Vellore, hospital-based trial at a secondary hospital in Vellore. 199 and 130 3-59 month old children in the community- and hospital-based trials, respectively. Racecadotril (1.5 mg/kg/dose, thrice a day for three days) or placebo were given to manage acute diarrhea in both trials. Median duration of diarrhea. Among 124 children completing the hospital trial, the median duration of diarrhea was 25 h in both arms (P=0.5); median total stool weight was 74 g/kg and 53.5 g/kg in racecadotril group and placebo group, respectively (P=0.4); and average fluid intake per day was 3.6 mL/kg/h and 3mL/kg/h in racecadotril and placebo arms, respectively (P=0.3). Among rotavirus-positive children, median duration of diarrhea was 26.9 h and 30.2 h in racecadotril and placebo arms, respectively (P=0.7). In the community, 196 completed the trial, the median duration of diarrhea was 2 days for both arms (P=0.8) and rotavirus positive children had similar outcomes with median diarrheal duration of 3 d in both arms (P=0.4). Treatment with racecadotril did not reduce diarrheal duration, stool volume or the requirement for fluid replacement in children with acute gastroenteritis, both with and without rotavirus infection.

Rotavirus Diarrhea in Children Presenting to an Urban Hospital in Western Uttar Pradesh, India.

To determine the proportion and clinical profile of rotavirus associated diarrhea in children aged 6 months to 5 years. Clinical details and stool samples were collected from 254 children aged between 6 months to 5 years presenting with acute diarrhea, irrespective of hydration status, to the outpatient department or emergency room of a hospital in Meerut, Uttar Pradesh, India. Rotavirus accounted for 26.3% (51 of 194) of diarrhea cases overall, and 41.2% (14 of 34) in hospitalized children. Rotavirus infection was associated with significantly longer duration [3.3 (1.4) d vs. 2.5 (1.1) d; P=0.004) of diarrhea, and more chances of dehydration (OR 1.85; 95% CI 1.19, 3.57) as compared to non-rotavirus diarrhea. Rotavirus is a common cause of acute diarrhea in under-five children, and is associated with a longer duration and more chances of dehydration than non-rotavirus diarrhea.

Direct medical costs in children with rotavirus and non-rotavirus diarrhea admitted to a pediatric intensive care unit and high dependency unit in Delhi

To estimate direct medical costs of diarrheal hospitalization of children <5 years admitted in pediatric intensive care unit (PICU) or high dependency unit (HDU). Analysis of medical records and hospital bills of 84 children during two time frames, 2005-08 and 2012-14. Direct medical costs in PICU increased from INR 17,941 to INR 50,663 per child for rotavirus diarrhea and INR 11,614 to INR 27,106 for non-rotavirus diarrhea, and in HDU from approximately INR 5,800 to INR 10,500 per child for all-cause diarrhea between the two time frames. Costs of PICU and HDU care are high and should be included in cost-effectiveness analysis of vaccination.

Use of Patients With Diarrhea Who Test Negative for Rotavirus as Controls to Estimate Rotavirus Vaccine Effectiveness Through Case-Control Studies.

Case-control studies are often performed to estimate postlicensure vaccine effectiveness (VE), but the enrollment of controls can be challenging, time-consuming, and costly. We evaluated whether children enrolled in the same hospital-based diarrheal surveillance used to identify rotavirus cases but who test negative for rotavirus (test-negative controls) can be considered a suitable alternative to nondiarrheal hospital or community-based control groups (traditional controls). We compared calculated VE estimates as a function of varying values of true VE, attack rates of rotavirus and nonrotavirus diarrhea in the population, and sensitivity and specificity of the rotavirus enzyme immunoasssay. We also searched the literature to identify rotavirus VE studies that used traditional and test-negative control groups and compared VE estimates obtained using the different control groups. Assuming a 1% attack rate for severe rotavirus diarrhea, a 3% attack rate for severe nonrotavirus diarrhea in the population, a test sensitivity of 96%, and a specificity of 100%, the calculated VE estimates using both the traditional and test-negative control groups closely approximated the true VE for all values from 30% to 100%. As true VE decreased, the traditional case-control approach slightly overestimated the true VE and the test-negative case-control approach slightly underestimated this estimate, but the absolute difference was only ±0.2 percentage points. Field VE estimates from 10 evaluations that used both traditional and test-negative control groups were similar regardless of control group used. The use of rotavirus test-negative controls offers an efficient and cost-effective approach to estimating rotavirus VE through case-control studies.

Risk factors for hospital admission of Brazilian children with non-rotavirus diarrhoea: a case control-study.

