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Article

Rotavirus Gastroenteritis in Children Less than Five Years of Age in Primary Care Settings in Bulgaria: An Observational Study

by
Mayda Tiholova
1,
Kusuma Gopala
2,
Magda Berberova
3,
Margarita Strokova-Stoilova
3 and
Monica Tafalla
4,*
1
Department of Infectious Diseases, Medical University Sofia, Sofia, Bulgaria
2
GSK Pharmaceuticals Ltd., Bangalore, India
3
GSK Bulgaria, Sofia, Bulgaria
4
Epidemiology Europe, GSK Vaccines, Avenue Fleming 20, 1300 Wavre, Belgium
*
Author to whom correspondence should be addressed.
GERMS 2016, 6(3), 97-105; https://doi.org/10.11599/germs.2016.1095
Submission received: 8 April 2016 / Revised: 27 July 2016 / Accepted: 10 August 2016 / Published: 1 September 2016

Abstract

Background: Rotavirus (RV) causes a high proportion of acute gastroenteritis (AGE) cases, especially among children under the age of five years old. This surveillance study was undertaken to study the incidence and severity of rotavirus gastroenteritis (RVGE) in primary care settings in Bulgaria over a one-year period. Methods: In this prospective, observational study of AGE cases in children under five years of age presenting in the primary care setting over a one year period, stool samples were collected and tested for RV using a rapid visual immunochromatographic test kit. After the first visit, parents monitored their child for about two weeks and reported the symptoms experienced by the child during the follow-up period to the physician in a follow-up phone call. The percentage of RVGE cases among AGE was calculated and the severity of AGE (according to the 20-point Vesikari scale) was assessed by the physician based on the symptoms reported by the parents. The seasonality of RVGE was also studied. Results: The proportion of RVGE among the 624 AGE cases examined was 25.5%. Severe AGE was experienced by 81.8% RV-positive and 54.6% RV-negative children (p-value < 0.001) and a third of all severe AGE cases occurred in RV-positive patients. A multivariate logistic regression analysis of the determinants of hospitalization indicated that severity of disease and RV-positivity were the statistically significant variables explaining hospitalization of AGE cases; even controlling for severity, RV-positive patients were more often hospitalized than RV-negative ones. RVGE cases occurred throughout the year, with peaks during August and September. Conclusion: Our study emphasizes that RV is an important cause of AGE in children under five presenting in primary care settings in Bulgaria and a disproportionately high proportion of severe AGE cases may be attributed to RV infections. Trial registration number: NCT01733849
Keywords: rotavirus; acute gastroenteritis; RV disease burden; primary care settings rotavirus; acute gastroenteritis; RV disease burden; primary care settings

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MDPI and ACS Style

Tiholova, M.; Gopala, K.; Berberova, M.; Strokova-Stoilova, M.; Tafalla, M. Rotavirus Gastroenteritis in Children Less than Five Years of Age in Primary Care Settings in Bulgaria: An Observational Study. GERMS 2016, 6, 97-105. https://doi.org/10.11599/germs.2016.1095

AMA Style

Tiholova M, Gopala K, Berberova M, Strokova-Stoilova M, Tafalla M. Rotavirus Gastroenteritis in Children Less than Five Years of Age in Primary Care Settings in Bulgaria: An Observational Study. GERMS. 2016; 6(3):97-105. https://doi.org/10.11599/germs.2016.1095

Chicago/Turabian Style

Tiholova, Mayda, Kusuma Gopala, Magda Berberova, Margarita Strokova-Stoilova, and Monica Tafalla. 2016. "Rotavirus Gastroenteritis in Children Less than Five Years of Age in Primary Care Settings in Bulgaria: An Observational Study" GERMS 6, no. 3: 97-105. https://doi.org/10.11599/germs.2016.1095

APA Style

Tiholova, M., Gopala, K., Berberova, M., Strokova-Stoilova, M., & Tafalla, M. (2016). Rotavirus Gastroenteritis in Children Less than Five Years of Age in Primary Care Settings in Bulgaria: An Observational Study. GERMS, 6(3), 97-105. https://doi.org/10.11599/germs.2016.1095

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