The Clinical Burden of Rotavirus Gastroenteritis: A Prospective Study

Abstract

BackgroundIn Saudi Arabia, there is a lack of recently published, appropriately conducted epidemiological studies on rotavirus (RV) diarrhea, which emphasizes the need for up-to-date and comprehensive studies.ObjectiveOur objective was to provide more recent data on the clinical and epidemiological characteristics as well as the economic burden of RV diarrhea among young children admitted to a tertiary care hospital in the city of Riyadh in the year prior to the initiation of the RV vaccine.DesignWe conducted a prospective observational study at a children’s specialized hospital at King Fahad Medical City. We included children under five years of age who were hospitalized for gastroenteritis over a 12-month period from January 2012 to December 2012. Stool samples were collected on admission and tested for the presence of RV using an enzyme immunoassay.ResultsOf the 204 children included over the study period (mean age, 9.8 months ± 10.2; 124 males), 102 (50%) were RV-positive. Two-thirds (69.6%) were under one year old, and 38.2% were under six months of age. RV infections occurred throughout the year, with the highest proportion occurring during the spring and summer. RV-positive diarrhea was more severe than the RV-negative diarrhea as indicated by a significantly lower bicarbonate level (68.6% versus 31.3%, P-value < 0.0001), a higher frequency of severe dehydration (11.7% versus 3%, P-value = 0.015), and longer hospital stay (mean duration, 8.78 versus 6.56 days, P-value = 0.027). In addition, the financial burden of the RV-positive cases was greater than the RV-negative cases (median 1692 USD versus 1287 USD, P-value = 0.001).ConclusionOur study shows a high prevalence of RV infections among young children admitted to the hospital for acute gastroenteritis. Furthermore, RV infections are associated with severe diarrhea and significant financial burden.

Clinical Characteristics of Rotavirus-Induced Gastroenteritis in Infants

“…In our study, vomiting, as a symptom of the disease, was present in 84% of infants with RVGE. The results similar to ours were obtained in their study by Nahari et al, where vomiting was reported as a symptom in 81.3% (15). A slightly lower incidence of vomiting was observed in the study of Karampatsas et al, where it was 74% (13) and in the study by Arístegui et al, where it was 69.1% (14).…”

“…In our study, Rotavirus infection occurred throughout, with statistically significant occurrence in March. The results of compatibility with ours were obtained by Shrestha et al who conducted his research in the territory of Nepal (12), Aristegui et al in the territory of Spain (14), as well as Nahari et al in the territory of Saudi Arabia (15). Different results from ours were reported in Thailand, where the highest incidence was recorded in the summer months (16) as well as during the summer rains in Ethiopia (17).…”

“…In the study by Konda et al, conducted in the territory of Japan, the gender distinction is also without a statistically significant difference (19). The compatible results were obtained in the study by Aristegui et al, where there was a higher male representation with 51.9% (14), as in the study by Nahari et al, where there was a higher male representation with 66.6% (15). Some authors in the youngest age group of 0-5 months either do not have the disease or their number is very low.…”

“…An identical incidence of fever was registered in the study conducted by Karampatsas et al (13). In the study of Nahari et al, fever was observed in 81.3% of cases (15), while slightly lower incidences were reported in the study by Arístegui et al, 69.1% (14), and a significantly lower incidence of fever was registered in the study of Shresth et al, where it was present in 25% of RVGE cases (12).…”

“…Gurwith et al do not have patients at all at that age (20). Holdaway et al have a frequency of RVGE in the youngest age group of 4.7% (21), while in the study of Nahari et al, the incidence of less than 6 months among the patients with RVGE was 38.2% (15).…”