Paediatric rota-virus diarrhoea in Sri Lanka: a preliminary report

Abstract

OBJECTIVE: To determine the prevalence, severity and molecular epidemiology of group A rotavirus infections among children hospitalized with diarrhoea in Sri Lanka. DESIGN, SETTINGS AND METHODS: A prospective hospital-based study was conducted in the paediatric units of the Colombo North Teaching Hospital from April 2005 to February 2006. Stool samples of children admitted with diarrhoea were analysed for Group A rotavirus antigen by enzyme linked immunosorbent assay (ELISA) (Rotaclone ®). Samples positive for rotavirus were characterised by electropherotyping (PAGE) and serotyping (reverse transcription-polymerase chain reaction (RT-PCR) respectively. Severity of diarrhoea was assessed by the Vesikari severity score. RESULTS: A total of 341 children [(204 males, mean age 25.7 months (range 1-144)] were studied. Sixty seven (19.6%) had rotavirus diarrhoea. RT-PCR and PAGE were done on 58 rotavirus positive samples. Thirty one samples were PAGE positive with 6 different electropherotypes. RT-PCR revealed the presence of serotypes Gl, G2, G3, G4 and G9 in 7 (12.1%), 16 (27.6%), 2 (3.4%), 2 (3.4%) and 11 (19.0%) samples respectively. Twenty samples (34.5%) were untypable. Severity score assessed in 326 patients revealed a mean score of 13.3 and 11.4 in rotavirus positive and negative diarrhoeas respectively (p<0.05). Presence, frequency and duration of vomiting and duration of diarrhoea were significantly higher in rotavirus infections (p<0.05). CONCLUSIONS: Rotavirus is an important agent of severe paediatric diarrhoea in Sri Lanka. Molecular analysis indicates genetic diversity among group A rotavirus. This study reports for the first time G9 type rotavirus infection in Sri Lanka.