Rotavirus Diarrhea In Children Research Articles

Epidemiological characteristics and genotype trends of rotavirus diarrhea in China from 2009 to 2020

Objective: To investigate the epidemiological characteristics and genotype trends of rotavirus infection among the population with diarrhea in China, from 2009 to 2020 and provide evidence for strategic surveillance and prevention. Methods: Surveillance data on diarrhea syndrome from 252 sentinel hospitals across 28 provinces (municipalities, autonomous regions) were obtained from the information management system of the Infectious Disease Surveillance Technology Platform of the National Science and Technology Major Project. Descriptive epidemiological methods were employed to analyze the distribution of rotavirus diarrhea cases in different climatic zones, populations, and times from 2009 to 2020, as well as the genotyping characteristics and changing trends of group A rotavirus diarrhea cases. Results: From 2009 to 2020, a total of 114 606 diarrhea cases were tested for rotavirus, and the positive rate was 19.1% (21 872/114 606); group A rotavirus was dominant (98.2%, 21 471/21 872). The positive rate of rotavirus was the highest in 2009 (36.9%, 2 436/6 604) and 2010 (30.6%, 5 130/16 790), fluctuated between 14.0% to 18.0% from 2011 to 2017, raised slightly in 2018 (20.3%, 2 211/10 900), and declined continuously in the following two years (15.5%, 2 262/14 611 and 9.5%, 470/4 963). The positive rate of males (20.2%, 13 660/67 471) was significantly higher than that of females (17.4%, 8 212/47 135). Children under five had the highest positive rate (28.4%, 18 261/64 300), more than four times that of adults. The positive rate peaked from December to February in the mediate temperate zone, warm temperate zone, and subtropical zone, while there were two peaks from November to January and May to June in the frigid zone of the plateau. The dominant genotype of group A rotavirus gradually changed from G3P[8] and G1P[8] to G9P[8] during 2009-2020. Conclusions: The overall rotavirus infection rate in China was on a downward trend. Meanwhile, significant variations of positive rates were observed in seasonal epidemics and different age groups from 2009 to 2020. Rotavirus diarrhea in children was still a prominent concern. Vaccination of rotavirus vaccine should be promoted, and the epidemiological characteristics and genotypes of rotavirus diarrhea should be continuously monitored.

Clinical factors predicting rotavirus diarrhea in children: A cross-sectional study from two hospitals.

Rotavirus is still a significant contributing morbidity and mortality in pediatric patients. To look at clinical signs and symptoms and laboratory findings that can predict rotavirus gastroenteritis compared to non-rotavirus gastroenteritis. This was a cross-sectional study with medical records obtained from December 2015 to December 2019. Inclusion criteria for this study include all hospitalised pediatric patients (0-18 years old) diagnosed with suspected rotavirus diarrhea. The receiver operating curve and Hosmer-Lemeshow test would be used to assess the final prediction findings' calibration (goodness of fit) and discrimination performance. This study included 267 participants with 187 (70%) rotavirus-diarrhea cases. The patients were primarily male in both rotavirus (65.2%) and non-rotavirus (62.5%) groups. The median age is 1.33 years old (0.08-17.67 years old). Multivariate analysis shows that wet season (ORadj = 2.5; 95%CI: 1.3-4.8, Padj = 0.006), length of stay (LOS) ≥ 3 days (ORadj = 5.1; 95%CI: 1.4-4.8, Padj = 0.015), presence of abdominal pain (ORadj = 3.0; 95%CI: 1.3-6.8, Padj = 0.007), severe dehydration (ORadj = 2.9; 95%CI: 1.1-7.9, Padj = 0.034), abnormal white blood cell counts (ORadj = 2.8; 95%CI: 1.3-6.0, Padj = 0.006), abnormal random blood glucose (ORadj = 2.3; 95%CI: 1.2-4.4, Padj = 0.018) and presence of fecal leukocytes (ORadj = 4.1, 95%CI: 1.7-9.5, Padj = 0.001) are predictors of rotavirus diarrhea. The area under the curve for this model is 0.819 (95%CI: 0.746-0.878, P value < 0.001), which shows that this model has good discrimination. Wet season, LOS ≥ 3 d, presence of abdominal pain, severe dehydration, abnormal white blood cell counts, abnormal random blood glucose, and presence of fecal leukocytes predict rotavirus diarrhea.

