Multicountry Analysis of Spectrum of Clinical Manifestations of Children &lt;5 Years of Age Hospitalized with Diarrhea

Murray, Jillian; Soenarto, S. Yati; Mulyani, Nenny Sri; Wijesinghe, Pushpa S.; Mpabalwani, Evans; Simwaka, Julia; Matapo, Belem; Mwenda, Jason M.; Sahakyan, Gayane; Grigoryan, Svetlana; Vanyan, Artavazd; Khactatryan, Sergey; Sanwogou, Jennifer; Oliveira, Lúcia Helena de; Rey-Benito, Gloria; Kang, Gagandeep; Serhan, Fatima; Tate, Jacqueline E.; Aliabadi, Negar; Cohen, Adam L.

doi:10.3201/eid2512.180712

Cited by 3 publications

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References 9 publications

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“…The identified surveillance sites expanded their case definition from acute, watery diarrhoea only to prospectively enrol all children admitted for diarrhoea, regardless of duration or the presence of blood. 18 19 Thirty-three GRSN sentinel surveillance sites in 28 globally representative countries with a history of uninterrupted surveillance and high-quality data collection participated in prospective, active surveillance of all children less than 5 years of age hospitalised with diarrhoea ( online supplemental table 1 ). The surveillance sites in Côte d’Ivoire, Ethiopia, Mauritius, Moldova and Zimbabwe aggregated patients from two or three surveillance hospitals within the same catchment area.…”

Section: Methodsmentioning

confidence: 99%

“…Sites were required to have a history of uninterrupted surveillance, with enrolment of a minimum of 100 cases of hospitalised diarrhoea in children less than 5 years of age per year. The identified surveillance sites expanded their case definition from acute, watery diarrhoea only to prospectively enrol all children admitted for diarrhoea, regardless of duration or the presence of blood 18 19. Thirty-three GRSN sentinel surveillance sites in 28 globally representative countries with a history of uninterrupted surveillance and high-quality data collection participated in prospective, active surveillance of all children less than 5 years of age hospitalised with diarrhoea (online supplemental table 1).…”

Section: Methodsmentioning

confidence: 99%

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Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network

et al. 2022

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IntroductionDiarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise interventions.MethodsWe established the Global Pediatric Diarrhea Surveillance network, in which children under 5 years hospitalised with diarrhoea were enrolled at 33 sentinel surveillance hospitals in 28 low-income and middle-income countries. Randomly selected stool specimens were tested by quantitative PCR for 16 causes of diarrhoea. We estimated pathogen-specific attributable burdens of diarrhoeal hospitalisations and deaths. We incorporated country-level incidence to estimate the number of pathogen-specific deaths on a global scale.ResultsDuring 2017–2018, 29 502 diarrhoea hospitalisations were enrolled, of which 5465 were randomly selected and tested. Rotavirus was the leading cause of diarrhoea requiring hospitalisation (attributable fraction (AF) 33.3%; 95% CI 27.7 to 40.3), followed by Shigella (9.7%; 95% CI 7.7 to 11.6), norovirus (6.5%; 95% CI 5.4 to 7.6) and adenovirus 40/41 (5.5%; 95% CI 4.4 to 6.7). Rotavirus was the leading cause of hospitalised diarrhoea in all regions except the Americas, where the leading aetiologies were Shigella (19.2%; 95% CI 11.4 to 28.1) and norovirus (22.2%; 95% CI 17.5 to 27.9) in Central and South America, respectively. The proportion of hospitalisations attributable to rotavirus was approximately 50% lower in sites that had introduced rotavirus vaccine (AF 20.8%; 95% CI 18.0 to 24.1) compared with sites that had not (42.1%; 95% CI 33.2 to 53.4). Globally, we estimated 208 009 annual rotavirus-attributable deaths (95% CI 169 561 to 259 216), 62 853 Shigella-attributable deaths (95% CI 48 656 to 78 805), 36 922 adenovirus 40/41-attributable deaths (95% CI 28 469 to 46 672) and 35 914 norovirus-attributable deaths (95% CI 27 258 to 46 516).ConclusionsDespite the substantial impact of rotavirus vaccine introduction, rotavirus remained the leading cause of paediatric diarrhoea hospitalisations. Improving the efficacy and coverage of rotavirus vaccination and prioritising interventions against Shigella, norovirus and adenovirus could further reduce diarrhoea morbidity and mortality.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%