Skip to main content
Top
Published in: BMC Pediatrics 1/2010

Open Access 01-12-2010 | Research article

Prevalence and factors associated with rotavirus infection among children admitted with acute diarrhea in Uganda

Authors: Jane S Nakawesi, Eric Wobudeya, Grace Ndeezi, Edison A Mworozi, James K Tumwine

Published in: BMC Pediatrics | Issue 1/2010

Login to get access

Abstract

Background

Rotavirus remains the commonest cause of severe dehydrating diarrhea among children worldwide. Children in developing countries die more because of several factors including poorer access to hydration therapy and greater prevalence of malnutrition. Hitherto, the magnitude of rotavirus disease in Uganda has remained unknown. This study was therefore done to determine the prevalence and factors associated with rotavirus infection among children aged 3-59 months admitted with acute diarrhea to paediatric emergency ward of Mulago Hospital, Uganda

Methods

Three hundred and ninety children, aged between 3-59 months with acute diarrhoea were recruited. The clinical history, socio-demographic characteristics, physical examination findings and laboratory investigations were recorded. Stool samples were tested for rotavirus antigens using the DAKO IDEIA rotavirus EIA detection kit.

Results

The prevalence of rotavirus infection was 45.4%. On multivariate analysis rotavirus was significantly associated with a higher education (above secondary) level of the mother [OR 1.8; 95% CI 1.1-2.7]; dehydration [OR 1.8; 95% CI 1.1-3.0] and breastfeeding [OR 2.6; 95% CI 1.4-4.0]. Although age was significantly associated with rotavirus on bivariate analysis; this association disappeared on multivariate analysis. No significant association was found between rotavirus infection and nutritional status, HIV status and attendance of day care or school.