Burden of Rotavirus Diarrhoea in Children in Abuja

Background: Diarrhoea is the second leading cause of death in children. Nigeria has the continent’s highest mortality due to diarrhoeal diseases with little information on specific causes and the proportion affected by rotavirus infection. The main objectives of this study were to describe the features of young children with diarrhoea, with and without rotavirus, in Abuja the Federal Capital Territory. Materials and Methods: Retrospective review of local hospital activity data related to diarrhoea was retrieved from General Hospitals in Abuja. Then a one-year prospective descriptive study of children under 5 years of age with acute diarrhoea was conducted from September 2012 to August 2013. Children with acute diarrhoea attending three government hospitals and one private hospital were recruited. Children without diarrhoea were recruited as the control group. Faecal specimens were transported in cold chain boxes from Nigeria and stored at -80 °C at the Institute of Global Health, virology section of the University of Liverpool, where all laboratory work was performed. Results: Hospital records were poorly preserved and did not provide meaningful data for trend analyses or disease surveillance. 1331 participants were enrolled in this prospective study. Stool samples were collected from 1242 (93.3%) participants, of whom 957 (77.0%) were ambulatory, 123 (9.9%) hospitalised and 160 (12.8%) controls without diarrhoea. 881 and 450 children with diarrhoea were recruited from government and the private hospitals, respectively. The median age of the children was 8 months in the ambulatory and 9.5 months in the hospitalized group (p&lt;0.05). A total of 209 (16.8%) children were vaccinated, 858 (69.1%) were unvaccinated, and 174 (14.0%) had an unclear vaccination status. Rotavirus ELISA was positive in 123 (11.4%) children with diarrhoea and 2 (1.2%) controls. Among children with diarrhoea, 92 (10.4%) of 881 children attending government hospitals had rotavirus, compared to 33 (7.3%) of 450 children attending a private hospital (p&lt;0.001) where a vaccination program had been in place. The peak months for rotavirus infection were November and February. The efficacy of Rotarix® RV1 vaccine in preventing rotavirus diarrhoea was indirectly assessed to be 64.5%. Conclusion: Rotavirus is an important pathogen in children, especially in unvaccinated children in Abuja. The introduction of a rotavirus vaccine is highly desirable in Nigeria, but this is still awaited. Local and national infrastructure are inadequate for basic surveillance of diarrhoeal disease, and this will have to be improved, together with access to virological stool testing, to monitor the planned vaccine program. The retrospective studies reported here provide indirect evidence of vaccine efficacy in Abuja but need prospective confirmation.

A Comparison of Anti-Rotavirus Vaccines Monitoring of the Vaccination Activities Over the Period 2020-2022 in the Local Health Authority of Viterbo

Introduction: Rotavirus is an RNA virus that belongs to the family Reoviridae and is highly infectious. In addition to being one of the leading causes of acute gastroenteritis worldwide, it contributes most to mortality and morbidity in children under 5 years of age. The virus is mainly transmitted via the fecal-oral-route but it could also be spread by contact, from person to person or through contaminated objects, surfaces or food. Airborne transmission is also possible, although it is much less effective. Several studies have indicated that natural immunity acquired from infection offers both a certain degree of protection from future symptomatic infections and that repeated exposures expand a heterotypic immune response to different viral strains. This has been the essential premise upon which live-attenuated oral vaccines against Rotavirus have been developed over the past 30 years. In all countries – whether they are industrialized or developing – where vaccines against the virus have been introduced, a real impact on public health has been consistently observed, with significant reductions in mortality and hospitalizations due to Rotavirus diarrhea in children under 5 years of age. Two anti-Rotavirus vaccines, Rotarix Human Rotavirus Vaccine (GSK) and RotaTeq Human-Bovin Reassortant Vaccine (Merck &amp; Co.), have been approved for clinical use in Europe and showed good efficacy and a favorable security profile in preventing Rotavirus disease. Aim of the Study: The study aims to illustrate the Rotavirus vaccinations given at the vaccination centers located in the Local Health Authority of Viterbo during the three-year period 2020-2022. A comparison was conducted between the vaccination coverage reached with Rotarix and RotaTeq vaccines in newborns in 2020 and in 2021 residing in the province of Viterbo. Furthermore, adhesions to Rotavirus vaccination were detected. Material and Methods: The scenario was defined through extrapolation of data recorded in the company software Antares. The following data were considered: • Births in the year 2020 in the province of Viterbo • Births in the year 2021 in the province of Viterbo • Rotarix vaccines given in the three-year period 2020-2022 • RotaTeq vaccines given in the three-year period 2020-2022• Anti-Rotavirus vaccination coverage among newborns in 2020 • Anti-Rotavirus vaccination coverage among newborns in 2021 • Percentage of newborns in 2020 who did not complete the anti-Rotavirus vaccination course • Percentage of newborns in 2021 who did not complete the anti-rotavirus vaccination course Results: From January 1st, 2020 to November 30, 2022, 9318 anti-Rotavirus vaccinations were given in the vaccination centers located in the Local Health Authority of Viterbo. Among these, 3124 patients received Rotarix, while 6194 received RotaTeq vaccine. Over the period analyzed, the 2021 birth cohort appears to be the most vaccinated, with 455 Rotarix and 3193 RotaTeq vaccinations, with a total number of 3648 vaccinations. A person can be defined as vaccinated against Rotavirus only when he/she finishes the complete vaccination course, consisting of 2 doses in the case of the Rotarix vaccine, and 3 doses in the case of the RotaTeq vaccine. For this reason, the total vaccination coverage reached among newborns in 2020 (1764 births) was 64%, in which Rotarix vaccine contributed 45%, and RotaTeq the remaining 19%. As regards the cohort of newborns in 2021 (1820 births), the total vaccination coverage reached was 66%, of which 12% with Rotarix vaccine, and 54% with RotaTeq. Discussion and Conclusions: From the data obtained, a positive upward trend in the vaccinations against Rotavirus dispensed year by year is immediately brought to light. This is due to the success of an effective information campaign toward vaccination in general and specifically toward anti-rotavirus prophylaxis. All this gives hope that more and more persons will be vaccinated against the virus in the future. Globally, we can say that in recent years also the vaccination coverage is increasing. Particularly, an encouraging fact is a decrease in hospitalizations from Rotavirus gastroenteritis, which was made possible also thanks to the indirect immunity fostered by an increase in the vaccinations given.