Rotavirus has been the leading cause of severe cases of acute diarrhoea (AD) among children worldwide; however, in the same areas, a large reduction in AD related to rotavirus has been observed after the introduction of the rotavirus vaccine. In Brazil, where there is a high rotavirus vaccine coverage, AD caused by pathogens other than rotavirus is still a frequent cause of outpatient visits and hospitalisations among children under 5 years. A hospital-based case-control study enrolled children aged 4 to 24 months admitted to 10 hospitals from all five Brazilian Regions. Cases (n=1178) were children admitted with diarrhoea who tested negative for rotavirus in a stool sample. Controls (n=2515) were children admitted without diarrhoea, frequency matched to cases by sex and age group. We estimated odds ratios using logistic regression, in a hierarchical approach according to a previously defined conceptual framework. Population-attributable fractions (PAF) were estimated for each variable, each block and for all significant variables in the latter model adjusted. The factors studied accounted for 41% of the non-rotavirus AD hospital admissions and the main risk factors included lack of adequate excreta disposal (PAF=12%), untreated drinking water (PAF=11%) and a history of previous hospitalization due to AD (PAF=21%). Low socio-economic conditions, no public water supply, crowding and low weight-for-age made smaller contributions. These findings further our knowledge of risk factors associated with severe AD in the post-rotavirus vaccination era. We recommend further increase in coverage of basic sanitation, improvements in water quality and further expansion of primary healthcare coverage to reduce the occurrence of non-rotavirus severe diarrhoea and subsequent hospitalization of Brazilian children.

Effectiveness of the monovalent rotavirus vaccine in Colombia: A case-control study

ObjectiveTo assess the effectiveness of the monovalent rotavirus vaccine (RV1) to prevent rotavirus diarrhea admissions to emergency departments (ED) in Colombia. MethodsA multicenter case-control study was carried out in six Colombian cities from 2011 to January, 2013. Cases were laboratory confirmed rotavirus diarrhea patients admitted to ED of selected health centers. Controls were patients with non-rotavirus diarrhea. Vaccination status was card-confirmed. Vaccine effectiveness and 95% confidence intervals (CI) were calculated from the conditional logistic regression models using the formula 1−adjusted odds ratio×100. Results1051 fecal samples were collected from 193 cases and 858 controls. Vaccination history was confirmed on 173 cases (90%) and 801 controls (93%). Among the rotavirus-positive samples with vaccination history, 57% were G2P[4], 9.8% G9P[8], 6% G9P[6]. Median age of cases (17 months) was greater than controls (15 months) (P<0.001), and mothers of cases had lower level of education (P=0.025). The adjusted effectiveness was 79.19% (95% CI, 23.7 to 94.32) among children 6–11 months of age and −39.75% (95% CI, −270.67 to 47.24) among those >12 months of age. Against overnight rotavirus hospitalizations, RV1 provided protection of 84.42% (95% CI, 22.68 to 96.86) among children 6–11 months of age, and −79.49% (95% CI, −555.8 to 51.08) among those >12 months. ConclusionsRV1 provided significant protection against rotavirus hospitalization among children under 1 year of age in the Colombian setting. The observation of lower effectiveness in children >12 months requires further assessment.

Risk factors of rotavirus diarrhea in hospitalized children in Sanglah Hospital, Denpasar: a prospective cohort study.

BackgroundDiarrhea is a major public health concern throughout the world because the prevalence of morbidity of diarrhea has not changed significantly in the past decade. It remains the third leading cause of death among children less than 5 years of age. Recent surveillance studies have shown that rotavirus is a significant cause of pediatric hospitalization and death due to diarrhea. Indonesia has limited data on risk factors, disease burden, and deaths in children due to rotavirus diarrhea. The objective of this study was to examine the above mentioned factors related to rotavirus diarrhea in hospitalized children in Sanglah Hospital, Denpasar.MethodsA prospective cohort study was conducted at Sanglah Hospital Denpasar from April 2009 to December 2011. The present study was part of a nationwide study on Extension for Hospital-based Surveillance and Strain Characterization of Rotavirus Diarrhea Indonesia involving four hospitals throughout Indonesia as a part of the Asian Rotavirus Surveillance Network. We studied children aged <5 years who were hospitalized with acute diarrhea, and analyzed their stool samples using an immunoassay that detects the rotavirus antigen.ResultsA total of 656 patients met the inclusion criteria for this study. Of 5805 patients under the age of 5 who were hospitalized between April 2009 and December 2011, the prevalence of diarrhea among hospitalized pediatric patients was 11.3% and the prevalence of rotavirus diarrhea was 49.8%. The male to female ratio of those affected by rotavirus was 1.6:1. The occurrence of vomiting was significantly higher in rotavirus diarrhea than in non-rotavirus diarrhea (RR, 1.4; 95% CI, 1.08 to 1.70; p = 0.004).ConclusionsDiarrhea remains an important cause of hospitalization in children, and rotavirus was the most important etiology. We found that boys had a greatest risk of rotavirus infection than girls. Good nutritional status and breastfeeding provided the same protection against rotavirus and non-rotavirus diarrhea.