Conclusions

Rotavirus infection is highly prevalent among children with acute diarrhoea admitted to Mulago Hospital in Uganda.
Literature
1.
go back to reference WHO: Global networks for surveillance of rotavirus gastroenteritis, 2001-2008. Weekly epidemiological report. 2008, 83 (47): 421-425. WHO: Global networks for surveillance of rotavirus gastroenteritis, 2001-2008. Weekly epidemiological report. 2008, 83 (47): 421-425.
3.
go back to reference Binka FN, Anto FK, Oduro AR, Awini EA, Nazzar AK, Armah GE, Asmah RH, Hall AJ, Cutts F, Alexander N, et al: Incidence and risk factors of paediatric rotavirus diarrhoea in northern Ghana. Trop Med Int Health. 2003, 8 (9): 840-846. 10.1046/j.1365-3156.2003.01097.x.CrossRefPubMed Binka FN, Anto FK, Oduro AR, Awini EA, Nazzar AK, Armah GE, Asmah RH, Hall AJ, Cutts F, Alexander N, et al: Incidence and risk factors of paediatric rotavirus diarrhoea in northern Ghana. Trop Med Int Health. 2003, 8 (9): 840-846. 10.1046/j.1365-3156.2003.01097.x.CrossRefPubMed
4.
go back to reference Parashar UD, Burton A, Lanata C, Boschi-Pinto C, Shibuya K, Steele D, Birmingham M, Glass RI: Global mortality associated with rotavirus disease among children in 2004. J Infect Dis. 2009, 200 (Suppl 1): S9-S15. 10.1086/605025.CrossRefPubMed Parashar UD, Burton A, Lanata C, Boschi-Pinto C, Shibuya K, Steele D, Birmingham M, Glass RI: Global mortality associated with rotavirus disease among children in 2004. J Infect Dis. 2009, 200 (Suppl 1): S9-S15. 10.1086/605025.CrossRefPubMed
5.
go back to reference Aparecido Nunes A, Marques de Mello L, Neiva Parrode R, Paulo Maneira Bittar J, Luiz da Silva Domingues A: Prevalence of Rotavirus in Acute Diarrhea and its Association with Clinical Signs and Symptoms. J Trop Pediatr. 2009, 56 (3): 212-213. 10.1093/tropej/fmp091.CrossRef Aparecido Nunes A, Marques de Mello L, Neiva Parrode R, Paulo Maneira Bittar J, Luiz da Silva Domingues A: Prevalence of Rotavirus in Acute Diarrhea and its Association with Clinical Signs and Symptoms. J Trop Pediatr. 2009, 56 (3): 212-213. 10.1093/tropej/fmp091.CrossRef
6.
go back to reference Ceyhan M, Alhan E, Salman N, Kurugol Z, Yildirim I, Celik U, Keser M, Koturoglu G, Tezer H, Bulbul EK, et al: Multicenter prospective study on the burden of rotavirus gastroenteritis in Turkey, 2005-2006: a hospital-based study. J Infect Dis. 2009, 200 (Suppl 1): S234-238. 10.1086/605056.CrossRefPubMed Ceyhan M, Alhan E, Salman N, Kurugol Z, Yildirim I, Celik U, Keser M, Koturoglu G, Tezer H, Bulbul EK, et al: Multicenter prospective study on the burden of rotavirus gastroenteritis in Turkey, 2005-2006: a hospital-based study. J Infect Dis. 2009, 200 (Suppl 1): S234-238. 10.1086/605056.CrossRefPubMed
7.
go back to reference de Oliveira LH, Danovaro-Holliday MC, Andrus JK, de Fillipis AM, Gentsch J, Matus CR, Widdowson MA: Sentinel hospital surveillance for rotavirus in latin american and Caribbean countries. J Infect Dis. 2009, 200 (Suppl 1): S131-139. 10.1086/605060.CrossRefPubMed de Oliveira LH, Danovaro-Holliday MC, Andrus JK, de Fillipis AM, Gentsch J, Matus CR, Widdowson MA: Sentinel hospital surveillance for rotavirus in latin american and Caribbean countries. J Infect Dis. 2009, 200 (Suppl 1): S131-139. 10.1086/605060.CrossRefPubMed
8.
go back to reference Duan ZJ, Liu N, Yang SH, Zhang J, Sun LW, Tang JY, Jin Y, Du ZQ, Xu J, Wu QB, et al: Hospital-Based Surveillance of Rotavirus Diarrhea in the People's Republic of China, August 2003-July 2007. J Infect Dis. 2009, 200 (Suppl 1): S167-173. 10.1086/605039.CrossRefPubMed Duan ZJ, Liu N, Yang SH, Zhang J, Sun LW, Tang JY, Jin Y, Du ZQ, Xu J, Wu QB, et al: Hospital-Based Surveillance of Rotavirus Diarrhea in the People's Republic of China, August 2003-July 2007. J Infect Dis. 2009, 200 (Suppl 1): S167-173. 10.1086/605039.CrossRefPubMed