Factors associated with dehydrating rotavirus diarrhea in children under five in Bangladesh: An urban-rural comparison.

IntroductionRotavirus is the leading cause of dehydrating diarrhea in young children worldwide. This study aimed to identify the factors associated with dehydrating rotavirus diarrhea in children under five years of age in urban and rural Bangladesh.MethodsThe study analyzed data from 7,758 children under five who presented with rotavirus diarrhea to Dhaka (urban) and Matlab (rural) hospital of icddr,b during 2009–2018, and were enrolled in the Diarrheal Disease Surveillance System. Cases were defined as children having rotavirus isolated in stool specimens presented with dehydrating diarrhea. Controls were children infected with rotavirus have no dehydration. Multivariable logistic regression models were built to identify the factors associated with dehydrating diarrhea.ResultsAmong the rotavirus-infected children, 1,784 (34%) in Dhaka and 160 (6%) in Matlab had diarrhea with some or severe dehydration. The female children and age group 24–59 months age was found to be at higher risk of dehydration compared to 6–11 months age. In the multivariable logistic regression model, maternal illiteracy, vomiting, the onset of diarrhea less than 24 hours prior to presenting to the hospital, monsoon months, stunting, and wasting were significantly associated with dehydrating rotavirus diarrhea among children aged 0–59 months in Dhaka. In Matlab, monthly income, duration less than 24 hours prior to attending the hospital, and wasting had an independent significant association with dehydrating rotavirus diarrhea episodes.ConclusionsConsidering factors diversity, educating parents and proper counselling by health care personnel during diarrhea, could lessen the severity of dehydration and the number of hospital visits later on by eliminating the modifiable risk factors among the children, which needs further studies.

Prevalence and risk factors of acute gastroenteritis caused by Rotavirus among children in tertiary hospitals, southeastern Nigeria

Background: Diarrhea is a worldwide problem and rotavirus is the commonest viral etiologic agent. In Nigeria, diarrhea causes more than 315,000 deaths of preschool-age children annually. In Ebonyi State, it is among the leading causes of pediatric emergency visits and one of the major causes of infant morbidity and mortality. This study was aimed at determining the prevalence and associated risk factors of acute gastroenteritis due to rotavirus infection among under-five children in Abakaliki, Ebonyi state. Methodology: This was a cross-sectional study of 275 children under 5 years of age hospitalized for acute watery diarrhea, who were consecutively recruited into the study. Stool samples were collected from each child for rotavirus antigen detection using an enzyme-linked immunosorbent assay (ELISA). Socio-demographic information of each child and selected risk factors were collected using structured questionnaire. Data analysis was done on SPSS software version 20.0, and association of demographic characteristics and risk factors with rotavirus diarrhoea was measured using Chi-square test, odds ratio (and 95% confidence interval). Significant value was set at p &lt; 0.05. Results: The prevalence of rotavirus diarrhea among children under 5 years of age in this study was 26.5% (73/275). Aside from educational level of the mothers, there was no significant association between any of the socio-demographic characteristics and prevalence of rotavirus diarrhoea (p&gt;0.05). Although the prevalence of diarrhoea in the children was lower with the use of maize gruel (pap) as weaning feed (26.3%, 71/270) compared to the use of other complementary feeding such as ‘Cerelac’ and ‘NAN’ (40%, 2/5), this association did not reach a significant level(OR=0.5352, 95% CI=0.0875-0.3270, p=0.6110), probably due to the small number of children weaned using other complementary feeds. Conclusion: The relatively high prevalence of rotavirus diarrhea in children under 5 years of age in this study is an indication of the need for the parents/guardians of these children to improve child feeding hygiene.

