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Open AccessArticle

Seasonality of Rotavirus Hospitalizations at Costa Rica’s National Children’s Hospital in 2010–2015

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Servicio de Pediatría, Hospital William Allen Taylor, Caja Costarricense del Seguro Social (CCSS), Turrialba 30501, Costa Rica
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Posgrado de Pediatría, Universidad de Costa Rica (UCR) & Caja Costarricense de Seguro Social (CCSS), San José 2060, Costa Rica
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Servicio de Emergencias, Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José 10103, Costa Rica
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Division of Nutrition Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
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Servicio de Infectología, Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José 10103, Costa Rica
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Servicio de Gastroenterología y Nutrición, Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José 10103, Costa Rica
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(13), 2321; https://doi.org/10.3390/ijerph16132321
Received: 1 June 2019 / Revised: 27 June 2019 / Accepted: 28 June 2019 / Published: 30 June 2019
(This article belongs to the Special Issue Infectious Disease Modeling in the Era of Complex Data)
Rotavirus is a leading cause of acute diarrhea in children worldwide. Costa Rica recently started universal rotavirus vaccinations for infants with a two-dose schedule in February 2019. We aimed to study the seasonality of rotavirus during the pre-vaccination era. We retrospectively studied a six-year period of hospital admissions due to rotavirus gastroenteritis. We estimated seasonal peak timing and relative intensities using trend-adjusted negative binomial regression models with the δ-method. We assessed the relationship between rotavirus cases and weather characteristics and estimated their effects for the current month, one-month prior and two months prior, by using Pearson correlation coefficients. A total of 798 cases were analyzed. Rotavirus cases predominated in the first five months of the year. On average, the peak of admissions occurred between late-February and early-March. During the seasonal peaks, the monthly count tended to increase 2.5–2.75 times above the seasonal nadir. We found the strongest negative association of monthly hospitalizations and joint percentiles of precipitation and minimal temperature at a lag of two months (R = −0.265, p = 0.027) and we detected correlations of −0.218, −0.223, and −0.226 (p < 0.05 for all three estimates) between monthly cases and the percentile of precipitation at lags 0, 1, and 2 months. In the warm tropical climate of Costa Rica, the increase in rotavirus hospitalizations coincided with dry and cold weather conditions with a two-month lag. The findings serve as the base for predictive modeling and estimation of the impact of a nation-wide vaccination campaign on pediatric rotaviral infection morbidity. View Full-Text
Keywords: rotavirus; children; acute gastroenteritis; seasonality; epidemiology; meteorology rotavirus; children; acute gastroenteritis; seasonality; epidemiology; meteorology
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Ureña-Castro, K.; Ávila, S.; Gutierrez, M.; Naumova, E.N.; Ulloa-Gutierrez, R.; Mora-Guevara, A. Seasonality of Rotavirus Hospitalizations at Costa Rica’s National Children’s Hospital in 2010–2015. Int. J. Environ. Res. Public Health 2019, 16, 2321.

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