Prevalence and factors associated with rotavirus infection among children admitted with acute care diarrhoea in Mulago hospital

Abstract

BACKGROUND: Rotavirus remains the most common cause of severe dehydration diarrhoea among children worldwide. By five years of age, almost all children will have had an episode of rotavirus gastroenteritis. Children in developing countries die more because of severe factors including poorer access to hydration therapy and greater prevalence of malnutrition. The magnitude of rotavirus disease in Uganda is not known. OBJECTIVE: To determine the prevalence and factors associated with rotavirus infection among children 3-59 months admitted with acute diarrhoea to Acute Care Unit (acu) of Mulago hospital METHODS: Three hundred ninety children, aged between 3-59 months with acute diarrhoea were recruited consecutively after consent by the caretakers. Records of clinical history, sociodemographic characteristics, physical examination and laboratory investigations were recorded on a precoded questionnaire. Stool samples were tested for presence of rotavirus antigens using the EIA kit (DAKO IDELA) rotavirus EIA detection kit) STUDY RESULTS: The prevalence of rotavirus infection was 45.4%. On multivariate analysis rotavirus was significantly associated with a higher education (above secondary) level of caretaker (p=0.003), more than 4 people in the house (p=0.025) and breast feeding (p=0.017). Age was significantly associated with rotavirus on bivariate analysis but 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. CONCLUSION AND RECOMMENDATIONS: Rotavirus infection is highly prevalent among children with acute diarrhoea admitted to ACU Mulago Hospital. A rotavirus vaccine is therefore recommended and a community based study to identify the type of rotavirus strains circulating in Uganda is needed so that an appropriate vaccine can be used if a decision to give the vaccine is made.