Morbidity, Mortality and the Impact of Climate on the Evolution of Acute Rotavirus Diarrhea in Children under 5 Years Old in Bangui

Background: Rotavirus is the most common pathogen of severe acute diarrhea in children under five years of age worldwide. Objective: The objective of this study was to determine the morbidity and mortality of rotavirus diarrhea while describing the seasonal kinetics of the infection according to climatic parameters in Bangui. Methodology: This was a descriptive and analytical cross-sectional study conducted from January 1, 2011 to December 31, 2020 in the Central African Republic (CHUPB). The health data were recorded and processed with the Access 2019 software, then analyzed with the STATA version 14 software. The climatic trends in the study area and its seasonal variations were highlighted by the monthly rainfall coefficient of Alfred Angot: Cm = 12 Pm/P. Results: Morbidity was 45.99% of cases. The 1 to 12 months old represented 93.81% of cases. The mean age of the children was 6.8 months, the sex ratio was 1.20. The symptomatic triad was diarrhea (100%), vomiting (90.20%) and fever (87.5%). Moderate dehydration was reported in 81.05% of cases. The main genotype combinations found were P[8]G1 in 34.02% (n = 115/338), P[6]G1 in 21.59% (n = 73/338) and P[6]G2 in 16.86% (n = 57/338). Case fatality was 11.45%. The risk of death was influenced by rural origin, severe dehydration, hypovolemic cloc and duration of hospitalization > 5 days. Low rainfall correlated with the highest rates of rotavirus diarrhea. Likewise, high temperature correlated with the highest number of cases of rotavirus diarrhea. Conclusion: Acute rotavirus diarrhea is an important morbidity and mortality issue in children under 5 years old in Bangui.

Cryptosporidium and Rotavirus Diarrhoea in Children under the Age of Five Years in FCT Abuja, Nigeria

Introduction: Diarrhoea is the second leading cause of death among children, and Nigeria has the continent's highest mortality with little information on the specific cause, proportion affected by Cryptosporidium and Rotavirus, and the prevalent genotypes for Rotavirus.&#x0D; Aim: To identify children with diarrhoea, in Abuja in the Federal Capital Territory; to estimate the proportion of children with Cryptosporidium and rotavirus diarrhoea. &#x0D; Study Design: One-year cross-sectional study of children under five years with acute diarrhea.&#x0D; Duration: The study was conducted in Abuja from June 2018 to May 2019.&#x0D; Methodology: Cryptosporidium and Rotavirus ELISA were done with commercially available kits.&#x0D; Results: Stool samples were collected from 1450 participants, of whom 1185 (81.7%) were ambulatory, 109 (7.5%) were hospitalized, and 156 (10.7%) were controls without diarrhoea. Cryptosporidium-ELISA was positive among 274 (21.1%) children with diarrhoea and 23 (1.7%) of children without diarrhoea, with August and September as peak months for infection. Rotavirus-ELISA was positive among 231 (17.8%) children with diarrhoea and 29 (2.2%) controls, with November, December, and January as peak months. Children of 12 to 17 months were most affected for both and Rotavirus (39.8%) and Cryptosporidium (37.2%).&#x0D; Conclusion: Cryptosporidium and Rotavirus are essential pathogens in children, especially among Rotavirus unvaccinated children in Abuja. Local and national infrastructure is inadequate for essential surveillance of diarrhoeal disease, and this will have to be improved, together with access to virological and parasitic stool testing, to monitor the planned vaccine program, especially for Rotavirus.

NITAZOXANIDE IN TREATMENT OF ROTAVIRUS DIARRHEA IN CHILDREN: A SINGLE CENTER STUDY

BACKGROUND &amp; OBJECTIVE: As Rota virus leads to significant morbidity in children 2 months to 5 years, this study was done to observe the effect of one dose of nitazoxanide on the total duration of rotavirus diarrhea. The primary objective was to evaluate the reduction in the mean duration of viral diarrhea in children after administration of first dose of Nitazoxanide.&#x0D; METHODLOGY: This descriptive study was done in the Department of Pediatric Medicine Unit I, Mayo Hospital, Lahore from Jan 2016 to June 2016 after approval from the ethical review committee. Sample size calculated was 175 using WHO sample size calculator. Patients of 4–5 years were given 200 mg nitazoxanide twice daily for 3 days; 100 mg nitazoxanide was given twice daily to 12–47 months age group, and patient of &lt;12 months age were given 7.5 mg/kg twice day along with routine care and were followed 12 hourly till the passage of normally formed stools. Duration of diarrhea was recorded.&#x0D; RESULTS: Out of 175 cases, 58.9% (n=103) were between 2-36 months age while 41.2% (n=72) were 37-60 months age, mean+SD was calculated as 35.06+13.34 months, mean reduction in duration of rotavirus diarrhea in children after administration of first dose of Nitazoxanide was recorded as 32.85+2.32 hours.&#x0D; CONCLUSION: With the use of nitazoxanide along with routine care for rotavirus diarrhea children, the mean duration of rotavirus diarrhea was reported to be less than 1.5 days.

