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Longitudinal study of rotavirus infections among children from Belém, Brazil
A C Linhares1, Y B Gabbay, R B Freitas
1Instituto Evandro Chagas, Fundação, Ministério da Saúde, Belém, Pará, Brasil.
Insights
Rotavirus infections caused 8.2% of diarrhea episodes in young Brazilian children. Early infections were often asymptomatic, with later ones becoming more severe, unlike those from other pathogens.
Area of Science:
- Pediatrics
- Virology
- Public Health
Background:
- Diarrheal diseases are a major cause of morbidity in young children globally.
- Rotavirus is a leading viral pathogen responsible for severe acute gastroenteritis in infants and young children.
Purpose of the Study:
- To investigate the incidence, characteristics, and clinical impact of rotavirus infections in children under three years old in Belém, Brazil.
- To analyze rotavirus strains and explore the relationship between feeding practices and rotavirus disease severity.
Main Methods:
- A longitudinal study followed 80 children (0-3 years) from December 1982 to March 1986, recording diarrheal episodes.
- Rotavirus strains were identified and characterized using polyacrylamide gel electrophoresis of viral RNA.
- Age-specific attack rates and feeding practices (breast vs. bottle) were compared using statistical analysis.
Main Results:
- A total of 441 diarrheal episodes were observed, with 36 (8.2%) attributed to rotavirus.
- Rotavirus was the sole pathogen in 50% of related cases. Subgroup II strains were predominant.
- Rotavirus reinfections occurred. Early infections (before 4 months) were more frequently asymptomatic (P=0.021).
- No significant protection against rotavirus disease was found with maternal milk (P=0.21).
- Rotavirus-associated diarrhea presented more severe clinical symptoms compared to diarrhea from other agents.
Conclusions:
- Rotavirus is a significant cause of diarrhea in young children in Belém, Brazil, with specific strain profiles identified.
- The age of infection influences symptom presentation, with earlier infections being less symptomatic.
- While maternal milk did not show significant protection, the severity of rotavirus illness highlights the need for targeted interventions.
Abstract:
From December 1982 to March 1986 a group of 80 children between 0 and 3 years old who lived in the peripheral area of Belém, Brazil, were followed up for episodes of diarrhoea. A total of 441 diarrhoeal episodes were recorded and 36 (8.2%) were associated with rotavirus. This agent was the only pathogen in 50% of rotavirus-related episodes of acute diarrhoea, and strains were characterized by analysis of RNA in polyacrylamide gels. Forty-one belonged to subgroup II (long pattern) and five to subgroup I. Reinfections by rotavirus were noted in 12 children involving either the same or different subgroups. Ten distinct electrophoretypes were detected in the study period and the predominant one had the '1N2L' profile. The cumulative age-specific attack rate for diarrhoea reached 2.8 by the end of the first year of life; a frequency of 2.3 episodes of diarrhoea per child per year was observed throughout the complete investigation. In comparing the age-specific attack rates for diarrhoea between breast-fed and bottle-fed children, a peak at 6 months of age was noted in the former, and at 1 month in the latter. A comparison by Fischer's exact test (P = 0.21) provided no evidence for protection against clinical rotavirus disease by maternal milk. By the same test, however (P = 0.021), we found significant evidence that early rotavirus infections were more likely to be asymptomatic and that infections after 4 months were more likely to be symptomatic. The clinical picture in children with rotavirus-related diarrhoea was more severe than in those suffering from acute diarrhoea due to another agent.