Rotavirus gastroenteritis in children under 5 years in the Kingdom of Bahrain: hospital-based surveillance

Abstract

Purpose

Rotavirus (RV) is the leading cause of morbidity and mortality in children under 5 years of age worldwide. This study assessed the role of RV as a cause of gastroenteritis (GE)-associated hospitalization in children, generating baseline information to evaluate the potential impact of the RV vaccine in reducing RVGE disease burden in the Kingdom of Bahrain.

Methods

This single, pediatric hospital-based surveillance study was conducted over a period of 12 months beginning April 1, 2006. A total of 314 children aged under 5 years and hospitalized due to GE were enrolled in the study, following collection of written informed consent from parents/guardians. Stool samples were tested for the presence of RV using enzyme immunoassay, and a random subset of RV-positive samples was further genotyped using reverse transcriptase-polymerase chain reaction and reverse hybridization assay.

Results

Of 314 enrolled children, 239 were included in the final analysis. RV was detected in 107 children (44.8%), mostly in the 6–23 months age group (82/107; 76.6%). RVGE occurred throughout the year, with the highest proportion occurring during April (26/42; 61.9%). G1P[8] was the most commonly detected RV strain (10/17; 58.8%) in the limited number of samples analyzed. Vomiting and severe RVGE were more commonly observed in RV-positive than RV-negative children before hospitalization (P = 0.0008 and 0.0204, respectively).

Conclusion

In our study, RV accounted for over 40% of GE-associated hospitalizations and particularly affected children under 2 years of age. These data will serve as a baseline for assessing the potential changes in the epidemiology of RV disease and for evaluating the potential impact of the introduction of RV vaccination.

Keywords:

• rotavirus
• gastroenteritis
• epidemiology
• Kingdom of Bahrain

Acknowledgments

The authors thank Nada Riachi, Karin Hallez, and Aly Ziwar (all employed by the GlaxoSmithKline group of companies) for their contributions and monitoring support, and DDL Diagnostic Laboratory, The Netherlands for performing the genotyping assay. The authors also thank Devi Priya (employed by the GlaxoSmithKline group of companies) for medical writing, Abdelilah Ibrahimi (XPE Pharma and Science on behalf of GlaxoSmithKline Vaccines) for publication coordination, and Julia Donnelly (on behalf of GlaxoSmithKline Vaccines) for support in copy editing.

Disclosure

GlaxoSmithKline Biologicals SA was the funding source and was involved in all stages of the study conduct and analyses. GlaxoSmithKline Biologicals SA also paid all costs associated with the development and publication of the present manuscript. RD, FS, and SA are employees of the GlaxoSmithKline group of companies and RD has stock options. MA and HZ report no conflicts of interest in this work.