The impact of the rotavirus vaccine on diarrhoea, five years following national introduction in Fiji

BackgroundIn 2012, Fiji became the first independent Pacific island country to introduce rotavirus vaccine. We describe the impact of rotavirus vaccine on all-cause diarrhoea admissions in all ages, and rotavirus diarrhoea in children <5 years of age. MethodsAn observational study was conducted retrospectively on all admissions to the public tertiary hospitals in Fiji (2007–2018) and prospectively on all rotavirus-positive diarrhoea admissions in children <5 years at two hospital sites (2006–2018, and 2010–2015), along with rotavirus diarrhoea outpatient presentations at one secondary public hospital (2010–2015). The impact of rotavirus vaccine was determined using incidence rate ratios (IRR) of all-cause diarrhoea admissions and rotavirus diarrhoea, comparing the pre-vaccine and post-vaccine periods. All-cause admissions were used as a control. Multiple imputation was used to impute missing stool samples. FindingsAll-cause diarrhoea admissions declined among all age groups except among infants ≤2 months old and adults ≥55 years. For children <5 years, all-cause diarrhoea admissions declined by 39% (IRR)=0•61, 95%CI; 0•57–0•65, p-value<0•001). There was an 81% (95%CI; 51–94%) reduction in mortality among all-cause diarrhoea admissions in children under <5 years. Rotavirus diarrhoea admissions at the largest hospital among children <5 years declined by 87% (IRR=0•13, 95%CI; 0•10–0•17, p-value<0•001). Among rotavirus diarrhoea outpatient presentations, the IRR was 0•39 (95%CI; 0•11, 1.21, p-value=0.077). InterpretationsMorbidity and mortality due to rotavirus and all-cause diarrhoea in Fiji has declined in people aged 2 months to 54 years after the introduction of the RV vaccine. FundingSupported by WHO and the Australian Government.

Protective efficacy of probiotics on the treatment of acute rotavirus diarrhea in children: an updated meta-analysis.

This meta-analysis aims to uncover the therapeutic efficacy of probiotics on acute rotavirus diarrhea (RVD) in children. Randomized controlled studies reporting therapeutic efficacy of probiotics on acute RVD in children published before 1st June 2019 were searched in PubMed, EMBASE, and Cochrane. The citations in all searched literature were manually examined. Data were extracted from eligible literature for calculating STD Mean Difference (SMD) and its corresponding 95% confidence interval (CI). Subsequently, the association between therapeutic efficacy of probiotics and acute RVD in children was evaluated. Moreover, data were weighted by an inverse variance and analyzed by a fixed or random effect model. Heterogeneity test was applied in the enrolled literature. Sensitivity and publication bias was examined. STATA 12.0 was used for meta-analysis. A total of 19 independent Randomized Controlled Trials (RCTs) involving 1,624 children with acute RVD were enrolled in this study. Three pieces of literature were excluded through sensitivity and publication bias analyses. Data extracted from eligible literature indicated that probiotics could markedly reduce the occurrence of acute RVD in children (SMD=-0.49, 95% CI=-0.74-0.25). Subgroup analysis conducted based on ethnicity uncovered a poor therapeutic efficacy of probiotics on reducing the occurrence of acute RVD in Asian children (SMD=-0.45, 95% CI=-0.94-0.04), which was markedly significant in Caucasian children (SMD=-0.54, 95% CI=-0.78--0.30). In addition, the subgroup analysis based on the probiotic subtypes found a pronounced efficacy of both Lactobacillus acidophilus (SMD=-0.67, 95% CI=-0.92-0.42) and non-Lactobacillus acidophilus probiotic (SMD=-0.45, 95% CI=-0.77-0.14) on the occurrence of acute RVD in children. Probiotics could reduce the occurrence of acute RVD in children, especially in Caucasian population. Our findings still needed to be further validated in a multi-center institution with larger sample size and more qualified data.