9.
go back to reference Eesteghamati A, Gouya M, Keshtkar A, Najafi L, Zali MR, Sanaei M, Yaghini F, El Mohamady H, Patel M, Klena JD, et al: Sentinel hospital-based surveillance of rotavirus diarrhea in iran. J Infect Dis. 2009, 200 (Suppl 1): S244-247. 10.1086/605050.CrossRefPubMed Eesteghamati A, Gouya M, Keshtkar A, Najafi L, Zali MR, Sanaei M, Yaghini F, El Mohamady H, Patel M, Klena JD, et al: Sentinel hospital-based surveillance of rotavirus diarrhea in iran. J Infect Dis. 2009, 200 (Suppl 1): S244-247. 10.1086/605050.CrossRefPubMed
10.
go back to reference Flem ET, Kasymbekova KT, Vainio K, Gentsch J, Abdikarimov ST, Glass RI, Bresee JS: Rotavirus infection in hospitalized children and estimates of disease burden in Kyrgyzstan, 2005-2007. Vaccine. 2009, 27 (Suppl 5): F35-39. 10.1016/j.vaccine.2009.08.087.CrossRefPubMed Flem ET, Kasymbekova KT, Vainio K, Gentsch J, Abdikarimov ST, Glass RI, Bresee JS: Rotavirus infection in hospitalized children and estimates of disease burden in Kyrgyzstan, 2005-2007. Vaccine. 2009, 27 (Suppl 5): F35-39. 10.1016/j.vaccine.2009.08.087.CrossRefPubMed
11.
go back to reference Kenya-Mugisha: Some aetiological factors in acute diarrhoea in children at Mulago Hospital. Dissertation. 1987, Kampala: Makerere University(Unpublished) Kenya-Mugisha: Some aetiological factors in acute diarrhoea in children at Mulago Hospital. Dissertation. 1987, Kampala: Makerere University(Unpublished)
12.
go back to reference Kiulia NM, Kamenwa R, Irimu G, Nyangao JO, Gatheru Z, Nyachieo A, Steele AD, Mwenda JM: The epidemiology of human rotavirus associated with diarrhoea in Kenyan children: a review. J Trop Pediatr. 2008, 54 (6): 401-405. 10.1093/tropej/fmn052.CrossRefPubMed Kiulia NM, Kamenwa R, Irimu G, Nyangao JO, Gatheru Z, Nyachieo A, Steele AD, Mwenda JM: The epidemiology of human rotavirus associated with diarrhoea in Kenyan children: a review. J Trop Pediatr. 2008, 54 (6): 401-405. 10.1093/tropej/fmn052.CrossRefPubMed
13.
go back to reference Mpabalwani M, Oshitani H, Kasolo F, Mizuta K, Luo N, Matsubayashi N, Bhat G, Suzuki H, Numazaki Y: Rotavirus gastro-enteritis in hospitalized children with acute diarrhoea in Zambia. Ann Trop Paediatr. 1995, 15 (1): 39-43.PubMed Mpabalwani M, Oshitani H, Kasolo F, Mizuta K, Luo N, Matsubayashi N, Bhat G, Suzuki H, Numazaki Y: Rotavirus gastro-enteritis in hospitalized children with acute diarrhoea in Zambia. Ann Trop Paediatr. 1995, 15 (1): 39-43.PubMed
14.
go back to reference Odimayo MS, Olanrewaju WI, Omilabu SA, Adegboro B: Prevalence of rotavirus-induced diarrhea among children under 5 years in Ilorin, Nigeria. J Trop Pediatr. 2008, 54 (5): 343-346. 10.1093/tropej/fmn081.CrossRefPubMed Odimayo MS, Olanrewaju WI, Omilabu SA, Adegboro B: Prevalence of rotavirus-induced diarrhea among children under 5 years in Ilorin, Nigeria. J Trop Pediatr. 2008, 54 (5): 343-346. 10.1093/tropej/fmn081.CrossRefPubMed
15.
go back to reference Wu FT, Liang SY, Tsao KC, Huang CG, Lin CY, Lin JS, Su CY, Eng HL, Yang JY, Chen PJ, et al: Hospital-based surveillance and molecular epidemiology of rotavirus infection in Taiwan, 2005-2007. Vaccine. 2009, 27 (Suppl 5): F50-54. 10.1016/j.vaccine.2009.08.090.CrossRefPubMed Wu FT, Liang SY, Tsao KC, Huang CG, Lin CY, Lin JS, Su CY, Eng HL, Yang JY, Chen PJ, et al: Hospital-based surveillance and molecular epidemiology of rotavirus infection in Taiwan, 2005-2007. Vaccine. 2009, 27 (Suppl 5): F50-54. 10.1016/j.vaccine.2009.08.090.CrossRefPubMed
16.
