The Burden of Rotavirus Gastroenteritis in Children: A Hospital-Based Prospective Study in Western Rajasthan

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.

Keywords: enzyme linked immunosorbent assay (elisa); feeding infants and young children; gastroenteritis; rotavirus.

Figure 1. Prevalence of rotavirus diarrhea in the study group

Figure 2. Distribution of case according to genotyping

Figure 3. Age distribution of patients with rotavirus and non-rotavirus diarrhea

Figure 4. Month-wise distribution of diarrhea cases

Figure 5. Distribution of cases according to the grade of malnutrition