title: The epidemiology and aetiology of diarrhoeal disease in infancy in southern Vietnam: a birth cohort study.
abstract: OBJECTIVE
  Previous studies indicate a high burden of diarrhoeal disease in Vietnamese children, however longitudinal community-based data on burden and aetiology are limited. The findings from a large, prospective cohort study of diarrhoeal disease in infants in southern Vietnam are presented herein.
  
  
  METHODS
  Infants were enrolled at birth in urban Ho Chi Minh City and a semi-rural district in southern Vietnam, and followed for 12 months (n=6706). Diarrhoeal illness episodes were identified through clinic-based passive surveillance, hospital admissions, and self-reports.
  
  
  RESULTS
  The minimum incidence of diarrhoeal illness in the first year of life was 271/1000 infant-years of observation for the whole cohort. Rotavirus was the most commonly detected pathogen (50% of positive samples), followed by norovirus (24%), Campylobacter (20%), Salmonella (18%), and Shigella (16%). Repeat infections were identified in 9% of infants infected with rotavirus, norovirus, Shigella, or Campylobacter, and 13% of those with Salmonella infections.
  
  
  CONCLUSIONS
  The minimum incidence of diarrhoeal disease in infants in both urban and semi-rural settings in southern Vietnam was quantified prospectively. A large proportion of laboratory-diagnosed disease was caused by rotavirus and norovirus. These data highlight the unmet need for a rotavirus vaccine in Vietnam and provide evidence of the previously unrecognized burden of norovirus in infants.
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: katieanders99@gmail.com.
authors: Katherine L
authors: KL
authors: Anders
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK; The London School of Hygiene and Tropical Medicine, London, UK.
authors: Corinne N
authors: CN
authors: Thompson
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.
authors: Nguyen Thi Van
authors: NT
authors: Thuy
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam; The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors: Nguyen Minh
authors: NM
authors: Nguyet
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.
authors: Le Thi Phuong
authors: le TP
authors: Tu
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.
authors: Tran Thi Ngoc
authors: TT
authors: Dung
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.
authors: Voong Vinh
authors: VV
authors: Phat
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.
authors: Nguyen Thi Hong
authors: NT
authors: Van
authors: Hung Vuong Hospital, Ho Chi Minh City, Vietnam.
authors: Nguyen Trong
authors: NT
authors: Hieu
authors: Dong Thap Hospital, Cao Lanh, Vietnam.
authors: Nguyen Thi Hong
authors: NT
authors: Tham
authors: District 8 Hospital, Ho Chi Minh City, Vietnam.
authors: Phan Thi Thanh
authors: PT
authors: Ha
authors: Children's Hospital No. 1, Ho Chi Minh City, Vietnam.
authors: Le Bich
authors: le B
authors: Lien
authors: The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors: Nguyen Van Vinh
authors: NV
authors: Chau
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK; The London School of Hygiene and Tropical Medicine, London, UK.
authors: Stephen
authors: S
authors: Baker
authors: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK; Department of Microbiology and Immunology, University of Melbourne, Victoria, Australia.
authors: Cameron P
authors: CP
authors: Simmons
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology / Q000821:virology; D003968:Diarrhea, Infantile / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D029322:Norovirus / Q000302:isolation & purification; D011446:Prospective Studies; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology / Q000821:virology; D014744:Vietnam / Q000453:epidemiology
keywords: Cohort study; Diarrhoeal disease; Epidemiology; Infants; Infectious diarrhoea; Rotavirus