title: Risk factors of rotavirus diarrhea in hospitalized children in Sanglah Hospital, Denpasar: a prospective cohort study.
abstract: BACKGROUND
  Diarrhea is a major public health concern throughout the world because the prevalence of morbidity of diarrhea has not changed significantly in the past decade. It remains the third leading cause of death among children less than 5 years of age. Recent surveillance studies have shown that rotavirus is a significant cause of pediatric hospitalization and death due to diarrhea. Indonesia has limited data on risk factors, disease burden, and deaths in children due to rotavirus diarrhea. The objective of this study was to examine the above mentioned factors related to rotavirus diarrhea in hospitalized children in Sanglah Hospital, Denpasar.
  
  
  METHODS
  A prospective cohort study was conducted at Sanglah Hospital Denpasar from April 2009 to December 2011. The present study was part of a nationwide study on Extension for Hospital-based Surveillance and Strain Characterization of Rotavirus Diarrhea Indonesia involving four hospitals throughout Indonesia as a part of the Asian Rotavirus Surveillance Network. We studied children aged <5 years who were hospitalized with acute diarrhea, and analyzed their stool samples using an immunoassay that detects the rotavirus antigen.
  
  
  RESULTS
  A total of 656 patients met the inclusion criteria for this study. Of 5805 patients under the age of 5 who were hospitalized between April 2009 and December 2011, the prevalence of diarrhea among hospitalized pediatric patients was 11.3% and the prevalence of rotavirus diarrhea was 49.8%. The male to female ratio of those affected by rotavirus was 1.6:1. The occurrence of vomiting was significantly higher in rotavirus diarrhea than in non-rotavirus diarrhea (RR, 1.4; 95% CI, 1.08 to 1.70; p = 0.004).
  
  
  CONCLUSIONS
  Diarrhea remains an important cause of hospitalization in children, and rotavirus was the most important etiology. We found that boys had a greatest risk of rotavirus infection than girls. Good nutritional status and breastfeeding provided the same protection against rotavirus and non-rotavirus diarrhea.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Child Health, Medical School, Udayana University/Sanglah Hospital, Denpasar, Indonesia. misionarispelayanan@yahoo.com.
authors.forename: Hendra
authors.initials: H
authors.lastname: Salim
authors.forename: I Putu Gede
authors.initials: IP
authors.lastname: Karyana
authors.forename: I Gusti Ngurah
authors.initials: IG
authors.lastname: Sanjaya-Putra
authors.forename: Soetjiningsih
authors.initials: S
authors.lastname: Budiarsa
authors.forename: Yati
authors.initials: Y
authors.lastname: Soenarto
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D003681:Dehydration / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology* / Q000821:virology*; D005243:Feces / Q000821:virology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012400:Rotavirus Infections / Q000150:complications* / Q000453:epidemiology*; D012737:Sex Factors; D014839:Vomiting / Q000453:epidemiology