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Acute nonbacterial gastroenteritis in hospitalized children: a cross sectional study
Mohammad Reza Shokrollahi1, Samileh Noorbakhsh2, Hamid Reza Monavari2
1Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, IR Iran ; Department of Medicine, Qom University of Medical Sciences and Health services, Qom, IR Iran.
Insights
Rotavirus, human parechovirus-1, and adenovirus are key causes of viral acute gastroenteritis in Iranian children. Human bocavirus is infrequent, highlighting the need for targeted control strategies, especially where rotavirus vaccination isn't routine.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Public Health
Background:
- Viral acute gastroenteritis (AGE) is a significant cause of childhood illness and hospitalization in developed nations, including Iran.
- Understanding the specific viral agents responsible for AGE is crucial for effective disease management and prevention.
Purpose of the Study:
- To determine the prevalence and types of viral pathogens (rotavirus, adenovirus, human parechoviruses-1, and human bocavirus) causing acute nonbacterial gastroenteritis in hospitalized children in Iran.
- To assess the epidemiological characteristics and clinical associations of these viral infections.
Main Methods:
- A prospective, cross-sectional study involving 80 hospitalized children with viral AGE at Rasoul Hospital, Tehran, Iran (2009-2011).
- Stool samples were analyzed using Real-time PCR (for HBoV), nested RT-PCR (for HPeV-1), and rapid chromatographic tests (for rotavirus and adenovirus).
Main Results:
- Rotavirus was the most prevalent pathogen (48.8%), followed by human parechovirus-1 (23.2%) and adenovirus (20%). Human bocavirus was detected in only 8% of cases.
- Rotavirus infection was more common in males and younger children and was significantly associated with the degree of dehydration.
- Co-infection with adenovirus and rotavirus occurred in 6% of cases.
Conclusions:
- Rotavirus, HPeV-1, and adenovirus are the primary viral causes of AGE in hospitalized children in this Iranian cohort.
- Human bocavirus is an infrequent cause of viral AGE in children.
- Identifying the specific viral agents of AGE is vital for developing effective diarrhea disease control strategies, particularly in regions without routine rotavirus vaccination.
Background:
Viral acute gastroenteritis (AGE) is a major cause of morbidity in childhood and leads to hospitalization in developed countries, such as Iran.
Objectives:
The aim of this study was to determine the prevalence and viral types (rotavirus, adenovirus, human parechoviruses-1, and human bocavirus) of acute nonbacterial gastroenteritis in hospitalized children.
Patients And Materials:
This was a across-sectional prospective study performed at the Pediatric Department of Rasoul Hospital, Tehran, Iran (2009-2011) on 80 hospitalized children with viral AGE. All Stool samples were collected on viral transport media. Human bocavirus (HBoV) was detected using the Real-time PCR TaqMan method. Molecular detection of human parechovirus type 1 (HPeV-1) RNA in stool samples was done using a specific nested reverse transcription PCR (RT-PCR). Rota and adeno virus antigens were sought by rapid chromatographic tests. P values less than 0.05 were considered statistically significant.
Results:
Fever was determined in 47.5% of cases (38), nausea and vomiting in 42.5% (34), respiratory symptoms in 16.3% (13), abdominal pain in 76%. Duration of diarrhea was 1-30 days (mean = 6.3 + 4.3 days). No dehydration was observed in 43.5% of subjects, mild dehydration in 33.8%, moderate dehydration in 17.5% and severe dehydration in 5% of cases. Positive rotavirus was found in 48.8% of cases (39), adenovirus in 20% (16), HBoV in 8% (6) and HPeV-1 in 23.2% (19), and adeno and rotaviruses co-infection in 6% (4). The frequency of positive HBoV was significantly lower than adeno and rotaviruses infection (P value = 0.0001). Rotavirus was more frequent in males (P value = 0.003) and in young children (17.49 months vs. 21.44 months) [P value = 0.03, CI = -13.4, 5.5]. Rotavirus infection was related to the degree of dehydration (P value = 0.001) but was not related to the presence of vomiting or fever (P value > 0.5).
Conclusions:
This study indicates that viral agents, especially rotavirus (48.8%), HPeV-1 (23.2%) and adenovirus (20%) are the most important causes for viral AGE in children while HBoV (8%) is infrequent during childhood. Determination of various viral pathogens of AGE is very important in planning diarrhea disease control strategies in our country where rotavirus vaccination in not routinely used.
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