Burden of rotavirus acute gastroenteritis in
children under 5 years at Komfo Anokye
Teaching Hospital,
Sandra K Owusu,
Daniel Ansong
Richard Kwarteng Owusu
Samuel Blay Nguah,
Justice Sylverken
A Osei-Akoto
E Addo -Yobo
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Introduction• Rotavirus is the most common cause of severe acute
gastroenteritis in infants and young childrenworldwide.
• It is estimated to account for 39% of all diarrhoealdeaths, this amounts to approximately half a milliondeaths each year among children aged under 5 years.
• Greater than 80% of diarrhoeal deaths occurring in thedeveloping countries.
• Acute gastroenteritis caused by rotavirus is a frequentcause of admission and nosocomial infection inchildren who are hospitalized for reasons other thandiarrhoea.
Design:
• A prospective cross-sectional study was
conducted in the Komfo Anokye Teaching
Hospital between October 2007 and January
2008.
• The study collected history of illness,
stools and followed up all children reporting
with diarrhoea defined as three or more
episodes of loose watery stool within 24 hours
period.
Inclusion and Exclusion criteria
• Children under five years who presented with
gastroenteritis lasting less than seven days -defined as an
episode of at least three (3) loose or watery stools, or
forceful vomiting in a 24-hr period in the 7 days before
the medical visit.
• Children less than five years whose parents and or
guardians refused to consent to their participation were
excluded.
• Children with previous diagnosis of chronic disease of
the (GIT) Gastrointestinal tract for which symptoms are
compatible with the definition of acute gastroenteritis
were also be excluded from the study.
•Methods: Sites
• KATH, Department of Child Health, has 200 beds
with bed occupancy rate between 80 to 120%. The
monthly admission to the PEU averages 450 children
• About 40% of these cases are children under five
years. ;;;;;;
RESEARCH QUESTIONS
1.What are the socio-demographic characteristics
of children with acute gastroenteritis?
2.What is the percentage of Rotavirus in children
with acute gastroenteritis at Komfo Anokye
Teaching hospital?
3.How do patients with Rotavirus gastroenteritis
commonly present?
GENERAL OBJECTIVE
To determine the prevalence of Rotavirus infection in
children under five years with acute gastroenteritis at
Komfo Anokye Teaching Hospital.
SPECIFIC OBJECTIVES
• To determine the socio-demographic characteristics ofchildren with acute gastroenteritis at KATH
• To determine the percentage of rotavirus acutegastroenteritis at KATH
• To identify the common presentations of children withRotavirus acute gastroenteritis
Demographic Characteristics of the Study subjects
Characteristics
Number(%) Positive N(%)
Negative N(%)
P-Value
Sex
Male 39(50.6) 21(53.9) 18(46.2)
Female 38(49.4) 25(65.8) 13(34.2)
Total 77(100) 46(59.7) 31(40.3) 0.29
Age
0-6mths 22(28.6) 15(68.2) 7(31.8)
7-12mths 31(40.3) 17(54.8) 14(45.2)
13-24mths 18(23.4) 12(66.7) 6(33.3)
>24mths 6(7.8) 2(33.3) 4(66.7)
Total 77(100) 46(59.7) 31(40.3) 0.383
Social characteristics of the study subjects
Education Number(%)
Positive N(%)
Negative N(%)
P-Value
No Formal 4(5.2) 3(75.0) 1(25.0)
Primary 17(22.1) 10(58.8) 7(41.2)
JSS 28(36.4) 16(57.1) 12(41.2)
SSS 14(18.2) 8(57.1) 6(42.9)
Tertiary 14(18.2) 9(64.3) 5(35.7)
Total 77(100) 46(59.7) 31(40.3) 0.96
OccupationOccupation Number(%) Positive
N(%)Negative N(%)
P-Value
Trader 27(35.1) 14(51.9) 13(48.1)
Seamstress 2(2.6) 2(100) 0(0)
Hairdresser 8(10.4) 7(87.5) 1(12.5)
Teacher 22(29.9) 13(59.1) 9(40.9)
Unemployed 8(23.0) 5(62.5) 3(37.5)
Other 10(13.0) 5(50.0) 5(50.0)
Total 77(100) 31(40.3) 46(59.7) 0.41
Source of drinking water
Source of water
Number(%)
Positive N(%)
Negative N(%)
P-Value
Pipe 54(70.1) 36(66.7) 18(33.3)
Open well
7(9.1) 3(42.9) 4(57.1)
Borehole 9(11.7) 4(44.4) 5(55.6)
Stream water
1(1.3) 0(0) 1(100)
Other 6(7.8) 3(50.0) 3(50.0)
Total 77(100) 46(59.7) 31(40.3) 0.34
Results
Figure 1: Results of stools
samples tested for presence of
rotavirus
57%
43%Positive
Negative
Relationship between clinical features and presence of rotavirus infection
Characteristics Number(%) Positive N(%)
Negative N(%)
P-Value
Fever
Yes 54(100) 33(61.1) 21(38.9)
No 21(100) 11(52.4) 10(47.6)
Total 75(100) 44(58.7) 31(41.3) 0.37
Dehydration
None 22(100) 13(59.1) 9(40.9)
Some 33(100) 19(57.6) 14(42.4)
Severe 20(100) 12(60) 8(40.0)
Total 75(100) 44(58.7) 31(41.3) 0.36
Vomiting
Yes 14(100) 7(50.0) 7(50.0)
No 61(100) 37(60.7) 24(39.3)
Total 75(100) 44(58.7) 31(41.3) 0.54
Discussion
• Prevalence of Rotavirus gastroenteritis
• Common Presentations of children with Rotavirus Gastroenteritis
• Demographic Characteristics and Rotavirus Prevalence
• Maternal Educational Level and Occupation
• Conclusion
• The study has demonstrated that rotavirus is an
important cause of diarrhoea in the study area.
• Younger children were the most affected group.
The study did not show any relationship to other
clinical symptoms.
CONCLUSION
• 1. Rotavirus acute gastroenteritis is common in KomfoAnokye Teaching Hospital.
• 2. Children less than 24 months are the age group most affected.
• 3. Severe dehydration due to rotavirus acute gastroenteritis is common.
• 4. Socioeconomic characteristic of care givers was not found to be a statistically significant factor.
Recommendation
1. A bigger study on a large scale considering the rural and urban distribution
of the disease as well as the impact of the disease on the children will be
helpful. This would enable us estimate the true burden of the disease in
both settings. Such information would be used for policy formulation and
planning towards disease prevention.
2. Since studies has shown that maternal socio-economic status does not
impact on the prevalence of the disease. Efforts should be directed towards
Maternal Education on the home management of diarrohea across all levels
of socioeconomic class.
3. The high prevalence of rotavirus acute gastroenteritis at this tertiary care
center may indicate the need to consider rotavirus vaccination as part of
our Expanded Programme on Immunization.
Recommendation
• Study to evaluate the association between presence of antigenemia and severity of rotavirus diarrhoea.
Acknowledgements
• Department of Child Health-KATH
• Malaria Research Lab-KATH
• Nogouchi Memorial Institute-Legon
