title: Rotavirus and other Diarrheal Disease in a Birth Cohort from Southern Indian Community.
abstract: OBJECTIVE
  To describe the incidence, severity and etiology of diarrheal disease in infants and young children residing in an urban slum community in Southern India.
  
  
  METHODS
  Three contiguous urban slums in Vellore, Tamil Nadu.
  
  
  METHODS
  452 children participating in a birth cohort study on diarrheal disease; 373 completed three years of follow-up.
  
  
  METHODS
  Diarrheal incidence (obtained by twice-weekly home visits) and severity (assessed by the Vesikari scoring system), and etiological agents associated with diarrhea (through examination of stool specimens by bacteriologic culture, rotavirus enzyme immunoassay, PCR for norovirus and microscopy for parasites).
  
  
  RESULTS
  A total of 1856 diarrheal episodes were reported in 373 children. The overall incidence rate of diarrhea was 1.66 episodes per child year for three years, with 2.76 episodes per child year in infancy. The incidence peaked during the months of July and August. Severe diarrhea formed 8% of the total episodes. Rotavirus was the most common pathogen detected, being identified in 18% of episodes. Good hygiene status resulted in 33% protection against moderate-to-severe diarrhea.
  
  
  CONCLUSIONS
  This study highlights the burden of diarrheal disease and the important etiological agents of childhood diarrhea in Southern India. Promotion of hygienic behavior through health education may help reduce diarrheal incidence in this and similar communities.
authors: Division of Gastrointestinal Sciences, and *Community Health Department, Christian Medical College, Vellore, Tamil Nadu, India. Correspondence to: Dr Gagandeep Kang, Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632 004, Tamil Nadu, India. gkang@cmcvellore.ac.in.
authors: R
authors: R
authors: Sarkar
authors: B P
authors: BP
authors: Gladstone
authors: J P
authors: JP
authors: Warier
authors: S L
authors: SL
authors: Sharma
authors: U
authors: U
authors: Raman
authors: J
authors: J
authors: Muliyil
authors: G
authors: G
authors: Kang
mesh_terms: D001942:Breast Feeding; D002675:Child, Preschool; D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000821:virology; D005243:Feces / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D009752:Nutritional Status; D011204:Poverty Areas; D012401:Rotavirus; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology