Burden of Rotavirus-Associated and Non-Rotavirus-Associated Diarrhea among Nonhospitalized Individuals in Central Italy: A 1-Year Sentinel-Based Epidemiological and Virological Surveillance

Abstract

A community sentinel pediatrician-based epidemiological and virological surveillance study was conducted to estimate the incidence of gastroenteritis and laboratory-confirmed rotavirus-associated disease. The 1-year cumulative incidence of gastroenteritis in the cohort of children aged 0-5 years was 21%, with the highest rates in the 7-12-month and 13-18-month age groups (41.1% and 41.7%, respectively). Approximately one-third of gastroenteritis cases requiring an office visit or telephone consultation were attributable to rotavirus infection.

Primary care-based surveillance to estimate the burden of rotavirus gastroenteritis among children aged less than 5 years in six European countries

“…In addition to the direct protective effects of vaccination, RV vaccines may also be expected to reduce the number of cases among unvaccinated children [34]. As in other surveillance studies in Europe [1,9,11,14,32], disease burden was found to be the greatest among the youngest age groups, with even infants aged less than 3 months of age affected. As expected, almost all RVGE occurred between the months of December and May.…”

“…An earlier surveillance study conducted in seven European countries from October 2004 to September 2005 showed RV to account for one third of primary care consultations for acute GE among children aged less than 5 years, with annual incidence rates of RVGE ranging from 20.7 to 49.7 per 1,000 children-years [32]. RV was also found to account for one third of acute GE cases among children aged less than 5 years in a study in an urban primary care centre in Italy from April 2005 to April 2006 [1]. In another study in Spain, the proportion of acute GE attributable to RV among children aged less than 5 years presenting to primary care physicians was only 15% during the period from December 2003 to November 2004 [9], but increased to 25 In addition, only PCR-positive RVGE cases were included in this study.…”

“…Data on disease burden prior to vaccine introduction are important for the assessment of RV vaccine benefit and impact. Previous surveillance studies have shown RVGE to place high demands on European healthcare systems, with RV found to account for up to two thirds of hospitalisations and emergency room visits and one third of primary care consultations for acute GE among children younger than 5 years [1,9,11,32]. However, current data on RVGE burden at the primary healthcare level are sparse, due to the absence of routine screening, testing and reporting of RV infections in this setting, and comparison between studies and/or countries is limited by differences in methodology.…”

Burden of community-acquired and nosocomial rotavirus gastroenteritis in the pediatric population of Western Europe: a scoping review

“…Another study from France confirmed this trend, showing significant differences in dehydration between rotavirus-positive and negative gastroenteritis (26.8% vs.14.7%, P < .0001) as did a study from Greece [17,46]. Further, one Italian community-based study showed that dehydration at initial presentation in primary care was associated with a higher likelihood of RVGE (OR: 1.8; 95% CI, 1.1-3; P = 0.02) [53]. …”

“…Information concerning serotype distribution over time for fully serotyped samples from children under five years of age was available for five countries (Denmark [36,50], France [25,36,51], Italy [25,52,53], Spain [25,30,36,54], and the UK [25,36,55,56]) (Figure 3). However, on examination of the evolution of genotype distribution and predominance over time, we were not able to discern any overall trends in serotype distribution within the region.…”