PurposeRotavirus (RV) is the leading cause of morbidity and mortality in children under 5 years of age worldwide. This study assessed the role of RV as a cause of gastroenteritis (GE)-associated hospitalization in children, generating baseline information to evaluate the potential impact of the RV vaccine in reducing RVGE disease burden in the Kingdom of Bahrain.MethodsThis single, pediatric hospital-based surveillance study was conducted over a period of 12 months beginning April 1, 2006. A total of 314 children aged under 5 years and hospitalized due to GE were enrolled in the study, following collection of written informed consent from parents/guardians. Stool samples were tested for the presence of RV using enzyme immunoassay, and a random subset of RV-positive samples was further genotyped using reverse transcriptase-polymerase chain reaction and reverse hybridization assay.ResultsOf 314 enrolled children, 239 were included in the final analysis. RV was detected in 107 children (44.8%), mostly in the 6–23 months age group (82/107; 76.6%). RVGE occurred throughout the year, with the highest proportion occurring during April (26/42; 61.9%). G1P[8[ was the most commonly detected RV strain (10/17; 58.8%) in the limited number of samples analyzed. Vomiting and severe RVGE were more commonly observed in RV-positive than RV-negative children before hospitalization (P = 0.0008 and 0.0204, respectively).ConclusionIn our study, RV accounted for over 40% of GE-associated hospitalizations and particularly affected children under 2 years of age. These data will serve as a baseline for assessing the potential changes in the epidemiology of RV disease and for evaluating the potential impact of the introduction of RV vaccination.
Background: Globally, rotavirus (RV) infection is the primary cause of severe gastroenteritis (GE) in children aged <5 years, leading to >500,000 deaths annually. In the Kingdom of Bahrain, recent data describing the epidemiology of rotavirus-associated gastroenteritis (RVGE) is not available. To address this gap, the present single-center, referral hospital-based surveillance study aimed to estimate the burden of RVGE in children aged <5 years in the Kingdom of Bahrain.Methods: Children aged <5 years hospitalized for GE were enrolled at Salmaniya Medical Complex, a reference pediatric hospital, between April 2006 and April 2007. Stool samples were tested for RV using ELISA and RV-positive samples were genotyped by RT-PCR. The severity of RVGE (Severe = Vesikari score ≥11) was assessed using the 20-point Vesikari scale. Chi-square test was used to analyze the association between the severity of GE and RV-positivity status (post-hoc analysis).Results: 314 children were enrolled after elimination of 75 children who did not meet the eligibility criteria. The according-toprotocol (ATP) analysis included 239 children; 107 (44.8%) children were RV-positive; 128 (53.5%) were RV-negative and 4 (1.7%) had an unknown RV status. The highest proportion of RVGE cases was observed in the 6-23 months age group (76.6%; 82/107). RVGE hospitalizations occurred year-round with peaks in March-06 (75%) and April-06 (61.9%).The association between severe GE episodes and RV-positive status was statistically significant (p = 0.0097). Intravenous rehydration was used for treatment in 28.0% RVpositive and 17.2% RV-negative children before hospitalization. Among the 17 (15.9%) RV-positive samples serotyped and genotyped, G1 (58.8%) and P[8] (82.4%) were the most common RV types detected. Conclusion:The data from this burden of disease study in the Kingdom of Bahrain shows that the disease burden of RVGE is substantial among children aged between 6 months and 23 months. This baseline data will facilitate the documentation of the potential reduction in the RVGE disease burden in children aged <5 years in the Kingdom of Bahrain, since the introduction of RV vaccination into the national immunization program in 2009.
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