title: A multicenter prospective hospital-based surveillance to estimate the burden of rotavirus gastroenteritis in children less than five years of age in India.
abstract: BACKGROUND
  Rotavirus is the leading cause of severe, dehydrating diarrhea in children aged <5 years globally, with an estimated 25 million outpatient visits and 2 million hospitalizations attributable to rotavirus infections each year. The aim of this hospital-based surveillance was to summarize the local epidemiological and virological features of rotavirus and to estimate the disease burden in the population under surveillance in India.
  
  
  METHODS
  During the 16 months surveillance period from April 2011 through July 2012, a total of 4711 children under the age of 5 years were admitted with acute diarrhea at 12 medical centers attached to medical schools throughout India. Stool samples were randomly collected from 2051 (43.5%) subjects and were analyzed for rotavirus positivity using commercial enzyme immunoassay kit (Premier Rotaclone Qualitative Elisa) at the respective study centers. Rotavirus positive samples were genotyped for VP7 and VP4 by reverse-transcription polymerase chain reaction (RT-PCR) at a central laboratory.
  
  
  RESULTS
  During the study period, maximum number of rotavirus related hospitalizations were reported from December 2011 through February 2012. Out of the 2051 stool samples tested for rotavirus, overall 541 (26.4%) samples were positive for rotavirus VP6 antigen in stool. The highest positivity was observed in the month of December, 2011 (52.5%) and lowest in the month of May, 2011 (10.3%). We found that majority of the rotavirus positive cases (69.7%) were in children <24 months of age. The most common genotypes reported were G1 (38%), G2 (18%), G9 (18%), G12 (9%) and mixed strains (17%).
  
  
  CONCLUSIONS
  The results of this study confirm the significant burden of acute rotavirus gastroenteritis as a cause of hospitalizations in under five children in India.
authors.affiliation: Shantha Biotechnics Ltd., Hyderabad, India.
authors.forename: T
authors.initials: T
authors.lastname: Saluja
authors.affiliation: SMS Medical College, Jaipur, India.
authors.forename: S D
authors.initials: SD
authors.lastname: Sharma
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: M
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Institute of Child Health, Kolkata, India.
authors.forename: R
authors.initials: R
authors.lastname: Kundu
authors.affiliation: Kalinga Institute of Medical Sciences, Bhubaneswar, India.
authors.forename: S
authors.initials: S
authors.lastname: Kar
authors.affiliation: Kalawati Saran Children's Hospital, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Dutta
authors.affiliation: Govt. Medical College, Goa, India.
authors.forename: M
authors.initials: M
authors.lastname: Silveira
authors.affiliation: CSM Medical University, Lucknow, India.
authors.forename: J V
authors.initials: JV
authors.lastname: Singh
authors.affiliation: Kasturba Medical College, Manipal, India.
authors.forename: V G
authors.initials: VG
authors.lastname: Kamath
authors.affiliation: Dayanand Medical College, Ludhiana, India.
authors.forename: A
authors.initials: A
authors.lastname: Chaudhary
authors.affiliation: Gandhi Medical College, Hyderabad, India.
authors.forename: J V
authors.initials: JV
authors.lastname: Rao
authors.affiliation: JSS Medical College, Mysore, India.
authors.forename: M D
authors.initials: MD
authors.lastname: Ravi
authors.affiliation: Kempegowda Institute of Medical Sciences, Bangalore, India.
authors.forename: S R K
authors.initials: SR
authors.lastname: Murthy
authors.affiliation: Christian Medical College, Vellore, India.
authors.forename: S
authors.initials: S
authors.lastname: Babji
authors.affiliation: Shantha Biotechnics Ltd., Hyderabad, India.
authors.forename: R
authors.initials: R
authors.lastname: Prasad
authors.affiliation: Shantha Biotechnics Ltd., Hyderabad, India.
authors.forename: R
authors.initials: R
authors.lastname: Gujjula
authors.affiliation: Shantha Biotechnics Ltd., Hyderabad, India.
authors.forename: R
authors.initials: R
authors.lastname: Rao
authors.affiliation: Shantha Biotechnics Ltd., Hyderabad, India. Electronic address: MandeepSingh.Dhingra@sanofi.com.
authors.forename: M S
authors.initials: MS
authors.lastname: Dhingra
mesh_terms: D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D005838:Genotype; D005843:Geography; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012401:Rotavirus / Q000235:genetics; D012400:Rotavirus Infections / Q000453:epidemiology*; D012621:Seasons
keywords: Diarrhea; India; Positivity; Rotavirus; Surveillance