A prospective hospital based surveillance to estimate rotavirus disease burden in Bhutanese children under 5 years of age

ABSTRACT

To develop aninformed policy for rotavirus vaccination, this prospective study was conductedto estimate the burden of rotavirus diarrhea among children less than 5 years oldattending the Department of Pediatrics, Jigme Dorji Wangchuk National ReferralHospital (JDWNRH), Thimphu, Bhutan. The duration of the study was three years, extendingfrom February 2010 through December 2012. We estimated the frequency of hospitalizationin pediatric ward and Dehydration Treatment Unit (DTU) for diarrhea and thenumber of events attributable to rotavirus infection among children under 5years of age. During the study period, a total of 284 children (1 in 45) werehospitalized in pediatric ward, and 2,220 children (1 in 6 children)  in Dehydration Treatment Unit (DTU) withdiarrhea among children residing in the Thimphu district. Group A rotavirus was detected in 32.5% of the stoolsamples from the hospitalized children in pediatric ward and 18.8% in DTU withdiarrhea. Overall, 22.3% of the stool samples were rotavirus-positive, and the majority(90.8%) of them was detected in children under 2 years of age. From this study,we estimated that the annual incidence of hospitalization in ward and DTU s dueto rotavirus diarrhea was 2.4/1000 (95% CI 1.7–3.4) and 10.8/1000 (95% CI9.1–12.7) children, respectively. This study revealed that rotavirus is a majorcause of diarrhea in Bhutanese children in Thimphu district and represents animportant finding to policy discussions regarding the adoption of a rotavirusvaccine in Bhutan since no study has been performed previously.