title: High burden of rotavirus gastroenteritis in young children in rural western Kenya, 2010-2011.
abstract: BACKGROUND
  Diarrhea is a leading cause of hospitalization and death in children <5 years of age.
  
  
  OBJECTIVE
  To facilitate evaluation of the impact of rotavirus vaccine introduction in western Kenya, we estimated baseline rates of rotavirus-associated hospitalization and mortality among children <5 years of age.
  
  
  METHODS
  From January 2010 to December 2011, we collected demographic, clinical and laboratory data for children <5 years of age seeking care at the district hospital and 2 outpatient facilities within a Health and Demographic Surveillance System (HDSS). Children with acute gastroenteritis (AGE), defined as ≥3 loose stools and/or ≥1 episode of unexplained vomiting followed by loose stool within a 24-hour period, were asked to provide a stool sample for rotavirus ELISA testing. Rates of rotavirus-associated hospitalization and mortality were estimated using time of residence in the HDSS to calculate person-years of observation. To estimate the rotavirus-associated mortality rate, we applied the percentage positive for rotavirus among AGE hospitalizations to verbal autopsy estimates of diarrhea deaths in the HDSS.
  
  
  RESULTS
  There were 4991 hospitalizations of children <5 years of age; 1134 (23%) were for AGE and stool specimens were obtained from 790 (70%). Rotavirus was detected in 211 (27%) specimens. Among 4951 <5 outpatient sick visits, 608 (12%) were for AGE; 320 (51%) provided specimens and 62 (20%) were positive for rotavirus. Rotavirus AGE accounted for 501 <5 hospitalizations per 100,000 person-years of observation. Rotavirus-associated <5 mortality was 136 deaths per 100,000 person-years of observation.
  
  
  CONCLUSIONS
  Continued surveillance of rotavirus AGE will provide timely data on the population-level impact of rotavirus vaccine following its likely introduction in 2014.
authors.affiliation: From the *Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi; ‡Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Nairobi, Kenya; §WHO Regional Office for Africa (WHO/AFRO), Brazzaville, Republic of Congo; and †CDC-Kenya, Kisumu and Nairobi, Kenya.
authors.forename: Sammy
authors.initials: S
authors.lastname: Khagayi
authors.forename: Deron C
authors.initials: DC
authors.lastname: Burton
authors.forename: Reuben
authors.initials: R
authors.lastname: Onkoba
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ochieng
authors.forename: Amina
authors.initials: A
authors.lastname: Ismail
authors.forename: David
authors.initials: D
authors.lastname: Mutonga
authors.forename: Junghae
authors.initials: J
authors.lastname: Muthoni
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Jason M
authors.initials: JM
authors.lastname: Mwenda
authors.forename: Frank
authors.initials: F
authors.lastname: Odhiambo
authors.forename: Kayla F
authors.initials: KF
authors.lastname: Laserson
mesh_terms: D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D062486:Public Health Surveillance; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000401:mortality