title: Hospital-based surveillance to estimate the burden of rotavirus gastroenteritis in children below five years of age in Romania.
abstract: BACKGROUND
  Rotavirus (RV) is a leading cause of acute gastroenteritis (AGE), affecting 95% of children below five years of age.
  
  
  METHODS
  In this prospective, multi-center study, children below five years of age who were hospitalized or those who visited the emergency room (ER) due to AGE or who developed AGE at least 48 hours after hospitalization (nosocomial infection) and had a RV-positive stool sample were included (n=1,222). RV-positive samples were genotyped by reverse-transcriptase polymerase chain reaction.
  
  
  RESULTS
  RV test results were available for 1,212 children (hospitalizations [n=677], ER visits [n=398] and nosocomial AGE cases [n=137]). Proportions of rotavirus gastroenteritis (RVGE) hospitalizations and ER visits were 51.70% (350/677; 95%CI: 47.86-55.52) and 36.18% (144/398; 95%CI: 31.45-41.12), respectively. Overall, 45.95% (494/1075) of all community-acquired AGE cases were due to RV. High numbers of RVGE cases were recorded between January and March. Most common genotypes were G9P[8] (34.27%) followed by G4P[8] (25.83%) and G1P[8] (23.02%). Of all community-acquired RVGE cases, the highest number of cases was observed in children aged 12-23 months. Median duration of hospitalization among RV-positive subjects was six days (range: 2-31 days). Incidence of nosocomial RVGE was 0.52 (95%CI: 0.45-0.60) cases per 1,000 child-days hospitalization. Median duration for additional hospitalization due to nosocomial RVGE was five days (range: 1-10). The highest burden of nosocomial RVGE was observed in children aged 12-23 months (42.34%, 58/137). Our findings confirm a high burden of acute RVGE disease in Romania and provide useful data to support the implementation of RV vaccination in Romania.
  
  
  BACKGROUND
  NCT01253967.
authors: MD, PhD, Carol Davila University of Medicine and Pharmacy; Institute For Mother and Child Care, Bucharest 020395, Romania.
authors: Ioana Alina
authors: IA
authors: Anca
authors: MD, PhD, Department of Complementary Sciences, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 050463, Romania.
authors: Florentina Ligia
authors: FL
authors: Furtunescu
authors: MD, PhD, Carol Davila University of Medicine and Pharmacy; Children's Clinical Hospital "Dr. Victor Gomoiu", Bucharest 022102, Romania.
authors: Doina
authors: D
authors: Pleşca
authors: MD, PhD, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest 021105, Romania.
authors: Adrian
authors: A
authors: Streinu-Cercel
authors: MD, PhD, Ovidius University, Faculty of Medicine, Infectious Diseases Clinic, Constanţa 900709, Romania.
authors: Sorin
authors: S
authors: Rugină
authors: MSc, PhD, GlaxoSmithKline Vaccines, Wavre 1300, Belgium.
authors: Katsiaryna
authors: K
authors: Holl
keywords: Romania; Rotavirus; acute gastroenteritis; epidemiology; incidence; nosocomial