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Published on: January 28, 2019
Clinical factors predicting rotavirus diarrhea in children: A cross-sectional study from two hospitals
Michelle Indrawan1, Jason Chendana1, Tan Gabriella Heidina Handoko1
1Department of Pediatric, Universitas Pelita Harapan, Banten 15811, Indonesia.
Insights
Clinical predictors like wet season, abdominal pain, and severe dehydration help identify rotavirus gastroenteritis in children. Early identification aids in timely and appropriate medical intervention for pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Clinical Epidemiology
Background:
- Rotavirus remains a major cause of illness and death in children globally.
- Accurate and timely diagnosis of rotavirus gastroenteritis is crucial for effective management.
Purpose of the Study:
- To identify clinical and laboratory predictors differentiating rotavirus gastroenteritis from non-rotavirus gastroenteritis in hospitalized pediatric patients.
- To develop a predictive model for rotavirus diarrhea.
Main Methods:
- A cross-sectional study analyzing medical records of pediatric patients (0-18 years) with suspected rotavirus diarrhea from December 2015 to December 2019.
- Statistical analysis included multivariate analysis, receiver operating curve (ROC), and Hosmer-Lemeshow tests to evaluate model performance.
Main Results:
- The study included 267 participants, with 70% diagnosed with rotavirus diarrhea.
- Predictors of rotavirus diarrhea included: wet season, length of stay ≥ 3 days, abdominal pain, severe dehydration, abnormal white blood cell counts, abnormal random blood glucose, and fecal leukocytes.
- The predictive model demonstrated good discrimination with an Area Under the Curve (AUC) of 0.819.
Conclusions:
- Clinical signs and laboratory findings such as abdominal pain, severe dehydration, and fecal leukocytes are significant predictors of rotavirus gastroenteritis.
- The identified predictors can aid clinicians in diagnosing rotavirus diarrhea more effectively in pediatric populations.
- The predictive model shows promise for improving the diagnostic accuracy of rotavirus gastroenteritis.
Background:
Rotavirus is still a significant contributing morbidity and mortality in pediatric patients.
Aim:
To look at clinical signs and symptoms and laboratory findings that can predict rotavirus gastroenteritis compared to non-rotavirus gastroenteritis.
Methods:
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.
Results:
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.
Conclusion:
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.
