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

Abstract

Muna Al Musawi,1 Hassan Zainaldeen,2 Fakrudeen Shafi,3 Sameh Anis,4 Rodrigo DeAntonio51Public Health Directorate, Ministry of Health, Manama, the Kingdom of Bahrain; 2Pediatric Department, Salmaniya Medical Complex, the Kingdom of Bahrain, Manama; 3GlaxoSmithKline Pharmaceuticals, Bangalore, India; 4GlaxoSmithKline Pharmaceuticals, Middle East and North Africa; 5GlaxoSmithKline Vaccines, Wavre, BelgiumPurpose: 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