Prevalence of severe rotavirus associated gastroenteritis among children under five years of age in Chennai, India

      Background: Rotavirus is the major cause of severe gastroenteritis affecting infants and young children globally. The Indian Council of Medical Research funded National Rotavirus Surveillance Network carries out hospital based surveillance to estimate the prevalence of rotavirus among children under 5 years of age hospitalized with gastroenteritis in different parts of India, adding new facilities as needed for surveillance. In this report, we present findings from the first year of surveillance carried out in the largest pediatric care facility in Chennai, a metropolis in southern India.
      Methods & Materials: Children under five years of age admitted with acute gastroenteritis were screened and eligible children were enrolled. A standardized clinical recruitment form was used to collect demographic and clinical details and treatment outcome. Stool specimens were screened for Group A Rotavirus by ELISA and G and P genotyping was carried out on a subset of positive samples using hemi-nested reverse transcription PCR.
      Results: During the 13-month period between July 2014 and August 2015, 759 eligible children were enrolled. Stool specimens from 670 children were tested and group A rotavirus was detected in 32.1%. Age-wise analysis showed that the highest positivity (39%) was seen among children aged 12-23 months followed by children aged 6-11 months (36.5%). Most rotavirus infections occurred during December to February (48.9%). Among rotavirus infected children, 87% had vomiting and 77.2% had ≥ 6 diarrheal episodes in a 24h period. Diarrhea disease severity analysis using Vesikari score revealed that 65.6% of rotavirus infected children had severe to very severe disease. G1P[8] (67.6%) was the most common rotavirus genotype followed by G9P[4] (19.1%).
      Conclusion: Surveillance data documents the high burden of severe rotavirus associated gastroenteritis among young children in Chennai and underscores the importance of rotavirus vaccination in tackling this major public health problem.