Pediatric hospitalizations attributable to rotavirus gastroenteritis among Cambodian children: Seven years of active surveillance, 2010–2016 |
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| Institution: | 1. National Pediatric Hospital, Ministry of Health, Phnom Penh, Cambodia;2. National Immunization Program, Ministry of Health, Phnom Penh, Cambodia;3. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, USA;4. Global Immunization Division, Centers for Disease Control & Prevention, Atlanta, USA;5. Expanded Programme on Immunization, Western Pacific Regional Office, Manila, Philippines;6. Expanded Programme on Immunization, World Health Organization, Phnom Penh, Cambodia;1. World Health Organization, Geneva, Switzerland;2. Centers for Disease Control and Prevention, Atlanta, GA, USA;3. World Health Organization, Geneva, Switzerland;4. Centers for Disease Control and Prevention, Atlanta, GA, USA;5. World Health Organization, Geneva, Switzerland;6. Centers for Disease Control and Prevention, Atlanta, GA, USA;1. Public Health Agency, 12-22 Linenhall Street, Belfast, Northern Ireland BT2 8BS, UK;2. Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 DO1 A4A3, Ireland;1. The Centre for Global Vaccine Research, Institute of Infection and Global Health, University of Liverpool, Ronald Ross Building, 8 West Derby Street, Liverpool L69 7BE, UK;2. Field Epidemiology Services, National Infection Service, Public Health England, Suite 3b, Third Floor, The Cunard Building, Water Street, Liverpool L3 1DS, UK;3. NIHR Health Protection Research Unit in Gastrointestinal Infections, The Farr Institute@HeRC, University of Liverpool, 2nd Floor, Block F, Waterhouse Buildings, 1-5 Brownlow Street, Liverpool L69 3GL, UK;4. NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection and Global Health, University of Liverpool, Ronald Ross Building, 8 West Derby Street, Liverpool L69 7BE, UK;5. Centre for Health Informatics, Computing and Statistics, Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK;6. Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Block F, Waterhouse Buildings, 1-5 Brownlow Street, Liverpool L69 3GL, UK;7. International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street 5th Floor, Baltimore, MD 21231, USA;1. Ethiopian Public Health Institute, Addis Ababa, Ethiopia;2. SAMRC Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Medunsa, Pretoria, South Africa;3. BeteZata Hospital, Addis Ababa, Ethiopia;4. Black Lion Hospital, AAU Medical Faculty, Addis Ababa, Ethiopia;5. Yekatit 12 Hospital, AAU Medical Faculty, Addis Ababa, Ethiopia;6. WHO Country Office, Addis Ababa, Ethiopia;7. WHO Regional Office for Africa (WHO/AFRO), Harare, Zimbabwe;8. WHO Regional Office for Africa (WHO/AFRO), Brazzaville, People’s Republic of Congo;1. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand;2. Faculty of Pharmacy, Mahidol University, Bangkok, Thailand;3. Phetchabun Provincial Health Office, Phetchabun, Thailand;4. Sukhothai Provincial Health Office, Sukhothai, Thailand;5. Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand;6. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA;1. Division of Social and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand;2. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand;3. Unit of PharmacoTherapy, -Epidemiology & -Economics, University of Groningen, Groningen Research Institute of Pharmacy (GRIP), Groningen, the Netherlands;4. Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands;5. Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, the Netherlands |
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| Abstract: | BackgroundEach year, approximately 1,066 Cambodian children under five years old die of diarrhea, and 51% of these deaths are due to rotavirus gastroenteritis. Quantifying childhood hospitalizations caused by severe rotavirus infections is also important in demonstrating disease burden caused by this virus. The objective of this study is to update and confirm the current burden of pediatric hospitalizations attributable to rotavirus gastroenteritis among Cambodian children using seven years of continuous active, prospective surveillance from 2010 to 2016. We also characterize the circulating rotavirus genotypic strains during this period.MethodsActive surveillance for rotavirus gastroenteritis was conducted from January 2010 through December 2016 at a national hospital in Phnom Penh, Cambodia. Children <60 months of age who were hospitalized for acute gastroenteritis (AGE) were consented and enrolled. Information on gender, age, clinical characteristics, and month of onset were collected. Stool specimens were collected and tested by enzyme immunoassay for the presence of rotavirus antigen, and genotyping was performed on rotavirus test-positive specimens to characterize predominant rotavirus strains during the surveillance period.ResultsOf 7007 children enrolled with AGE and having specimens collected, 3473 (50%) were attributed to rotavirus gastroenteritis. The majority of rotavirus hospitalizations occurred in children younger than two years old (92%). Year-round rotavirus transmission was observed, with seasonal peaks during the cooler, dry months between November and May. Genotypic trends in rotavirus were observed over the surveillance period; the predominant rotavirus strains changed from G1P8] (2010–2012), to G2P4] (2013–2014), the emergence of genotype G8P8] in 2015, and G3P8] in 2016.ConclusionsRotavirus is the leading cause of severe acute gastroenteritis hospitalizations in Cambodian children under five years old, with 50% of such hospitalizations attributable to rotavirus. Over 90% of rotavirus hospitalizations occurred in children under 2 years of age. Changes in the predominant rotavirus strains occurred over time among these unvaccinated children. This information is important to understand and prioritize the current potential impacts upon child health that could be achieved through the introduction of rotavirus vaccines in Cambodia. |
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| Keywords: | Acute gastroenteritis Rotavirus Diarrhea Disease burden Surveillance Hospitalizations Rotavirus vaccine Cambodia |
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