go back to reference Albano F, Bruzzese E, Bella A, Cascio A, Titone L, Arista S, Izzi G, Virdis R, Pecco P, Principi N, et al: Rotavirus and not age determines gastroenteritis severity in children: a hospital-based study. Eur J Pediatr. 2007, 166 (3): 241-247. 10.1007/s00431-006-0237-6.CrossRefPubMed Albano F, Bruzzese E, Bella A, Cascio A, Titone L, Arista S, Izzi G, Virdis R, Pecco P, Principi N, et al: Rotavirus and not age determines gastroenteritis severity in children: a hospital-based study. Eur J Pediatr. 2007, 166 (3): 241-247. 10.1007/s00431-006-0237-6.CrossRefPubMed
17.
go back to reference de Wit MA, Koopmans MP, van der Blij JF, van Duynhoven YT: Hospital admissions for rotavirus infection in the Netherlands. Clin Infect Dis. 2000, 31 (3): 698-704. 10.1086/314025.CrossRefPubMed de Wit MA, Koopmans MP, van der Blij JF, van Duynhoven YT: Hospital admissions for rotavirus infection in the Netherlands. Clin Infect Dis. 2000, 31 (3): 698-704. 10.1086/314025.CrossRefPubMed
18.
go back to reference Dennehy PH, Cortese MM, Begue RE, Jaeger JL, Roberts NE, Zhang R, Rhodes P, Gentsch J, Ward R, Bernstein DI, et al: A case-control study to determine risk factors for hospitalization for rotavirus gastroenteritis in U.S. children. Pediatr Infect Dis J. 2006, 25 (12): 1123-1131. 10.1097/01.inf.0000243777.01375.5b.CrossRefPubMed Dennehy PH, Cortese MM, Begue RE, Jaeger JL, Roberts NE, Zhang R, Rhodes P, Gentsch J, Ward R, Bernstein DI, et al: A case-control study to determine risk factors for hospitalization for rotavirus gastroenteritis in U.S. children. Pediatr Infect Dis J. 2006, 25 (12): 1123-1131. 10.1097/01.inf.0000243777.01375.5b.CrossRefPubMed
19.
go back to reference Sethi D, Cumberland P, Hudson MJ, Rodrigues LC, Wheeler JG, Roberts JA, Tompkins DS, Cowden JM, Roderick PJ: A study of infectious intestinal disease in England: risk factors associated with group A rotavirus in children. Epidemiol Infect. 2001, 126 (1): 63-70. 10.1017/S0950268801005088.CrossRefPubMedPubMedCentral Sethi D, Cumberland P, Hudson MJ, Rodrigues LC, Wheeler JG, Roberts JA, Tompkins DS, Cowden JM, Roderick PJ: A study of infectious intestinal disease in England: risk factors associated with group A rotavirus in children. Epidemiol Infect. 2001, 126 (1): 63-70. 10.1017/S0950268801005088.CrossRefPubMedPubMedCentral
20.
go back to reference Cunliffe NA, Gondwe JS, Kirkwood CD, Graham SM, Nhlane NM, Thindwa BD, Dove W, Broadhead RL, Molyneux ME, Hart CA: Effect of concomitant HIV infection on presentation and outcome of rotavirus gastroenteritis in Malawian children. Lancet. 2001, 358 (9281): 550-555. 10.1016/S0140-6736(01)05706-3.CrossRefPubMed Cunliffe NA, Gondwe JS, Kirkwood CD, Graham SM, Nhlane NM, Thindwa BD, Dove W, Broadhead RL, Molyneux ME, Hart CA: Effect of concomitant HIV infection on presentation and outcome of rotavirus gastroenteritis in Malawian children. Lancet. 2001, 358 (9281): 550-555. 10.1016/S0140-6736(01)05706-3.CrossRefPubMed
21.
go back to reference WHO: Rotavirus Vaccines;an update. Weekly epidimiological record. 2009, 84 (51-52): 537- WHO: Rotavirus Vaccines;an update. Weekly epidimiological record. 2009, 84 (51-52): 537-
22.
go back to reference WHO: WHO vaccine -preventable diseases:monitoring system 2009 global summary. Geneva: Immunisation, Vaccines and Biologicals. 2009, 29- WHO: WHO vaccine -preventable diseases:monitoring system 2009 global summary. Geneva: Immunisation, Vaccines and Biologicals. 2009, 29-
23.
go back to reference WHO: Readings on Diarrhoea:student manual. Geneva. 1992, 10- WHO: Readings on Diarrhoea:student manual. Geneva. 1992, 10-
24.
go back to reference Snedecor GW, Cochran WG: Statistical Methods. 1989, Ames, Iowa Iowa State University Press, 52: Snedecor GW, Cochran WG: Statistical Methods. 1989, Ames, Iowa Iowa State University Press, 52:
