Acute nonbacterial gastroenteritis in hospitalized children: a cross sectional study.
BACKGROUND
Viral acute gastroenteritis (AGE) is a major cause of morbidity in childhood and leads to hospitalization in developed countries, such as Iran.


OBJECTIVE
The aim of this study was to determine the prevalence and viral types (rotavirus, adenovirus, human parechoviruses-1, and human bocavirus) of acute nonbacterial gastroenteritis in hospitalized children.


METHODS
This was a across-sectional prospective study performed at the Pediatric Department of Rasoul Hospital, Tehran, Iran (2009-2011) on 80 hospitalized children with viral AGE. All Stool samples were collected on viral transport media. Human bocavirus (HBoV) was detected using the Real-time PCR TaqMan method. Molecular detection of human parechovirus type 1 (HPeV-1) RNA in stool samples was done using a specific nested reverse transcription PCR (RT-PCR). Rota and adeno virus antigens were sought by rapid chromatographic tests. P values less than 0.05 were considered statistically significant.


RESULTS
Fever was determined in 47.5% of cases (38), nausea and vomiting in 42.5% (34), respiratory symptoms in 16.3% (13), abdominal pain in 76%. Duration of diarrhea was 1-30 days (mean = 6.3 + 4.3 days). No dehydration was observed in 43.5% of subjects, mild dehydration in 33.8%, moderate dehydration in 17.5% and severe dehydration in 5% of cases. Positive rotavirus was found in 48.8% of cases (39), adenovirus in 20% (16), HBoV in 8% (6) and HPeV-1 in 23.2% (19), and adeno and rotaviruses co-infection in 6% (4). The frequency of positive HBoV was significantly lower than adeno and rotaviruses infection (P value = 0.0001). Rotavirus was more frequent in males (P value = 0.003) and in young children (17.49 months vs. 21.44 months) [P value = 0.03, CI = -13.4, 5.5]. Rotavirus infection was related to the degree of dehydration (P value = 0.001) but was not related to the presence of vomiting or fever (P value > 0.5).


CONCLUSIONS
This study indicates that viral agents, especially rotavirus (48.8%), HPeV-1 (23.2%) and adenovirus (20%) are the most important causes for viral AGE in children while HBoV (8%) is infrequent during childhood. Determination of various viral pathogens of AGE is very important in planning diarrhea disease control strategies in our country where rotavirus vaccination in not routinely used.
Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, IR Iran ; Department of Medicine, Qom University of Medical Sciences and Health services, Qom, IR Iran.
Mohammad Reza
MR
Shokrollahi
Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, IR Iran.
Samileh
S
Noorbakhsh
Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, IR Iran.
Hamid Reza
HR
Monavari
ENT-Head and Neck Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Sahar
S
Ghavidel Darestani
Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, IR Iran.
Ahmad
A
Vosoughi Motlagh
Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, IR Iran.
Shima
S
Javadi Nia
Diarrhea; Gastroenteritis; Rotavirus