title: Rotavirus mortality confirmed by etiologic identification in Venezuelan children with diarrhea.
abstract: BACKGROUND
  Hospital-based studies to determine the etiology of deaths from diarrhea are scarce. In this study, we specifically analyzed deaths due to rotavirus to assess the rotavirus impact on diarrhea mortality.
  
  
  METHODS
  To determine the rotavirus proportion contributing to mortality due to diarrhea, we analyzed data obtained from a hospital-based mortality surveillance, conducted over 7 years, in the Ciudad Hospitalaria Dr. Enrique Tejera, Valencia, Venezuela. Rotavirus was identified in stool samples collected from children who died of diarrhea, by a confirmatory ELISA and/or reverse transcription polymerase chain reaction.
  
  
  RESULTS
  Our results show that rotavirus (21%; 21/100) is the leading cause of death due to diarrhea among children <5 years of age; rotavirus also has an important impact (2%; 21/1336) on deaths from all causes in this age group. Shigella spp. (19%; 13/69) was the second most important cause of death, followed by calicivirus (6%; 3/53). Furthermore, this study documents a seasonal pattern in the deaths due to rotavirus (odds ratio 3.28; 95% confidence interval 1.13-9.76).
  
  
  CONCLUSIONS
  For Venezuela, it is estimated that approximately 300 children <5 years of age die of rotavirus each year, which means that 1 in 1800 children die by the age of 5. Rotavirus was found to be the main cause of death due to diarrhea, which supports previous estimations. This is the first study to present data of cause-specific mortality due to diarrhea based on hospital surveillance of diarrhea etiologies.
authors.affiliation: Instituto de Biomedicina, Fuvesin, Ministerio de Salud y Universidad Central de Venezuela, Caracas, Venezuela. iperez@movistar.net.ve
authors.forename: Irene
authors.initials: I
authors.lastname: Pérez-Schael
authors.forename: Belén
authors.initials: B
authors.lastname: Salinas
authors.forename: Rosabel
authors.initials: R
authors.lastname: González
authors.forename: Hans
authors.initials: H
authors.lastname: Salas
authors.forename: Juan Ernesto
authors.initials: JE
authors.lastname: Ludert
authors.forename: Marisol
authors.initials: M
authors.lastname: Escalona
authors.forename: Ana
authors.initials: A
authors.lastname: Alcalá
authors.forename: María Alejandra
authors.initials: MA
authors.lastname: Rosas
authors.forename: Mercedes
authors.initials: M
authors.lastname: Materán
mesh_terms: D002423:Cause of Death; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology* / Q000401:mortality / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012400:Rotavirus Infections / Q000401:mortality*; D014687:Venezuela / Q000453:epidemiology