25.
go back to reference Banerjee I, Ramani S, Primrose B, Moses P, Iturriza-Gomara M, Gray JJ, Jaffar S, Monica B, Muliyil JP, Brown DW: Comparative study of the epidemiology of rotavirus in children from a community-based birth cohort and a hospital in South India. Journal of Clin microbiol. 2006, 44 (7): 2468-2474. 10.1128/JCM.01882-05.CrossRef Banerjee I, Ramani S, Primrose B, Moses P, Iturriza-Gomara M, Gray JJ, Jaffar S, Monica B, Muliyil JP, Brown DW: Comparative study of the epidemiology of rotavirus in children from a community-based birth cohort and a hospital in South India. Journal of Clin microbiol. 2006, 44 (7): 2468-2474. 10.1128/JCM.01882-05.CrossRef
26.
go back to reference Golding J, Emmett PM, Rogers IS: Gastroenteritis, diarrhoea and breast feeding. Early Hum Dev. 1997, 49 (Suppl): S83-103. 10.1016/S0378-3782(97)00055-8.CrossRefPubMed Golding J, Emmett PM, Rogers IS: Gastroenteritis, diarrhoea and breast feeding. Early Hum Dev. 1997, 49 (Suppl): S83-103. 10.1016/S0378-3782(97)00055-8.CrossRefPubMed
27.
go back to reference Glass RI, Stoll BJ: The protective effect of human milk against diarrhea. A review of studies from Bangladesh. Acta Paediatr Scand Suppl. 1989, 351: 131-136. 10.1111/j.1651-2227.1989.tb11225.x.CrossRefPubMed Glass RI, Stoll BJ: The protective effect of human milk against diarrhea. A review of studies from Bangladesh. Acta Paediatr Scand Suppl. 1989, 351: 131-136. 10.1111/j.1651-2227.1989.tb11225.x.CrossRefPubMed
28.
go back to reference Clemens J, Rao M, Ahmed F, Ward R, Huda S, Chakraborty J, Yunus M, Khan MR, Ali M, Kay B, et al: Breast-feeding and the risk of life-threatening rotavirus diarrhea: prevention or postponement?. Pediatrics. 1993, 92 (5): 680-685.PubMed Clemens J, Rao M, Ahmed F, Ward R, Huda S, Chakraborty J, Yunus M, Khan MR, Ali M, Kay B, et al: Breast-feeding and the risk of life-threatening rotavirus diarrhea: prevention or postponement?. Pediatrics. 1993, 92 (5): 680-685.PubMed
29.
go back to reference Naficy AB, Abu-Elyazeed R, Holmes JL, Rao MR, Savarino SJ, Kim Y, Wierzba TF, Peruski L, Lee YJ, Gentsch JR, et al: Epidemiology of rotavirus diarrhea in Egyptian children and implications for disease control. Am J Epidemiol. 1999, 150 (7): 770-777.CrossRefPubMed Naficy AB, Abu-Elyazeed R, Holmes JL, Rao MR, Savarino SJ, Kim Y, Wierzba TF, Peruski L, Lee YJ, Gentsch JR, et al: Epidemiology of rotavirus diarrhea in Egyptian children and implications for disease control. Am J Epidemiol. 1999, 150 (7): 770-777.CrossRefPubMed
30.
go back to reference Glass RI, Stoll BJ, Wyatt RG, Hoshino Y, Banu H, Kapikian AZ: Observations questioning a protective role for breast-feeding in severe rotavirus diarrhea. Acta Paediatr Scand. 1986, 75 (5): 713-718. 10.1111/j.1651-2227.1986.tb10279.x.CrossRefPubMed Glass RI, Stoll BJ, Wyatt RG, Hoshino Y, Banu H, Kapikian AZ: Observations questioning a protective role for breast-feeding in severe rotavirus diarrhea. Acta Paediatr Scand. 1986, 75 (5): 713-718. 10.1111/j.1651-2227.1986.tb10279.x.CrossRefPubMed
31.
go back to reference EPI: Rotavirus Sentinel Surveillance Report. 2007, Ministry of Health, Uganda EPI: Rotavirus Sentinel Surveillance Report. 2007, Ministry of Health, Uganda
Metadata
Title
Prevalence and factors associated with rotavirus infection among children admitted with acute diarrhea in Uganda
Authors
Jane S Nakawesi
Eric Wobudeya
Grace Ndeezi
Edison A Mworozi
James K Tumwine
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2010
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-10-69

Other articles of this Issue 1/2010

BMC Pediatrics 1/2010 Go to the issue