A study of rotavirus infection in acute diarrhoea in children less than 5 years of age

: Diarrhoeal diseases account for an estimated 1.5 million deaths globally every year making it the second leading cause of childhood mortality. In India 1 out of every 250 children die of rotavirus diarrhea each year.: To find out the incidence of rotavirus infection in acute diarrhoeal cases in children under 5 years of age.: A prospective study was conducted on 100 non repetetive stool samples of Children under 5 years of age, presenting with acute diarrhea and hospitalized in the pediatric ward, during December 2015 to November 2016. Stool samples were processed according to premier rotaclone enzyme immunoassay protocol for the detection of rotavirus antigen, adhering to standard laboratory precautions.: The incidence of acute diarrhoeal diseases was 5.86% in our setting. was detected in 29% cases by ELISA method.The antigen detection by EIA is a reliable test, as it is quantitative and also has high sensitivity and specificity. Hence, can be routinely employed to prevent major morbidity and mortality among children, especially less than 5 years of age.

The Differences in Transaminase Enzyme Levels among Children with Acute Diarrhea due to Rotavirus and Non-rotavirus

BACKGROUND: Diarrhea is the particular disease that still affects children in Indonesia, with rotavirus being the most common etiology among children under 5 years old. Rotavirus and non-rotavirus diarrhea can spread to the extraintestinal and localized to the liver which causes liver cell damage, thus, the level of the glutamic oxaloacetic and glutamic pyruvic transaminase enzymes increases. AIM: The objective of the study was to prove that there are differences in serum levels of glutamic oxaloacetic and glutamic pyruvic transaminase in children with acute diarrhea due to rotavirus and non-rotavirus infection. METHODS: This study used a cross-sectional design, the research subjects were children aged 6 months old until 60 months old with acute diarrhea in Denpasar Public Health Center, Sanglah, and Wangaya General Hospital within the period of March 2018 until March 2021. Statistical analysis used the Mann–Whitney. RESULTS: A total of 70 subjects were analyzed in this study. There were 24.28% of subjects with rotavirus. Each group had nearly the same degree of severity of 29.4% for rotavirus and 30.2% for non-rotavirus, with a median of serum levels of glutamic oxaloacetic transaminase (SGOT) 47 (19–261) and glutamic pyruvic transaminase (SGPT) 25 (7–217). The results of this study showed that the median difference in aspartate aminotransferase and alanine aminotransferase levels was not significant in rotavirus and non-rotavirus diarrhea (SGOT 45 [16–168], 32 [11–261], p = 0.077; (SGPT 22 [14–91], 18 [5–217], p = 0.12). CONCLUSION: This study concluded that there is a higher median level of SGOT and SGPT in children with acute diarrhea due to rotavirus infection compared to non-rotavirus infection, although it is not statistically significant.

NITAZOXANIDE IN TREATMENT OF ROTAVIRUS DIARRHEA IN CHILDREN: A SINGLE CENTER STUDY

BACKGROUND & OBJECTIVE: As Rota virus leads to significant morbidity in children 2 months to 5 years, this study was done to observe the effect of one dose of nitazoxanide on the total duration of rotavirus diarrhea. The primary objective was to evaluate the reduction in the mean duration of viral diarrhea in children after administration of first dose of Nitazoxanide. METHODLOGY: This descriptive study was done in the Department of Pediatric Medicine Unit I, Mayo Hospital, Lahore from Jan 2016 to June 2016 after approval from the ethical review committee. Sample size calculated was 175 using WHO sample size calculator. Patients of 4–5 years were given 200 mg nitazoxanide twice daily for 3 days; 100 mg nitazoxanide was given twice daily to 12–47 months age group, and patient of <12 months age were given 7.5 mg/kg twice day along with routine care and were followed 12 hourly till the passage of normally formed stools. Duration of diarrhea was recorded. RESULTS: Out of 175 cases, 58.9% (n=103) were between 2-36 months age while 41.2% (n=72) were 37-60 months age, mean+SD was calculated as 35.06+13.34 months, mean reduction in duration of rotavirus diarrhea in children after administration of first dose of Nitazoxanide was recorded as 32.85+2.32 hours. CONCLUSION: With the use of nitazoxanide along with routine care for rotavirus diarrhea children, the mean duration of rotavirus diarrhea was reported to be less than 1.5 days.

