[Frequency and severity of rotavirus acute gastroenteritis hospitalized in Bucharest, Romania. Results of a case-control study].
BACKGROUND
rotavirus gastroenteritis is an emergent condition of morbidity at global level; WHO is currently recommending integration of rotavirus vaccination into the regions and states where rotavirus infection is identified as a public health priority problem.


OBJECTIVE
analyzing the frequency and clinical severity of rotavirus gastroenteritis in pediatric inpatients and commenting the programmatic signification of the analysis' results.


METHODS
descriptive retrospective study followed by case-control study upon the cohort of patients hospitalized in the year 2008, for acute diarrhoeal disease (ADD) of infectious nature in the biggest university clinic for children from Bucharest municipality. Rotavirus etiology was sustained on the ground of rotavirus antigen's detection, through immune chromatography assay, in the feces of patients with ADD clinical syndrome. The predictor factor for clinical severity was prolonged hospitalization, defined as any duration of hospitalization longer then the value calculated at 75 percentile, in the studied cohort. For the case-control study each case of rotavirus enteritis (Code ICD-10: A08.0) has been matched by age and gender with one control, selected at random from the list of patients with ADD of different etiology than the case.


RESULTS
in 2008 in our clinic, a lot of 684 of children was hospitalized for at least 24 hours, for infectious ADD, in which the median age was 8 months and the prevalence of male gender was 49%. In this lot, the prevalence of rotavirus enteritis was 12.7%. Cases of rotavirus enteritis have been admitted all year round, monthly highest prevalence being of 40%. The risk of prolonged hospitalization in patients discharged with the diagnosis of rotavirus enteritis was 2.36 higher (95% Confidence Interval: 1.17-4.78; p < 0.01) than in the same age and gender children hospitalized for ADD of other etiologies.


CONCLUSIONS
our study found an annual prevalence of 2.7%, a monthly maximum prevalence of 40% and a risk of prolonged hospitalization of rotavirus enteritis of 2.36 times higher then in ADD cases of other etiologies. In our opinion, these findings encompass objective arguments sustaining that in Bucharest, the rotavirus infection represents a public health problem, with high priority in allocation of health resources, mainly for surveillance and routine immunization.
Spitalul Clinic de Urgenţă pentru Copii "Grigore Alexandrescu" Bucureşti.
Coriolan
C
Ulmeanu
Irina
I
Nistor
Maria Dorina
MD
Crăciun
Niculae
N
Ion-Nedelcu
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012383:Romania / Q000453:epidemiology; D012401:Rotavirus / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000150:complications* / Q000453:epidemiology*; D012720:Severity of Illness Index