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Published on: January 28, 2019
The Burden of Rotavirus Gastroenteritis in Children: A Hospital-Based Prospective Study in Western Rajasthan
Suresh Kumar Meel1, Vikash Katewa1, Romil Singh2
1Pediatrics, Dr. S.N. Medical College, Jodhpur, IND.
Insights
Rotavirus causes significant gastroenteritis in young children in India. The G3P8 strain was most common in hospitalized children in western Rajasthan, with 23.05% testing positive.
Area of Science:
- Virology
- Pediatrics
- Public Health
Background:
- Rotaviruses are a leading cause of severe gastroenteritis in infants and young children globally.
- India faces a substantial mortality and economic burden due to rotavirus infections.
- Understanding regional rotavirus burden and prevalent strains is crucial for effective public health interventions.
Purpose of the Study:
- To determine the prevalence of rotavirus in acute watery diarrhea.
- To identify the circulating rotavirus genotypes in hospitalized children under five years old in western Rajasthan.
- To assess the clinical severity of rotavirus gastroenteritis in the studied population.
Main Methods:
- A prospective, hospital-based study was conducted over one year in Jodhpur, India.
- 399 hospitalized children under five with acute gastroenteritis were enrolled.
- Stool samples were analyzed using Enzyme-Linked Immunosorbent Assay (ELISA) and genotype determination.
Main Results:
- Rotavirus was detected in 92 (23.05%) of the 399 children.
- The most common age group affected was six months to two years.
- The G3P8 genotype was the predominant strain (55.43%), followed by G1P8 and G3+G12P8.
- Severe diarrhea (Vesikari score) was observed in 70.65% of rotavirus-positive patients.
- Infection peaked during winter months (November to February).
Conclusions:
- Rotavirus imposes a significant healthcare and economic burden on young children in western Rajasthan.
- Rotavirus infection is prevalent throughout the year, with a notable increase in winter.
- The G3P8 genotype is the primary cause of rotavirus diarrhea in this region, impacting both vaccinated and unvaccinated children.
Abstract:
Objective Rotaviruses are the prime cause of gastroenteritis amongst infants and young children worldwide. In India, the mortality and economic impact caused by rotavirus are high. The objective of this is to understand the burden of rotavirus in acute watery diarrhea and its circulating genotypes in hospitalized children less than five years of age for acute gastroenteritis in western Rajasthan. Methodology This is a hospital-based prospective study conducted in the pediatrics department of Dr. Sampurnanand (S.N.) Medical College of Jodhpur in India for one year during 2018. The study included 399 children less than five years old, presenting with acute gastroenteritis who needed to be admitted for at least six hours. We enrolled subjects after obtaining informed consent from the guardian. Stool samples of 5 gm or ml were collected in a sterile container and stored at minus 20 degrees centigrade while transporting to Christian Medical College (CMC) virology lab in Vellore, India. The stool samples were subjected to Enzyme-Linked Immunosorbent Assay (ELISA) testing, followed by genotype determination. We investigated data through statistical analysis from all collected data. Results A total of 399 patients fulfilled the enrollment criteria; out of them, 92 (23.05%) were positive for rotavirus, and maximum cases were seen in the age group of six months to two years (78.26%). Rotavirus positivity was more in males (64.13%) than females (35.86%). The rotavirus infection was seen throughout the year, with a peak in cases from November to February (73.91%). G3P8 (55.43%) was the most common strain causing rotavirus diarrhea, followed by G1P8 (9.72%) and G3+G12P8 (8.69%). Based on the Vesikari clinical severity score, 70.65% of patients had severe diarrhea. Conclusion This prospective study highlights the healthcare and economic burden of rotavirus, especially in children of less than five years. The incidence of rotavirus is observed in winter months, and its prevalence in all cases of acute diarrhea in our study is 23.05%. G3P8 was the most common genotype causing rotavirus diarrhea in our region in both non-vaccinated and vaccinated children, followed by G1P8 and G3+G12P8, respectively.
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