Rotavirus Powerpoint presentation.pdf

Burden of rotavirus acute gastroenteritis in

children under 5 years at Komfo Anokye

Teaching Hospital,

Sandra K Owusu,

Daniel Ansong

Richard Kwarteng Owusu

Samuel Blay Nguah,

Justice Sylverken

A Osei-Akoto

E Addo -Yobo

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Introduction• Rotavirus is the most common cause of severe acute

gastroenteritis in infants and young childrenworldwide.

• It is estimated to account for 39% of all diarrhoealdeaths, this amounts to approximately half a milliondeaths each year among children aged under 5 years.

• Greater than 80% of diarrhoeal deaths occurring in thedeveloping countries.

• Acute gastroenteritis caused by rotavirus is a frequentcause of admission and nosocomial infection inchildren who are hospitalized for reasons other thandiarrhoea.

Design:

• A prospective cross-sectional study was

conducted in the Komfo Anokye Teaching

Hospital between October 2007 and January

2008.

• The study collected history of illness,

stools and followed up all children reporting

with diarrhoea defined as three or more

episodes of loose watery stool within 24 hours

period.

Inclusion and Exclusion criteria

• Children under five years who presented with

gastroenteritis lasting less than seven days -defined as an

episode of at least three (3) loose or watery stools, or

forceful vomiting in a 24-hr period in the 7 days before

the medical visit.

• Children less than five years whose parents and or

guardians refused to consent to their participation were

excluded.

• Children with previous diagnosis of chronic disease of

the (GIT) Gastrointestinal tract for which symptoms are

compatible with the definition of acute gastroenteritis

were also be excluded from the study.

•Methods: Sites

• KATH, Department of Child Health, has 200 beds

with bed occupancy rate between 80 to 120%. The

monthly admission to the PEU averages 450 children

• About 40% of these cases are children under five

years. ;;;;;;

RESEARCH QUESTIONS

1.What are the socio-demographic characteristics

of children with acute gastroenteritis?

2.What is the percentage of Rotavirus in children

with acute gastroenteritis at Komfo Anokye

Teaching hospital?

3.How do patients with Rotavirus gastroenteritis

commonly present?

GENERAL OBJECTIVE

To determine the prevalence of Rotavirus infection in

children under five years with acute gastroenteritis at

Komfo Anokye Teaching Hospital.

SPECIFIC OBJECTIVES

• To determine the socio-demographic characteristics ofchildren with acute gastroenteritis at KATH

• To determine the percentage of rotavirus acutegastroenteritis at KATH

• To identify the common presentations of children withRotavirus acute gastroenteritis

Demographic Characteristics of the Study subjects

Characteristics

Number(%) Positive N(%)

Negative N(%)

P-Value

Sex

Male 39(50.6) 21(53.9) 18(46.2)

Female 38(49.4) 25(65.8) 13(34.2)

Total 77(100) 46(59.7) 31(40.3) 0.29

Age

0-6mths 22(28.6) 15(68.2) 7(31.8)

7-12mths 31(40.3) 17(54.8) 14(45.2)

13-24mths 18(23.4) 12(66.7) 6(33.3)

>24mths 6(7.8) 2(33.3) 4(66.7)

Total 77(100) 46(59.7) 31(40.3) 0.383

Social characteristics of the study subjects

Education Number(%)

Positive N(%)

Negative N(%)

P-Value

No Formal 4(5.2) 3(75.0) 1(25.0)

Primary 17(22.1) 10(58.8) 7(41.2)

JSS 28(36.4) 16(57.1) 12(41.2)

SSS 14(18.2) 8(57.1) 6(42.9)

Tertiary 14(18.2) 9(64.3) 5(35.7)

Total 77(100) 46(59.7) 31(40.3) 0.96

OccupationOccupation Number(%) Positive

N(%)Negative N(%)

P-Value

Trader 27(35.1) 14(51.9) 13(48.1)

Seamstress 2(2.6) 2(100) 0(0)

Hairdresser 8(10.4) 7(87.5) 1(12.5)

Teacher 22(29.9) 13(59.1) 9(40.9)

Unemployed 8(23.0) 5(62.5) 3(37.5)

Other 10(13.0) 5(50.0) 5(50.0)

Total 77(100) 31(40.3) 46(59.7) 0.41

Source of drinking water

Source of water

Number(%)

Positive N(%)

Negative N(%)

P-Value

Pipe 54(70.1) 36(66.7) 18(33.3)

Open well

7(9.1) 3(42.9) 4(57.1)

Borehole 9(11.7) 4(44.4) 5(55.6)

Stream water

1(1.3) 0(0) 1(100)

Other 6(7.8) 3(50.0) 3(50.0)

Total 77(100) 46(59.7) 31(40.3) 0.34

Results

Figure 1: Results of stools

samples tested for presence of

rotavirus

57%

43%Positive

Negative

Relationship between clinical features and presence of rotavirus infection

Characteristics Number(%) Positive N(%)

Negative N(%)

P-Value

Fever

Yes 54(100) 33(61.1) 21(38.9)

No 21(100) 11(52.4) 10(47.6)

Total 75(100) 44(58.7) 31(41.3) 0.37

Dehydration

None 22(100) 13(59.1) 9(40.9)

Some 33(100) 19(57.6) 14(42.4)

Severe 20(100) 12(60) 8(40.0)

Total 75(100) 44(58.7) 31(41.3) 0.36

Vomiting

Yes 14(100) 7(50.0) 7(50.0)

No 61(100) 37(60.7) 24(39.3)

Total 75(100) 44(58.7) 31(41.3) 0.54

Discussion

• Prevalence of Rotavirus gastroenteritis

• Common Presentations of children with Rotavirus Gastroenteritis

• Demographic Characteristics and Rotavirus Prevalence

• Maternal Educational Level and Occupation

• Conclusion

• The study has demonstrated that rotavirus is an

important cause of diarrhoea in the study area.

• Younger children were the most affected group.

The study did not show any relationship to other

clinical symptoms.

CONCLUSION

• 1. Rotavirus acute gastroenteritis is common in KomfoAnokye Teaching Hospital.

• 2. Children less than 24 months are the age group most affected.

• 3. Severe dehydration due to rotavirus acute gastroenteritis is common.

• 4. Socioeconomic characteristic of care givers was not found to be a statistically significant factor.

Recommendation

1. A bigger study on a large scale considering the rural and urban distribution

of the disease as well as the impact of the disease on the children will be

helpful. This would enable us estimate the true burden of the disease in

both settings. Such information would be used for policy formulation and

planning towards disease prevention.

2. Since studies has shown that maternal socio-economic status does not

impact on the prevalence of the disease. Efforts should be directed towards

Maternal Education on the home management of diarrohea across all levels

of socioeconomic class.

3. The high prevalence of rotavirus acute gastroenteritis at this tertiary care

center may indicate the need to consider rotavirus vaccination as part of

our Expanded Programme on Immunization.

Recommendation

• Study to evaluate the association between presence of antigenemia and severity of rotavirus diarrhoea.

Acknowledgements

• Department of Child Health-KATH

• Malaria Research Lab-KATH

• Nogouchi Memorial Institute-Legon