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Rotavirus diarrhoea in Thai infants and children
M K Hendricks1, L E Cuevas, C A Hart
1Department of Paediatrics and Child Health, University of Stellenbosch, Tygerberg, Cape Town, South Africa.
Insights
Human rotavirus (HRV) caused 18% of gastroenteritis in Bangkok children. RNA-polyacrylamide gel electrophoresis (PAGE) and enzyme immunoassay are recommended for reliable, inexpensive HRV detection.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Gastroenterology
Background:
- Human rotavirus (HRV) is a leading cause of severe gastroenteritis in young children worldwide.
- Gastroenteritis outbreaks in children necessitate accurate and efficient diagnostic methods.
Purpose of the Study:
- To assess the prevalence of HRV infection in children with gastroenteritis in Bangkok.
- To compare the sensitivity and specificity of different HRV detection methods.
- To identify reliable and cost-effective diagnostic tools for HRV.
Main Methods:
- A 5-week study involving 103 children (1 month to 5 years) with gastroenteritis.
- Detection of HRV and adenovirus using RNA-polyacrylamide gel electrophoresis (PAGE), electron microscopy (EM), and Rotascreen latex particle agglutination (LPA).
- Comparison of diagnostic method reliability, including sensitivity, specificity, and false positive rates.
Main Results:
- HRV was detected in 18% of children with gastroenteritis; adenovirus in 10.7%.
- Vomiting and dehydration were significantly associated with HRV-positive diarrhea.
- PAGE showed 90% sensitivity and 100% specificity; EM showed 84% sensitivity and 100% specificity; LPA showed 80% sensitivity and 81% specificity with 15.5% false positives.
- HRV subgroups I and II were found in 5.3% and 94.7% of positive samples, respectively.
Conclusions:
- HRV is a significant cause of gastroenteritis in the studied pediatric population.
- RNA-polyacrylamide gel electrophoresis (PAGE) and ID enzyme immunoassay are reliable, inexpensive, and recommended methods for HRV detection.
- These methods are particularly suitable for resource-limited settings with limited technical support.
Abstract:
One hundred and three children aged from 1 month to 5 years were assessed for human rotavirus (HRV) infection over a 5-week period at Children's Hospital, Bangkok. HRV was present in 18% and adenovirus in 10.7% of the children with gastro-enteritis. None of the controls excreted HRV. Vomiting and dehydration were significantly associated with HRV diarrhoea. A comparison of the reliability of the detection methods showed the following sensitivities: RNA-polyacrylamide gel electrophoresis (PAGE) 90%, electron microscopy (EM) 84% and Rotascreen latex particle agglutination (LPA) 80%. PAGE and EM were 100% specific while the Rotascreen LPA was 81% specific. Rotascreen LPA gave 15.5% false positive results. Of the HRV positive samples analyzed by PAGE, 5.3% and 94.7% were of subgroups I and II, respectively. The ID enzyme immunoassay and PAGE are reliable and inexpensive methods which can be recommended for HRV detection, particularly in areas with little technical support.