Longitudinal Observation on Rotavirus Infection in Children Aged under 5 Years Old Hospitalized in 2 Hospitals of Ukraine in 2006–2015

Abstract

Background. More than 50,000 cases of acute gastroenteritis are registered in children in Ukraine annually. Statistical data concerning rotavirus infection are not correct due to poor capacities of rotavirus laboratory diagnostics in medical units. The aim of the study was to estimate rotavirus infection burden, to analyze and describe rotavirus infection in children aged under 5 years old who were hospitalized into two infectious hospitals (Kyiv and Odessa) within 2006–2015 period. Material and Methods. Investigation was carried according to a standard protocol, adopted by WHO. The disease severity was estimated by score scale for clinical manifestations of rotavirus gastroenteritis assessment of Vesikari. Results. At the period from December 2006 to December 2015 20,932 children aged under 5 years old were observed. Those children admitted to hospitals of infectious diseases in Kyiv and Odessa for acute gastroenteritis and met studies inclusive criteria. From them 18,384 (87.33 %) children were investigated for rotavirus, i.e. wide majority of all children admitted to hospitals with gastroenteritis. The cause of their hospitalization was rotavirus infection in almost half of all children. It was mentioned that in some periods hospitalization rate for rotavirus as a cause of gastroenteritis was up to 70 % of all cases. In Ukraine incidence of rotavirus diarrhea in hospitalized children up to 5 years old was the highest one among 6 countries of the European region included into Global Rotavirus Surveillance Network. In Ukraine it was 41 % and the region mean value was 24 %. Within the total period of observation half of all hospitalizations caused by rotavirus occurred in children of first two years of life. All time the main viruses causing infection in both hospitals were of 4 genotypes: G1P[8], G2P[4], G3P[8], G4P[8]. Genotype G9P[8] possessed a significant position in Kyiv, but there were years, when it was not identified neither in Kyiv, nor in Odessa. This genotype is described in different combinations of G and Р rotaviruses which causes disease in almost 90 % of all cases of rotavirus infection in many parts of the globe. The leadership of these 4 rotaviruses as the main causes of rotavirus infection changed in different years of observation. When gastroenteritis was caused by rotavirus, its symptoms were more severe, e.g. frequency of diarrhea and vomiting was higher, and length of vomiting in days was also longer. Signs of dehydration were more severe in group of rotavirus-positive children. Conclusions. During 10 years of observation in Ukraine rotavirus infection was always the main reason of hospitalization among children up to 5 years old with gastroenteritis. Gastroenteritis with rotaviral etiology is characterized by much more severe symptoms than non-rotaviral one. Significant changes in main 4 genotypes as causes of rotaviral gastroenteritis were not found. However, leadership of certain genotypes as the main causes was periodically changed amongst these four ones. Data obtained are the scientific background of necessity of universal vaccination against rotavirus infection implementation in Ukraine.

Keywords

• rotavirus
• genotype
• diarrhea
• children