CLINICAL AND PARACLINICAL CHARACTERISTITICS OF ROTAVIRUS DIARRHEA IN CHILDREN LESS THAN 5 YEARS OLD IN PEDIATRIC DEPARTMENT OF BINH DINH GENERAL HOSPITAL

Background: Diarrhea is a leading cause of morbidity and mortality in children in developing countries. Rotavirus is the most important factor cause of severe diarrhea and mortality in children, especially under 2 years. Objective: To study Clinical and paraclinical characteristitics of rotavirus diarrhea in children less than 5 years old in the Pediatric Department of Binh Dinh General Hospital. Methods: Cross observational study, 417 children from 2 months to 5 years old who were hospitalized for acute diarrhea without blood in stool in Pediatric Department of Binh Dinh general hospital, from 15/3/2012 to 14/3/2013. There were 228 patients with rotavirus - positive stool specimens and 189 patients with rotavirus - negative stool specimens. Tested for rotavirus A classification by agglutination techniques. Results: Percentage of Rotavirus diarrhea in children &lt;5 years was 54.7%. The mean age of rotavirus diarrhea was 14.83 ± 9.08 tháng months. Ages with the highest cases of rotavirus diarrhea are 2 - 12 months: 48.2%. Rotavirrus diarrhea is experienced in every month but, the highest prevalence is experienced in the spring - summer) with 71,5%. Clinical characteristitics of rotavirus diarrhea: Vomit presents in 91,7% of cases. 32.9% of the initial symptoms of the disease is vomiting. Mean number of vomiting episodes per day: 7 ± 3.57 times, significantly higher compared with non-rotavirus acute diarrhea (p &lt;0,01). Mean number of bowel movement per day: 10.61±4.18 times, mean duration of diarrhea: 6.66 ± 2.52 days. Younger children have higher frequency and duration of diarrhea compared to older children. Paraclinical characteristitics of rotavirus diarrhea: the mean number leukocyte: 9.74 ±3.61 (x 109/l). 2.2% with low blood sodium status; 8.8% with reduction in serum potassium concentration. 26.3% with low blood calcium and glucose status. Laboratory characteristics of stool: 8.8% with white blood cells in stool, 41.7% with carbohydrate in stool. Conclusion: Rotavirus accounting for 54.7% of the causes of diarrhea in children. Rotavirus diarrhea is experienced throughout the year but the highest prevalence is in the spring-summer. Prominent symptoms of the disease are vomiting and watery stool. Children &lt;24 months experience higher frequency and duration of diarrhea compared to older age groups. Key words: Diarrhea, Rotavirus.

Duration of Protection of Pentavalent Rotavirus Vaccination in Nicaragua

To evaluate the duration of protection of pentavaent rotavirus vaccine (RV5) against rotavirus hospitalizations in Nicaragua, a developing country in Central America. We conducted a case-control study at 4 hospitals from 2007 through 2010, including 1016 children hospitalized with laboratory-confirmed rotavirus diarrhea, 4930 controls with nonrotavirus diarrhea (ie, "test-negative"), and 5627 controls without diarrhea. All cases and controls were aged ≥ 6 months and born after August 2006. Outcomes included odds of antecedent vaccination between case-patients and controls, and effectiveness of vaccination (1 - adjusted odds ratio [OR] × 100). Duration of protection was assessed by comparing effectiveness among children aged <1 year compared with ≥ 1 year. Indicators of socioeconomic conditions and nonrotavirus vaccination (oral polio vaccine and diphtheria/tetanus/pertussis/hepatitis A/hepatitis B) for test-negative controls were more comparable to the rotavirus case-patients than nondiarrhea controls. RV5 vaccination was associated with a significantly lower risk of rotavirus hospitalization by using test-negative controls (OR: 0.55; 95% confidence interval [CI]: 0.41-0.74) and nondiarrhea controls (OR: 0.30; 95% CI: 0.22-0.40). Risk of rotavirus hospitalization was twofold lower among RV5 vaccinated children aged <1 year (OR: 0.36; 95% CI: 0.22-0.57) compared with RV5 vaccinated children aged ≥ 1 year (OR: 0.70; 95% CI: 0.47-1.05). RV5 provided good protection against severe rotavirus disease in Nicaragua during the first year of life, when most severe and fatal rotavirus disease in developing countries occurs. However, the decline in protection with age warrants monitoring of disease among older children and consideration of a booster dose evaluation at the end of infancy.

Surveillance of rotavirus diarrhea

Background Rotavirus is a major cause of severe diarrhea anddehydration in children worldwide. Data on the burden of diseasein Indonesia is limited.Objective To provide an epidemiological profile of rotavirusinfection among children hospitalized for diarrhea in MohammadHoesin Hospital, Palembang.Methods In January- December 2006, a prospective, hospitalbasedsurveillance was carried out in children aged less thanfive years, presenting with diarrhea. Stool samples wereexamined for rotavirus using enzyme immunoassay (EIA).G- and P-typing were performed on specimens confirmed tobe positive by EIA.Results A total of 513 fecal specimens from 534 children weretested for rotavirus. Rotavirus was detected in 64% of thespecimens, mostly of the G9 type (62.5%). Incidence ofrotavirusdiarrhea was highest in the 6 month to 2 years age group (60.4%).Children with rotavirus diarrhea were more likely to present withdehydration, compared to those with non-rotavirus diarrhea (94%vs 70%, respectively, P=0.03).Conclusion Rotavirus was the most common pathogen foundin children with diarrhea. Rotavirus was detected in 64% ofpediatric diarrheal specimens tested in our study. This findingwarrants the use of a large-scale program to prevent disease,such as vaccination against rotavirus. [Paediatr lndones.2012;52:22-7].