title: Incidence of severe rotavirus diarrhea in New Delhi, India, and G and P types of the infecting rotavirus strains.
abstract: A total of 62,475 children <5 years old from a defined population of approximately 500,000 children and adults from slums in New Delhi, India, were assessed for 1 year by means of passive surveillance, to identify children who were hospitalized for diarrhea. The incidence of severe rotavirus diarrhea was estimated, and the G and P types of the infecting rotavirus strains were determined and were correlated with the clinical severity of diarrhea. Of 584 children who were hospitalized with diarrhea, 137 (23.5%) had rotavirus detected in stool specimens (incidence of rotavirus diarrhea-associated hospitalizations, 337 hospitalizations/100,000 children <5 years of age). Most cases of diarrhea (98%) occurred during the first 2 years of life, peaking at 9-11 months of age. Rotavirus-associated diarrhea occurred year-round but was predominant in winter. Among the strains that could be G-typed, G1 was the most common serotype, followed by G9 and G2; 10% of cases of diarrhea were due to mixed G-type infections. Common strains identified in the present surveillance study were P[8]G1, P[4]G2, P[8]G9, P[6]G1, P[6]G9, and P[6]G3. Children infected with G1 strains had a greater risk of developing more-severe cases of diarrhea than did children infected with other rotavirus strains (odds ratio, 2.95; 95% confidence interval, 1.3-6.67).
authors.affiliation: Center for Diarrheal Disease and Nutrition Research, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi. mkbhan_rv@bol.net.in
authors.forename: Rajiv
authors.initials: R
authors.lastname: Bahl
authors.forename: Pratima
authors.initials: P
authors.lastname: Ray
authors.forename: Swati
authors.initials: S
authors.lastname: Subodh
authors.forename: Prashant
authors.initials: P
authors.lastname: Shambharkar
authors.forename: Manju
authors.initials: M
authors.lastname: Saxena
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.forename: Jon
authors.initials: J
authors.lastname: Gentsch
authors.forename: Roger
authors.initials: R
authors.lastname: Glass
authors.forename: M K
authors.initials: MK
authors.lastname: Bhan
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000821:virology; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D010343:Patient Admission; D011159:Population Surveillance; D011203:Poverty; D012401:Rotavirus / Q000235:genetics* / Q000472:pathogenicity; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology; D012621:Seasons; D013045:Species Specificity; D014505:Urban Population; D014774:Virulence / Q000235:genetics