Rotavirus acute gastroenteritis common among young children, breastfeeding may reduce risk
Rotavirus acute gastroenteritis (AGE) is a common occurrence in children less than 2 years of age, though breastfed infants appear to have a lower risk of rotavirus-related diarrhoea, according to a study presented at the 49th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2016 held in Athens, Greece.
In this single tertiary care centre study, researchers set out to identify the rotavirus genotypes in infants and children <3 years of age (n=92; 52 male, 40 female; mean age 10.64±7.87 months) admitted to Mansoura University Children’s Hospital in Cairo, Egypt with rotavirus AGE. The study took place between September 2012 and February 2014. Stool analysis demonstrated rotavirus presence in 45 children (48.9 percent; rotavirus positive) with acute diarrhoea. [ESPGHAN 2016, abstract G-O-059]
More than 90 percent of rotavirus AGE cases were in children <2 years, with the highest prevalence in infants 6-12 months of age (44.4 percent). Infants who were breastfed had a reduced risk of rotavirus diarrhoea compared to those who were not breastfed (odds ratio [OR], 0.3, 95 percent confidence interval [CI], 0.11-0.85; p=0.02).
“Breastfeeding was reported to be a significant contributing factor in the prevention of rotavirus infection,” said study author Dr. Ahmed Megahed, associate professor of paediatrics at Mansoura University Children’s Hospital, Cairo, Egypt who presented the results.
Multivariate analysis demonstrated that severe dehydration and vomiting were significant predictors of rotavirus AGE (OR, 1.42, 95 percent CI, 0.06-2.68; p=0.036 and OR, 1.66, 95 percent CI, 0.74-3.7; p=0.021).
The most prevalent strains of rotavirus were the genotypes G1P, G9P, and G3P, which accounted for 26.7, 20, and 15.6 percent of rotavirus AGE cases, respectively. Individuals with the G9 strain had significantly longer gastroenteritis episodes (diarrhoea lasting more than 5 days; 91 percent) and more cases of severe dehydration (50 percent) compared to individuals with G1 and G3 strains.
“G1 and G3 genotypes show seasonal variation, while the G9 genotype does not obey this rule and there was no significant variation among the different seasons,” said Megahed, who suggested that the emergence of the G9 genotype calls for wider survey studies as well as the potential addition of this genotype to rotavirus vaccines for use in Egypt.