Burden of rotavirus acute gastroenteritis in children under 5 years - - PowerPoint PPT Presentation

Burden of rotavirus acute gastroenteritis in children under 5 years at Komfo Anokye Teaching Hospital,

Sandra K Owusu, Daniel Ansong Richard Kwarteng Owusu Samuel Blay Nguah, Justice Sylverken A Osei-Akoto E Addo -Yobo

Introduction

• Rotavirus is the most common cause of severe acute

gastroenteritis in infants and young children worldwide.

• It is estimated to account for 39% of all diarrhoeal

deaths, this amounts to approximately half a million deaths each year among children aged under 5 years.

• Greater than 80% of diarrhoeal deaths occurring in the

developing countries.

• Acute gastroenteritis caused by rotavirus is a frequent

cause of admission and nosocomial infection in children who are hospitalized for reasons other than

diarrhoea.

Design:

• A prospective cross-sectional study was

conducted in the Komfo Anokye Teaching Hospital between October 2007 and January 2008.

• The study collected history of

illness, stools and followed up all children reporting with diarrhoea defined as three or more episodes of loose watery stool within 24 hours period.

Inclusion and Exclusion criteria

• Children

under five years who presented with gastroenteritis lasting less than seven days -defined as an episode of at least three (3) loose or watery stools, or forceful vomiting in a 24-hr period in the 7 days before the medical visit.

• Children less than five years whose parents and or

guardians refused to consent to their participation were excluded.

• Children with previous diagnosis of chronic disease of

the (GIT) Gastrointestinal tract for which symptoms are compatible with the definition of acute gastroenteritis were also be excluded from the study.

• Methods: Sites
• KATH, Department of Child Health, has 200 beds

with bed occupancy rate between 80 to 120%. The monthly admission to the PEU averages 450 children

• About 40% of these cases are children under five
• years. ;;;;;;

RESEARCH QUESTIONS 1.What are the socio-demographic characteristics

• f children with acute gastroenteritis?

2.What is the percentage of Rotavirus in children with acute gastroenteritis at Komfo Anokye Teaching hospital? 3.How do patients with Rotavirus gastroenteritis commonly present?

GENERAL OBJECTIVE To determine the prevalence of Rotavirus infection in children under five years with acute gastroenteritis at Komfo Anokye Teaching Hospital. SPECIFIC OBJECTIVES

• To determine the socio-demographic characteristics of

children with acute gastroenteritis at KATH

• To determine the percentage of rotavirus acute

gastroenteritis at KATH

• To identify the common presentations of children with

Rotavirus acute gastroenteritis

Demographic Characteristics of the Study subjects

Characteristi cs Number(%) Positive N(%) Negative N(%) P-Value Sex Male 39(50.6) 21(53.9) 18(46.2) Female 38(49.4) 25(65.8) 13(34.2) Total 77(100) 46(59.7) 31(40.3) 0.29 Age 0-6mths 22(28.6) 15(68.2) 7(31.8) 7-12mths 31(40.3) 17(54.8) 14(45.2) 13-24mths 18(23.4) 12(66.7) 6(33.3) >24mths 6(7.8) 2(33.3) 4(66.7)

Social characteristics of the study subjects

Education Number( %) Positive N(%) Negative N(%) P-Value No Formal 4(5.2) 3(75.0) 1(25.0) Primary 17(22.1) 10(58.8) 7(41.2) JSS 28(36.4) 16(57.1) 12(41.2) SSS 14(18.2) 8(57.1) 6(42.9) Tertiary 14(18.2) 9(64.3) 5(35.7) Total 77(100) 46(59.7) 31(40.3) 0.96

Occupation

Occupation Number(%) Positive N(%) Negative N(%) P-Value Trader 27(35.1) 14(51.9) 13(48.1) Seamstress 2(2.6) 2(100) 0(0) Hairdresser 8(10.4) 7(87.5) 1(12.5) Teacher 22(29.9) 13(59.1) 9(40.9) Unemployed 8(23.0) 5(62.5) 3(37.5) Other 10(13.0) 5(50.0) 5(50.0) Total 77(100) 31(40.3) 46(59.7) 0.41

Source of drinking water

Source

• f water

Number( %) Positive N(%) Negative N(%) P-Value Pipe 54(70.1) 36(66.7) 18(33.3) Open well 7(9.1) 3(42.9) 4(57.1) Borehole 9(11.7) 4(44.4) 5(55.6) Stream water 1(1.3) 0(0) 1(100) Other 6(7.8) 3(50.0) 3(50.0) Total 77(100) 46(59.7) 31(40.3) 0.34

Results

Figure 1: Results of stools samples tested for presence of rotavirus

57% 43% Positive Negative

Relationship between clinical features and presence of rotavirus infection

Characteristics Number(%) Positive N(%) Negative N(%) P-Value

Fever Yes 54(100) 33(61.1) 21(38.9) No 21(100) 11(52.4) 10(47.6) Total 75(100) 44(58.7) 31(41.3) 0.37 Dehydration None 22(100) 13(59.1) 9(40.9) Some 33(100) 19(57.6) 14(42.4) Severe 20(100) 12(60) 8(40.0) Total 75(100) 44(58.7) 31(41.3) 0.36 Vomiting Yes 14(100) 7(50.0) 7(50.0) No 61(100) 37(60.7) 24(39.3) Total 75(100) 44(58.7) 31(41.3) 0.54

Discussion

• Prevalence of Rotavirus gastroenteritis
• Common Presentations of children with

Rotavirus Gastroenteritis

• Demographic Characteristics and

Rotavirus Prevalence

• Maternal Educational Level and

Occupation

• Conclusion
• The study has demonstrated that rotavirus is an

important cause of diarrhoea in the study area.

• Younger children were the most affected group.

The study did not show any relationship to other clinical symptoms.

CONCLUSION

• 1.

Rotavirus acute gastroenteritis is common in Komfo Anokye Teaching Hospital.

• 2.

Children less than 24 months are the age group most affected.

• 3.

Severe dehydration due to rotavirus acute gastroenteritis is common.

• 4.

Socioeconomic characteristic of care givers was not found to be a statistically significant factor.

Recommendation

1.A bigger study on a large scale considering the rural and urban distribution

• f the disease as well as the impact of the disease on the children will be
• helpful. This would enable us estimate the true burden of the disease in

both settings. Such information would be used for policy formulation and planning towards disease prevention. 2.Since studies has shown that maternal socio-economic status does not impact on the prevalence of the disease. Efforts should be directed towards Maternal Education on the home management of diarrohea across all levels

• f socioeconomic class.

3.The high prevalence of rotavirus acute gastroenteritis at this tertiary care center may indicate the need to consider rotavirus vaccination as part of

• ur Expanded Programme on Immunization.

Recommendation

• Study to evaluate the association

between presence of antigenemia and severity of rotavirus diarrhoea.

Acknowledgements

• Department of Child Health-KATH
• Malaria Research Lab-KATH
• Nogouchi Memorial Institute-Legon