Documentation of rotavirus diarrhea in a rural, resource-poor setting is a difficult task. We analyzed stool samples of 103 children admitted for acute diarrhea in a pediatric hospital in Bijnor, UP, India, using a simple bedside immunochromatography kit. Rotavirus infection was detected in 47 out of total of 103 children (45.6%).

Keywords: Dehydration, Epidemiology, Surveillance.

During the study period, 103 under-five children hospitalized due to acute diarrhea were tested. Key demographic features are listed in Table I. Most of the testing occurred in months of May, June and July in both the years (about 98% of total testing for year 2010 and 73% of total testing for year 2011). Rotavirus was detected in 47 (45.6%) children. The disease characteristics, except severity, were similar for rotavirus-positive and rotavirus-negative cases as per Clarke and Vesikari scoring system. However, these two scales differ greatly in categorizing the severity. As the Clarke score does not include direct assessment of dehydration, it is less likely to identify an episode of disease as severe, as compared to Vesikari score [6].

TABLE I Characteristics of the Study Participants

*Mean (SD); SES: Socioeconomic status; all P >0.05.

The rotavirus disease proportion in this study is close to the earlier reported studies in hospitalized children using ELISA for diagnosis of infection. An earlier study showed good sensitivity and specificity of rapid diagnostic kit when compared to standard diagnostic test [7], whereas another study reported high false positivity [8]. Limitations of the study include small sample size, and lack of comparison of the results with the standard diagnostic method. These results might not be generalized or representative of the actual epidemiology. In conclusion, the study re-affirms that significant proportion of acute diarrhea in hospitalized under-five children is caused by rotavirus. There is a need to evaluate the rapid diagnostic kits vis-à-vis standard diagnostics.

1. Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD, et al. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: A systematic review and meta-analysis. Lancet Infect Dis. 2012;12:136-41.

2. Kang G, Arora R, Chitambar SD, Deshpande J, Gupte MD, Kulkarni M, et al. Multicenter, hospital-based surveillance of rotavirus disease and strains among indian children aged <5 years. J Infect Dis. 2009;200:S147-53.

3. Ramani S, Kang G. Burden of disease and molecular epidemiology of group A rotavirus infections in India. Indian J Med Res. 2007;125:619-32.

4. Ruuska T, Vesikari T. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarhoeal episodes. Scand J Infect Dis.1990;22:259-67.

5. Clark HF, Borian FE, Bell LM, Modesto K, Gouvea V, Plotkin SA. Protective effect of WC3 vaccine against rotavirus diarrhea in infants during a predominantly serotype I rotavirus season. J Infect Dis. 1988;158: 570-87.

6. Givon-Lavi N, Greenberg D, Dagan R. Comparison between two severity scoring scales commonly used in the evaluation of rotavirus gestroenteritis in children. Vaccine. 2008;26:5798-801.

7. de Rougemont A, Kaplon J, Billaud G, Lina B, Pinchinat S, Derrough T, et al. Sensitivity and specificity of the VIKIA Rota-Adeno immuno-chromatographic test (bioMérieux) and the ELISA IDEIA Rotavirus kit (Dako) compared to genotyping. Pathol Biol. 2009;57:86-9.