Incidence of Severe Rotavirus Diarrhea in New Delhi, India, and G and P Types of the Infecting Rotavirus Strains

Abstract

A total of 62,475 children <5 years old from a defined population of approximately 500,000 children and adults from slums in New Delhi, India, were assessed for 1 year by means of passive surveillance, to identify children who were hospitalized for diarrhea. The incidence of severe rotavirus diarrhea was estimated, and the G and P types of the infecting rotavirus strains were determined and were correlated with the clinical severity of diarrhea. Of 584 children who were hospitalized with diarrhea, 137 (23.5%) had rotavirus detected in stool specimens (incidence of rotavirus diarrhea-associated hospitalizations, 337 hospitalizations/100,000 children <5 years of age). Most cases of diarrhea (98%) occurred during the first 2 years of life, peaking at 9-11 months of age. Rotavirus-associated diarrhea occurred year-round but was predominant in winter. Among the strains that could be G-typed, G1 was the most common serotype, followed by G9 and G2; 10% of cases of diarrhea were due to mixed G-type infections. Common strains identified in the present surveillance study were P[8]G1, P[4]G2, P[8]G9, P[6]G1, P[6]G9, and P[6]G3. Children infected with G1 strains had a greater risk of developing more-severe cases of diarrhea than did children infected with other rotavirus strains (odds ratio, 2.95; 95% confidence interval, 1.3-6.67).

Prevalence and Molecular Characterization of Group a Rotavirus in Children of Punjab, India

“…Thus children below 1 year of age are found to be more susceptible to rotavirus infection and it may be due to lack of fully developed immune system. The results of the present study are in agreement with other previous reports (Sarvanan et al, 2004;Bahl et al, 2005;Kang et al, 2009). …”

“…Thus, analysis of season in relation to rotavirus infection from Punjab revealed a significant association of the occurrence of infection with cooler months. The results of the present study are comparable with previous studies (Saravanan et al, 2004;Bahl et al, 2005;Kang et al, 2009;Kaur, 2011), who have reported the pre-dominance of human rotavirus infection during cooler months in India. The correlation of rotavirus gastroenteritis with the age of the subject is studied by grouping the children of different age into eight groups, as depicted in (Table 1).…”

Prevalence of rotavirus diarrhea among hospitalized under-five children

“…The Indian Rotavirus Strain Surveillance Network carried out a multi-centric study in seven different regions of India and reported that rotavirus was detected in stools of 39% children aged <5 years [3]. Inclusion of children at hospitals caring for lower acuity diarrheal episodes or less severe disease may account for a lower percentage of rotavirus positive cases among the total number of enrolled patients in our study compared with previous studies [3,[8][9][10][11][12][13][14][15].…”

Genotypic Distribution of Rotavirus in Phnom Penh, Cambodia: An Association of G9 with More Severe Diseases

“…Other studies also reported an increased predominance of G9 and its association with severe diarrhea in Latin America 22 and in the United Kingdom where 71% of patients infected with G9P2A [6] required hospitalization and 33% of those who were admitted were severely dehydrated. 23 However, G9 association with increased severity is debatable as others reported that G1 had greater association with severe dehydration when compared with G9, 24,25 whereas other studies showed no difference of severity with any specific G-genotypes. [26][27][28] Differences in clinical severity associated G-genotypes may rely on the geographical origin of the strain or associated P-genotypes.…”