ROTASCORE STUDY: EPIDEMIOLOGICAL OBSERVATIONAL STUDY OF ACUTE GASTROENTERITIS WITH OR WITHOUT ROTAVIRUS IN GREEK CHILDREN YOUNGER THAN 5 YEARS
INTRODUCTION: Pediatric rotavirus gastroenteritis (PRG) is the most frequent cause of severe acute gastroenteritis (AGE) in children up to 5 years of age worldwide.
OBJECTIVE: We sought to determine the proportion of PRG and compare its clinical burden to that of AGE caused by other pathogens.
METHODS: The study was conducted in 4 hospital emergency units (HEUs) and 50 private pediatric clinics between January and May 2006. Children up to 5 years of age were included. A rapid stool immunochromatographic test for rotavirus antigen detection was performed. Symptom-severity scores were calculated by using the Clark scale.
RESULTS: Seven hundred and six children participated in the study (median age: 20 months; 385 boys [54.5%]); 273 patients (38.6%) visited HEUs, and 433 (61.4%) visited private clinics. The proportion of PRG was 29% (95% confidence interval [CI]: 25.9%–32.6%) in the total study group, 18.3% (95% CI: 14.9%–22.3%) in private clinics, 45.7% (95% CI: 40.0%–51.7%) in HEUs, and 49.1% in hospitalized patients (95% CI: 42.3%–55.7%). Most children with PRG (71.7%) were between 6 months and 3 years old. Behavioral changes and signs of dehydration, weight loss, fever at ≥38°C, diarrhea, and vomiting were more prevalent with PRG (P < .01). In children with PRG, a higher incidence of moderate or severe gastroenteritis (P = .013 and .021, respectively), hospitalization (P = .011), and need for a clinical reevaluation (P = .012) was observed, as was longer hospitalization (5.14 ± 3.18 vs 3.69 ± 2.25 days; P = .039).
CONCLUSIONS: PRG was responsible for nearly half the patients with AGE who visited HEUs or required hospitalization. Vaccination against rotavirus would help prevent this frequent and often severe disease.
Submitted by Vassiliki Papaevangelou
- Copyright © 2008 by the American Academy of Pediatrics