Identification of Acute Rotavirus Diarrhea and Analysis of its Risk Factors in Children Under-5 Years in Surabaya, Indonesia

Background: Diarrhea is the most common disease among children and still a major cause of morbidity and mortality. Among the various causes of acute diarrhea in children, rotavirus is the most frequent one, especially in developing countries where universal rotavirus vaccination has not been introduced, including Indonesia. Objectives: This study aimed to determine the percentage of acute rotavirus diarrhea in children and analyze its risk factors in Tanah Kali Kedinding Primary Health Care, Surabaya, Indonesia. Method: Stool specimens were collected from a total 116 children under-5 years visiting Tanah Kali Kedinding Primary Health Care in Surabaya, Indonesia due to acute diarrhea during September 2018 – January 2019. Rapid stool antigen immunochromatograhic test was used to identify group A rotavirus antigen. Some potential risk factors were analyzed. Results: Among 116 samples from children with acute diarrhea, 67 (57.8%) were identified group A rotavirus positive. Samples with rotavirus positive were obtained mostly form male (p=0.008). Malnutrition was associated with an increased risk of rotavirus infection (p=0.025). Male and malnutrition were about 3 times more likely to have rotavirus infection. Other risk factors including children’ age, history of exclusive breastfeeding, mothers’ education and the amount of income were not statistically associated with rotavirus diarrhea. Conclusion: The occurence of children with acute rotavirus diarrhea in this study was 57.8%. Some risk factors for rotavirus infection were gender and malnutrition. Control measures such as anticipating its risk factors need to be adapted, according to the further epidemiology investigation.

Analysis of epidemiological characteristics of report cases of rotavirus diarrhea in children under 5 years old in China, 2005-2018

Objective: To analyze the epidemiological characteristics of rotavirus in children under 5 years old in China (excluding China Hong Kong, Macau and Taiwan data, the same below) from 2005 to 2018. Method: Data on other infectious diarrhea in the country from 2005 to 2018 were downloaded from the National Notifiable Disease Report System was to build a database for report cases of rotavirus diarrhea in children under 5 years of age, and descriptive epidemiological methods were used to analyze the data. Result: In 2005-2018, a total of 820 588 cases of rotavirus infection in children under 5 years old were reported nationwide, with male 500 944 cases, and with an average annual incidence of 63.7/100 000. The reported incidence showed a fluctuating upward trend increased from 8.4/100 000 to 178.1/100 000. The number of reporting provinces increased from 17 to 30. The reported incidence showed a peak of season from November to following February. The reported cases of rotavirus diarrhea in children under 5 months of age was 13.1%(107 845 cases), and the high-incidence age ranged from 6 months to 2 years old, accounting for 70.3% (576 874 cases), with a peak of 11-13 months (163 947 cases). The top three provinces (cities) reporting the incidence rate were Zhejiang (535.2/100 000), Guangdong (334.3/100 000) and Beijing (317.3/100 000), the provinces with the low reported case rates were Shanxi (0.9/100 000), Heilongjiang (1.6/100 000) and Liaoning (2.5/100 000), but there was no case reported in Tibet; The report cases of south region (745 526 cases) were 9.9 times north region (74 935 cases).The cases of rotavirus infection and other diarrhea pathogens were detected simultaneously accounted for 1.8% (15 030 cases) and mainly were positive for rotavirus and adenovirus (90.1%, 13 544 cases). Conclusion: The rate of rotavirus infection in children has increased rapidly since the age of 6 months, and 84.4% of the reported cases were infants before the age of 2 years.

Prevalence and clinical profile of rotavirus associated diarrhea in a tertiary care center in North India: A descriptive hospital-based study

Background: Rotavirus is the leading cause of severe diarrhea in infancy and childhood period especially in developing countries causing several deaths. Objective: This study was conducted to determine hospital-based prevalence, clinical profile, demographic data, and treatment outcome of rotavirus diarrhea in children under 5 years of age attending a tertiary care hospital in North India. Materials and Methods: A total of 210 patients, under 5 years of age, presenting with a complaint of watery diarrhea were enrolled in the study. Their stool samples were analyzed by latex agglutination test for rotavirus antigen. Significant values of variables were determined using t-tests and Chi-square tests as appropriate. Results: Out of 210 patients, 108 (51.4%) were tested positive for rotavirus. While 170 (80.9%) patients with gastroenteritis were hospitalized, 92 (54.1%) of the hospitalized patients had rotavirus gastroenteritis (RVGE). RVGE was maximum in the season of December (100%), January (92.8%), and February (93.7%). None of the exclusive breastfed patients were tested positive for rotavirus. 75% of the patients with RVGE were top fed and 25% were on mixed feeding. In this study, 79.5% of the patients who were malnourished had RVGE. 54.6% of the patients with RVGE had some dehydration while 35.2% had severe dehydration. The average duration of gastroenteritis (±standard deviation [SD]) in patients with RVGE was 4.30 (0.91) days. Conclusion: The result of the current study reflects that rotavirus is an important cause of severe diarrhea in infants and young children and hence emphasizes the need for the introduction of rotavirus vaccine in the existing national immunization schedule.

