Two-Year Prevalence of Rotavirus Among Under-Five Children Admitted with Acute Gastroenteritis in Andhra Pradesh, India.

OBJECTIVE: To estimate the burden of rotavirus diarrhea among under-five children admitted with acute gastroenteritis and to identify genotypes of rotavirus among positive rotavirus cases. METHODS: This is a cross-sectional study conducted from August 2017 to July 2019 in Government General Hospital and 5 private pediatric nursing homes (Padma Children's Hospital, Mother and Child Hospital, Chandamama Children's Hospital, Vennela Hospital) in Kakinada. Children admitted to the pediatric ward with acute gastroenteritis were included in this study. Stool samples were collected from all these children and tested for rotavirus by enzyme-linked immunosorbent assay and the positive samples were genotyped using reverse transcriptase polymerase chain reaction. RESULTS: Rotavirus diarrhea was seen in 7.4% of children among all diarrhea admissions. The mean age of the rotavirus-positive children was 13.1 ± 10 mo. The most common genotype in 2017 was G3P[8], and that in 2018 and 2019 was the mixed genotype. CONCLUSION: In this study, mixed genotype was found to be most common.

Rotavirus Gastroenteritis Hospitalizations Among Under-Five Children in Bhubaneswar, Odisha, India.

OBJECTIVE: To report rotavirus-associated AGE (AGE) profile of admitted children among vaccine-introduced areas in Bhubaneswar, Odisha. METHODS: This study was conducted between 2016 and 2019 at the Capital Hospital, Jagannath hospital and Hi-Tech Medical College and Hospital. All AGE patients below five years old, hospitalized in the study facilities were enrolled. A stool sample was collected and transported to the central laboratory (Christian Medical College, Vellore) for rotavirus antigen detection and genotyping. Clinical and demographic information was collected using a predesigned case report format (CRF). RESULTS: Out of the 1213 stool samples, 447 (36.9%) were identified to have rotavirus with 350 (78.3%) of them belonging to 6 mo to 2 y age group. Rotavirus gastroenteritis exhibited a single peak from November to February. A total of 414 (92.6%) of rotavirus gastroenteritis children had severe or very severe dehydration with odds of rotavirus diarrhea leading to severe dehydration being 1.5 (95% CI, 1-2.4) compared to moderate dehydration. The common genotype combination was G3P[8] (46%) followed by G1P[8] (19%), G2P[4] (5%), and G9P[4] (3%). CONCLUSION: Rotavirus gastroenteritis peaked between December to February while the most common genotype combination among the rotavirus GE was G3P[8] and G1P[8]. The present study provides the clinical profile of admitted children in the hospitals with diarrhea and the circulating strains of rotavirus which will help in documenting the epidemiology and the performance of vaccine against the disease in the state.

Epidemiology of Intussusception Hospitalizations in Children Under 2 Years of Age Post Rotavirus Vaccine Introduction in Tamil Nadu and Puducherry, India.

OBJECTIVE: High burden of rotavirus associated diarrhea has been documented among Indian children. The phased introduction of an indigenous rotavirus vaccine 'ROTAVAC' in India's national immunization programme began in 2017. Phase-III trial showed the vaccine to have a low-intussusception-risk profile. However, evaluation of post-licensure trends of intussusception is necessary to assess potential vaccine-associated intussusception risk. This study's objective was to describe the epidemiology of intussusception hospitalizations in children under two years of age in Tamil Nadu and Puducherry following ROTAVAC introduction. METHODS: A cross-sectional surveillance was established in six hospitals in Tamil Nadu and Puducherry. Children under two years of age with intussusception fulfilling Brighton Collaboration's criteria for level 1 diagnostic certainty were enrolled. Patient and disease characteristics were captured using a standardized questionnaire. Descriptive and inferential statistical analyses were performed using Stata Version 13. RESULTS: Overall, 287 cases were enrolled and had a median age of seven months. Frequently presenting symptoms were vomiting (78%), abdominal pain (76%), and blood in stool (71%). Abdominal ultrasonography or radiography confirmed diagnosis in 65% of cases and managed by nonoperative measures. Remaining 35% of cases were diagnosed and managed with surgery. Over 98% of the cases had positive treatment outcomes. Age less than five months (OR = 4.36), and hospitalization at a state government health facility (OR = 5.01) were significant predictors for children to receive surgical management. CONCLUSIONS: The present study documents the epidemiology of intussusceptions immediately after the rollout of rotavirus vaccine in Tamil Nadu and Puducherry. No appreciable increase in intussusception hospitalizations was seen in the study hospitals after vaccine introduction.