Acute gastroenteritis associated with Rotavirus A among children less than 5 years of age in Nepal

Abstract

Background Rotavirus gastroenteritis is a major public health problem in Nepal. This study was conducted to obtain information associated with Rotavirus gastroenteritis and to perform genotyping of Rotavirus A. Methods Hospital based cross sectional study was conducted from January to December 2017 among children less than 5 years of age attending Kanti Children’s Hospital and Tribhuvan University Teaching Hospital. Rotavirus A antigen detection was performed by Enzyme Linked Immunosorbent Assay (ELISA) using ProSpecT Rotavirus Microplate Assay. Rotavirus A positive strains were further confirmed by genotyping using Reverse-Transcription Polymerase Chain Reaction (RT-PCR). Results A total of 1074 stool samples were collected, of them 770 were hospitalized, and 304 were non-hospitalized cases. Rotavirus A infection was found in 28% of children with infection rate higher in hospitalized (34%) than in non-hospitalized (14%) children. Rotavirus A detection was higher in male (31%) than in female (24%), but this was statistically not significant ( p > 0.05). Rotavirus A positivity was higher in children of age group 0–23 months, this result was statistically not significant ( p > 0.05) with higher frequency found in the months of November, December, January, February and March ( p < 0.05). On the basis of molecular analysis of Rotavirus A genotyping, G12P[6] (46.39%) was found to be the predominant followed by G1P[8] (35.05%), G3P[8] (7.21%) and G1P[6] (5.15%) while 4.12% was mixed infection and 1.03% was partially typed ( p < 0.05). Conclusion Rotavirus A infection occurred throughout the year, but the infection was significantly higher during the month of March. The higher frequency of rotavirus infection was observed among children of age group 0–23 months; however this was not found to be statistically significant. In this study, G12P[6] is predominant genotype observed. The results of genotyping are essential for the introduction of Rotavirus vaccine in Nepal. Electronic supplementary material The online version of this article (10.1186/s12879-019-4092-2) contains supplementary material, which is available to authorized users.

Clinical Characteristics of Rotavirus-Induced Gastroenteritis in Infants

“…Diarrhea in our study was present in all infants 100%, which is identical with the study of Shresth et al (12). In the study of Karampatsas et al in London, diarrhea was reported in 86% of cases (13), and in the study by Arístegui et al, the incidence of diarrhea was 97% (14).…”

“…In the study of Shresth et al, the infection was more prevalent in male (31%) than in female (24%) but without statistical significance (12). The results obtained by the RVGE analysis in London are compatible with our results.…”

“…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).…”

“…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). The lowest incidence of vomiting registered in the study of Shresth et al, was 36% (12).…”

“…A systematic review of RVGE in children under the age of five in Asia has determined that rotavirus is associated with approximately 145.000 deaths per year (12).…”