Trends of Rotavirus Diarrhea in Hospitalized Children in Yogyakarta Year 2013–2015

Diarrhea, together with pneumonia, is accountable for 25% death of children under five globally (IVAC, 2017). In Indonesia, diarrhea is also among the top ten diseases of cause of death in children under five (WHO, 2015). Rotavirus diarrhea is responsible for 60% in 2006 (Soenarto et al, 2009) of children diarrhea in Indonesia. Rotavirus vaccine in Indonesia was introduced commercially in 2011, nonetheless its use was reportedly low. Despite the declining rate of rotavirus incidence, surveillance is important to show the burden of rotavirus diarrhea in children. Thus, this study aims to describe the incidence of rotavirus diarrhea in hospitalized children under five in Yogyakarta province. This was a prospective study, conducted in two participating hospitals in Yogyakarta: RSUP Sardjito Yogyakarta and RSUD Wates from January 2013 – December 2015. This study is a part of the Indonesia surveilance entitled “ Hospital-based surveillance of rotavirus diarrhea in children in Indonesia” , enrolling children under five hospitalized due to acute watery diarrhea. The questionare was modified from the WHO generic protocol of rotavirus surveillance (WHO, 2002). Data collection was perfomed after informed consent was signed by parent or guardian. The stool samples were tested for rotavirus with the EIA test and tested for genotyping with RT-PCR. The data were analysed and presented using descriptive analytic method. Of 684 eligible patients hospitalized with acute watery diarrhea, 557 subjects were enrolled with 518 feces were tested for rotavirus. The percentage of rotavirus incidence in year 2013, 2014, and 2015 were 37%, 41% and 61 % respectively. The predominant rotavirus genotyping was G3P [8]. Rotavirus mostly found in children age 6 – 23 months (55 %), and was identified more in male than female (62 % vs 38%). During the 3 years study period, rotavirus occurred all year round, and showed to reach its peak on January 2015. Rotavirus positive diarrhea commonly presented with dehydration (79%) compare to negative rotavirus diarrhea (55%). It indicated that the incidence rate of rotavirus diarrhea in Yogyakarta is quite high and rotavirus diarrhea remains as significant contributor to hospitalized children with diarrhea. The trend of rotavirus diarrhea in children under 5 years increased over the years’ period. The rotavirus diarrhea mostly presented with dehydration, thus rotavirus diarrhea remains as significant contributor to hospitalized children with diarrhea. This shows an evidence that the burden of rotavirus diarrhea in children under 5 years remains prominent.

Rotavirus Diarrhea in Children Under Five in Basrah: Hospital Based Study

Background: Human rotaviruses, particularly of group A are the most important cause of severe dehydrating diarrhea in young children worldwide in both developed and developing countries. Although rotavirus accounts for up to 50% of hospitalizations for severe diarrhea in infants and children, it has been underestimated within the public health community, particularly in developing countries. This is a cross sectional study which was carried out to determine the frequency of rotavirus diarrhea in hospitalized children under 5 yrs in Basra by stool enzyme linked immunosorbant assay test and study the relation of selected patients’ variables to rotavirus diarrhea. Methods: A hospital-based study includes 120 children aged less than 5 yrs who were admitted to the pediatric wards with acute gastroenteritis over a period of five months from the October 1st, 2015 till March 15th, 2016. All patients underwent physical examination for sign of dehydration and assessment of severity of diarrheal episode by Vesikari score which considered various parameters including frequency, duration of diarrhea, vomiting, temperature, hydration status and the treatment received by the patients. A score of <7 was considered mild, 7-11 was moderate and ≥ was 11 severe. Stool samples were collected within 48 hrs of hospitalization and examination for rotavirus was done by Enzyme Linked Immunosorbant Assay; One Step rotavirus Test (ABON biopharm, China) which is a qualitative immunoassay kit used for the detection of rotavirus in human stool sample. Result: The frequency of rotavirus infection was 32.5%, about two thirds of admitted children presented with severe diarrheal episodes and one third with moderate diarrhea. Sixty two percent of the studied patients aged 3-12 months with higher frequency of males than females (62.5%, 37.5%) respectively. All studied children with rotavirus infection were below 24 months of age, with higher frequency in males than females (74.36%, 25.64%) respectively with P value 0.001. Reviewing the immunization status history of rotavaccine reveals that; 64 (53.3%) of patients have missed or did not receive any vaccine with approximate percentage (53.8%) in patients who were positive for rotavirus with significant result (P value 0.001) and only 36.7% of children had an immunization status that was appropriate for their age. One third of studied parents were illiterate with higher frequency in mothers than fathers (22.5%, 14.1%) with rotavirus infection in children belong to illiterate parents (25.6%, 7.6%) respectively, with statistically significant results. Bottle feeding with or without complementary diet had been reported in higher frequency of studied patients (59.2%) with positive rotavirus stool test in 71.8% with statistically significant result. Inpatient management of studied children reveals that zinc therapy, oral rehydration solution and antibiotics prescribed for (56.4%, 66.7% and 89.7%) of patients with rotavirus infection respectively. Conclusion: Routine evaluation of children with acute diarrheal episodes by stool test for rotavirus is recommended to avoid un-rational prescription of antibiotics and proper practice according to integrated management of childhood illness program.