Impact of Monovalent Rotavirus Vaccine on Rotavirus Hospitalizations among Children Younger Than 5 Years of Age in the Ouest and Artibonite Departments, Haiti, 2013 to 2019

Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean. Haiti introduced the monovalent rotavirus vaccine in April 2014. The objective of this analysis is to describe the impact of the rotavirus vaccine on hospitalizations among Haitian children younger than 5 years old during the first 5 years after introduction. This analysis includes all children with diarrhea who were enrolled as part of a sentinel surveillance system at two hospitals from May 2013 to April 2019. We compare the proportion of rotavirus-positive specimens in each post-vaccine introduction year to the pre-vaccine period. To account for the potential dilution of the proportion of rotavirus-positive specimens from a waning cholera outbreak, we also analyzed annual trends in the absolute number of positive stools, fit a two-component finite-mixture model to the negative specimens, and fit a negative binomial time series model to the pre-vaccine rotavirus-positive specimens to predict the number of rotavirus diarrhea hospital admissions in the absence of rotavirus vaccination. The overall percentage of rotavirus-positive specimens declined by 22% the first year after introduction, increased by 17% the second year, and declined by 33% to 50% the subsequent 3 years. All sensitivity analyses confirmed an overall decline. We observed a clear annual rotavirus seasonality before and after vaccine introduction, with the greatest activity in December through April, and a biennial pattern, with high sharp peaks and flatter longer periods of increased rotavirus activity in alternating years, consistent with suboptimal vaccination coverage. Overall, our study shows evidence that the introduction of the rotavirus vaccine reduced the burden of severe rotavirus diarrhea.

Knowledge and Attitudes Towards Rotavirus Diarrhea and the Acceptance of Rotavirus Vaccination Amongst Primary Caregivers in Yogyakarta, Indonesia: A Qualitative Study

Background: Rotavirus is the leading cause of hospitalized diarrhea in Indonesia. Rotavirus vaccine has not been included on the Indonesian National Immunization Program (NIP). There are some key issues must be considered before introducing a new vaccine into a NIP. Our study aimed to explore the knowledge and attitudes of rotavirus diarrhea and barriers to the acceptance of the vaccine. Methods: We conducted 26 in-depth interviews in two districts (rural and urban areas) of Yogyakarta Province, Indonesia. Participants included pregnant women in their third trimester and mothers of infants aged less than 14 weeks. We conducted a thematic analysis. Results: Participants did not perceive diarrhea as being a priority health problem. Very few had heard of rotavirus diarrhea or were aware of the availability of the vaccine. While participants would accept a vaccine their children against rotavirus, some key barriers impacted the use of the vaccine. As the rotavirus vaccine is not included in the Indonesian National Immunisation Program (NIP), parents perceived it as not essential. Parents were concerned regarding the safety and benefit of the vaccine due to the perceived newness of the vaccine. Other concerns were the vaccine was too costly and the halal issue. Participants expressed a need for more information on the vaccine's effectiveness and safety, with their primary health care providers (HCPs) nominated as playing an important role in vaccine acceptance. Conclusions: There was low awareness of rotavirus being a serious disease and the availability of the rotavirus vaccine in Indonesia. The vaccine is not on the Indonesian NIP, the newness, the safety and efficacy, the cost, and the halal status of vaccine were barriers to vaccine acceptance. Information and recommendation by HCPs play an essential role in vaccine acceptance

Molecular Epidemiology and Clinical Risk Factors of Rotavirus Diarrhea: Single Center 5-Year Experience

Objective: Acute gastroenteritis due to the rotavirus is one of the common causes of morbidity and mortality in children under five years of age. The objective of this study was to evaluate the epidemiological, clinical, and laboratory data of rotavirus diarrhea in hospitalized children under five years of age. Methods: All children between one month and 60 months old ages who were hospitalized in Health Sciences University Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital during September 2013 to August 2017 and diagnosed as acute gastroenteritis with rotavirus antigen test positive in feces were included in the current study. Data of the patients were collected retrospectively from medical records. Results: A total of 100 patients were evaluated.The median age of the patients was 13 months (IQR 5-45 months) and 54 patients were male and 46 were female.The highest hospitalization rate was in December, followed by November, and in October. The most common type of G9P (8) serotype was detected in rotavirus serotype analysis by PCR. Breastfeeding infants had milder clinic findings in comparison to the older ones. It was found that clinical findings were milder and Vesicari score was lower in infants who had breast milk. Vesikari score was found to be high in children with severe clinical findings. Conclusion: Rotavirus infection is important for all ages.In case of fever, increased numbers of vomiting and diarrhea, and higher Vesikari system scores may be associated with the severe clinical forms. Determination of rotavirus serotypes and clinical monitoring of genotypic changes are required.