Rotavirus gastroenteritis in children under 5 years in the Kingdom of Bahrain: hospital-based surveillance

Abstract

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.

Systematic review of the rotavirus infection burden in the WHO-EMRO region

“…One hundred and sixty-five publications were included in the qualitative assessment ( Figure 2). The countries and number of associated references from which published data were obtained are: Afghanistan (1), 12 Bahrain (3), [13][14][15] Egypt (17), [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Iran (37), Iraq (3), 41,69,70 Jordan (9), [71][72][73][74][75][76][77][78][79] Kuwait (2), 80,81 Lebanon (3), [82][83][84] Libya (5), [85][86][87][88][89] Morocco (9), [90][91][92][93][94]…”

“…Iran, Saudi Arabia, Jordan, Bahrain, Morocco, Iraq) for which data from the past 15 years are available (Table 3). 15,34,37,45,48,57,69,78,79,90,[93][94][95][96]98,[100][101][102][130][131][132]138,139,141 G1P [8] and G2P [4] were the most common genotypes in Yemen and Egypt. 19,23,24,27,29,32,83,84,171,172 In Lebanon, the genotype distribution varied over time and geographical location: the G4P [8] type disappeared from the northern part of the country in two out of the three studied seasons, while the G2P [4] genotype did not.…”

Circulating rotavirus G and P strains post rotavirus vaccination in Eastern Mediterranean Region

“… 21 , 22 Three of these 5 studies investigated the rotavirus strains as pre- and post-vaccination, 2 in Yemen 19 , 20 and one in Morocco. 21 The studies that investigated the pre-vaccination rotavirus strain prevalence in other EMR countries are from Bahrain, 8 Egypt, 23 Kuwait, 10 Iran, 7 , 24 - 27 Iraq, 28 , 29 Jordan, 30 Saudi Arabia, 31 , 32 Libya, 33 Morocco, 21 , 34 , 35 Oman, 36 , 37 Yemen, 19 , 20 , 38 , 39 Tunisia, 40 - 44 and Pakistan. 45 - 49 We excluded other 8 countries of the EMR from this review (Sudan, Somalia, Afghanistan, Qatar, United Arab Emirates, Djibouti, Syria, and Lebanon) because there were no reports on circulating rotavirus strains among children under 5 years of age.…”

Gastroenteritis attributable to rotavirus in hospitalized Saudi Arabian children in the period 2007–2008

“…In this study, RV persisted throughout the year with no obvious peaks, which is consistent with earlier reports from Saudi Arabia 36 , 37 and other Middle Eastern countries. 33 , 38 , 39 However, another study conducted in Saudi Arabia between 2004 and 2005 reported a peak during the cooler months of November and December, with lowest infection rates in June, 40 whereas another study conducted in Bahrain between 2006 and 2007 reported RVGE peaks in April; 41 this might indicate differences in circulation from one year to the other.…”