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Paediatrica IndonesianaVOLUME 51 NUMBER 3May

Original Article

138Paediatr Indones, Vol. 51, No. 3, May 2011

Epidemiology of Rotavirus diarrhea in children under

five: A hospital-based surveillance in Jakarta

Muzal Kadim1, Yati Soenarto2, Badriul Hegar1, Agus Firmansyah1

AbstractBackground Rotavirus is still a major cause of acute diarrheain children around the world, both in developed and developing

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children under five years of age treated for acute diarrhea, on average

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showed that the incidence of rotavirus diarrhea in children ranged

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studies identifying the genotypes of rotavirus strains in Indonesia.

This information is indispensable for manufacturing vaccines.

Objective To examine the epidemiology of rotavirus diarrhea,including genotypes and clinical characteristics, in children under

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Methods This study was a prospective surveillance conductedat Cipto Mangunkusumo Hospital, Jakarta from January to

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years of age who suffered from acute diarrhea.

Results Ninety-nine patients joined the study. The incidence ofURWDYLUXVLQIHFWLRQLQWKLVVWXG\ZDV7KH\RXQJHVWZDV

months of age and the oldest 54 months of age, with an average age

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Nutritional status, degree of dehydration, bloating, fever, blood

in stool, and mucus in the feces were not significantly different

between rotavirus and non-rotavirus diarrhea. Vomiting tended to

be more frequently experienced by children with rotavirus diarrhea

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seasonal pattern for rotavirus diarrhea. Most G genotypes in thisVWXG\ZHUH***DQGWKHPDMRULW\RI

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Conclusions7KHLQFLGHQFHRIURWDYLUXVGLDUUKHDLQKRVSLWDOL]HGFKLOGUHQXQGHUILYH\HDUVRIDJHLQ-DNDUWDZDVZLWKD

SUHGRPLQDQFHRI**DQG*JHQRW\SHV[Paediatr Indones.

2011;51:138-43].

Keywords: epidemiology, incidence, acute

diarrhea, rotavirus, children, Jakarta

Rotavirus is the leading cause of acute

diarrhea in children across the world with

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diarrhea in children less than five years old.

Children in Asian and African countries account for

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cases worldwide in children less than five years

old were caused by rotavirus. The highest number

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of rotavirus diarrhea in Asia (Malaysia, Vietnam,Thailand, Hong Kong, Taiwan, Korea, India, Middle

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showed that rotavirus diarrhea remains a health

problem with negatively impacting health costs, time

wasted and quality of life, due to the high morbidity

and mortality rates.4-17

Improved hygiene and sanitation can drastically

lower the incidence of diarrhea caused by non-

rotavirus agents, whereas rotavirus diarrhea is

only slightly influenced by hygiene and sanitation

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Muzal Kadim et al: Epidemiology of Rotavirus diarrhea in children under five: A hospital-based surveillance

Paediatr Indones, Vol. 51, No. 3, May 2011 139

improvements. Rotavirus is often referred as a

democratic virus, because it can affect children in

developing and developed countries with similar

incidence. Through vaccination it is hoped that

morbidity and mortality rates of diarrhea caused by

rotavirus infection can be reduced in children. In

countries that have carried out a rotavirus vaccinationprogram, decreases in the incidence of severe rotavirus

infection have been observed, although mild infection

remains ongoing.

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incidence of rotavirus infection as a cause of acute

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Table 1 shows the clinical characteristics

associated with rotavirus infection including sex, age,

nutritional status, degree of dehydration, vomiting,

bloating, fever, and stool characteristics.

Figur e 2 shows the seasonal pattern of

rotavirus infection. The distribution suggested that

rotavirus infection was present at all times in a year.

Nevertheless, the highest number of cases mainly

occurred between January and June and decreased

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Forty stools specimens testing positive forrotavirus were randomly taken for genotype

examination. We found the G genotype distribution

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respectively.

Table 1. Clinical characteristics associated with rotavirus infection

in children < 5 years old with acute diarrhea

Clinical

Characteristic

Rotavirus

Positive

N = 66 (%)

Rotavirus

Negative

N = 33 (%)

P*

Male sex

Age group

0 5 months

6 35 months

36 59 months

Nutritional status

weight/height (z-score)

Under(< -2)

Normal (-2 to 2)

Over (> 2)

Degree of dehydrationNo dehydration

Mild-moderate

Severe

Vomiting

Yes

No

Bloating

Yes

No

Fever

Yes

No

Blood in stool

Yes

No

Mucus in stoolYes

No

33 (50)

11 (17)

53 (80)

2 (3)

15 (22.5)

50 (76)

1 (1.5)

1 (1.5)

64 (97)

1 (1.5)

58 (88)

8 (12)

41

25

8 (12)

58 (88)

2 (3)

64 (97)

22 (33)

44 (67)

19 (57)

8 (24)

22 (67)

3 (9)

8 (24)

24 (73)

1 (3)

0 (0)

33 (100)

0

22 (67)

11 (33)

26

7

5 (15)

28 (85)

4 (12)

29 (88)

11 (33)

22 (67)

0.477

0.247

0.861

0.600

0.012

0.095

0.674

0.074

1.00

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Figure 3. Rotavirus genotype distribution in children

< 5 years old in Jakarta.

Figure 2. Seasonal pattern of Rotavirus diarrhea in children < 5 years old in Jakarta.


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Discussion

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study was higher than that of other studies around

WKHZRUOGDQDYHUDJHLQFLGHQFHRI4-17 Rotavirus

remains a major cause of acute diarrhea in children

and previous studies in Indonesia showed that theincidence of rotavirus infection as a cause of acute

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Nutritional status, degree of dehydration, abdominal

bloating and fever were not significantly different

between rotavirus and non-rotavirus diarrhea cases.

Vomiting tended to be more frequently experienced by

children with rotavirus diarrhea, hence these patients

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QRQURWDYLUXVGLDUUKHD6WRROFKDUDFWHULVWLFVZHUHQRWa good determinant for distinguishing rotavirus and

non-rotavirus diarrhea.

Acknowledgements

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Wahab for data analysis, Abu Thalib Aman for determining

genotypes of rotavirus strains, and the nurses and administrative

staff for their assistance in this study.

References

3DUDVKDU8'+XPPHOPDQ(*%UHVVH-60LOOHU0$*ODVV

RI. Global illness and deaths caused by rotavirus disease in

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VHYHUHFKLOGKRRGGLDUUKHD(PHUJ,QIHFW'LV

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5RWDYLUXV VXUYHLOODQFHZRUOGZLGH00:5

0RUE0RUWDO:NO\5HS

%UHVHH-6+XPPHOPDQ(1HOVRQ$6*ODVV5,5RWDYLUXVLQAsia: the value of surveillance for informing decisions about the

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1HOVRQ($67DP-6%UHVHH-63RRQ.H, Ng CH, Ip K6,

et al. Estimates of rotavirus disease burden in Hong Kong:

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