Prevalence of Rotavirus Diarrhoea in Children in Davangere, Karnataka

Prevalence of Rotavirus Diarrhoea in Children in Davangere, Karnataka

Efficacy, safety and effectiveness of licensed rotavirus vaccines: a systematic review and meta-analysis for Latin America and the Caribbean.

BackgroundRotaTeq™ (RV5; Merck & Co. Inc., USA) and Rotarix™ (RV1, GlaxoSmithKline, Belgium) vaccines, developed to prevent rotavirus diarrhea in children under five years old, were both introduced into national immunization programs in 2006. As many countries in Latin America and the Caribbean have included either RV5 or RV1 in their routine childhood vaccination programs, we conducted a systematic review and meta-analysis to analyze efficacy, safety and effectiveness data from the region.MethodsWe conducted a systematic search in PubMed, EMBASE, Scielo, Lilacs and the Cochrane Central Register, for controlled efficacy, safety and effectiveness studies published between January 2000 until December 2011, on RV5 and RV1 across Latin America (where both vaccines are available since 2006). The primary outcome measures were: rotavirus-related gastroenteritis of any severity; rotavirus emergency department visits and hospitalization; and severe adverse events.ResultsThe results of the meta-analysis for efficacy show that RV1 reduced the risk of any-severity rotavirus-related gastroenteritis by 65% (relative risk (RR) 0.35, 95% confidence interval (CI) 0.25; 0.50), and of severe gastroenteritis by 82% (RR 0.18, 95%CI 0.12; 0.26) versus placebo. In trials, both vaccines significantly reduced the risk of hospitalization and emergency visits by 85% (RR 0.15, 95%CI 0.09; 0.25) for RV1 and by 90% (RR 0.099, 95%CI 0.012; 0.77) for RV5. Vaccination with RV5 or RV1 did not increase the risk of death, intussusception, or other severe adverse events which were previously associated with the first licensed rotavirus vaccine. Real-world effectiveness studies showed that both vaccines reduced rotavirus hospitalization in the region by around 45–50% for RV5 (for 1 to 3 doses, respectively), and, by around 50–80% for RV1 (for 1 to 2 doses, respectively). For RV1, effectiveness against hospitalization was highest (around 80–96%) for children vaccinated before 12 months of age, compared with 5–60% effectiveness in older children. Both vaccines were most effective in preventing more severe gastroenteritis (70% for RV5 and 80–90% for RV1) and severe gastroenteritis (50% for RV5 and 70–80% for RV1).ConclusionThis systematic literature review confirms rotavirus vaccination has been proven effective and well tolerated in protecting children in Latin America and the Caribbean.

A Correlational study between Nutritional Status and Severity of Rotavirus Diarrhea in children under five years in Bandung, Indonesia

AIM : Diarrheal disease is a major cause of poor nutritional status in children. Malnutrition can make a person more susceptible to infection that also contributes to malnutrition, causing a vicious cycle. Surveillance of children hospitalized for diarrhea in 3 Indonesian hospitals found 60% were rotavirus positive; and 41% were positive in outpatient clinics. The aim of this study was to measure the correlation of nutritional status with severity of rotavirus diarrhea. MATERIALS AND METHODS : This study uses a cross sectional design and included all children under 5 years old, both inpatients and outpatients, who presented with acute diarrhea at Dr. Hasan Sadikin General Hospital from January 2009 through December 2012. The Vesikari Clinical Severity Scoring System was considered the measurement for severe rotavirus diarrhea. Assessment of nutritional status used anthropometric weight for height from World Health Organization (WHO) child growth standards. Categorical data were analyzed by Pearson Chi square test. RESULTS : Among 427 children aged 1-59 months, with rotavirus seropositive stool specimens, there were 258 (60%) boys and 169 (40%) girls. Malnutrition status included “well nourished” (74%), “moderately malnourished” (23%) and “severely malnourished” (3%), while the distribution of severity for rotavirus diarrhea was “mild” (10%), “moderate” (21%) and “severe” (69%). This study showed that nutritional status had no significant correlation with severity of rotavirus diarrhea, p =0.524. CONCLUSIONS : Nutritional status had no significant correlation with severity of rotavirus diarrhea.

Rota virus diarrhea in children under five admitted to Basrah General Hospital

Rota virus diarrhea in children under five admitted to Basrah General Hospital