Group A rotavirus-associated diarrhea in children seeking treatment in Indonesia.
BACKGROUND
Globally, group A rotavirus causes significant morbidity and mortality among children. Limited data exist on the epidemiology of rotavirus disease among Indonesian children.


OBJECTIVE
We describe the epidemiology of rotavirus-associated diarrhea among Indonesian children <6 years of age, including clinical symptoms and genotypes.


METHODS
We conducted a hospital-based, case series study at four referral hospitals between February 2004 and February 2005 among children with diarrhea. Rotavirus positivity was defined by a positive result from either EIA or RT-PCR. A semi-nested RT-PCR was used to determine specific rotavirus genotypes.


RESULTS
1660 stools were tested for pathogens. The overall rotavirus prevalence was 45.5%. Children with rotavirus-associated diarrhea were significantly younger (p<0.0001) and more likely to be hospitalized (81.3% versus 72.2%; p<0.0001). Symptoms associated with rotavirus included, vomiting, fever, nausea, fatigue and dehydration, while bloody stool was significantly less common with rotavirus-associated diarrhea.


CONCLUSIONS
Rotavirus was an important contributor of morbidity to our study sample. Rotavirus genotyping demonstrated a temporal shift from G1-G4 to G9, but this was highly associated with the P[8] gene, suggesting that a multivalent rotavirus vaccine, incorporating G9 P[8] antigen, may reduce the burden of diarrheal illnesses among Indonesian children.
Putnam
Shannon D
SD
U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia. putnam@namrutwo.org
Sedyaningsih
Endang R
ER
Listiyaningsih
Erlin
E
Pulungsih
Sri Pandam
SP
Komalarini
Soenarto
Yati
Y
Salim
Octavianus Ch
OCh
Subekti
Decy
D
Riddle
Mark S
MS
Burgess
Timothy H
TH
Blair
Patrick J
PJ
D002675:Child, Preschool; D004403:Dysentery / Q000453:epidemiology / Q000821:virology*; D005243:Feces / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012401:Rotavirus / Q000235:genetics / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology / Q000821:virology*