Sungkapalee Thrissawan, Puntukosit Puntawee, Eunsuwan Orapun, Theamboonlers Apiradee, Chongsrisawat Voranush, Poovorawan Yong
Department of Pediatrics, Buri Ram Hospital, Buri Ram, Thailand.
Southeast Asian J Trop Med Public Health. 2006 Nov;37(6):1125-31.
To study the incidence and clinical manifestations of rotavirus among children at Buri Ram Hospital, admitted with the diagnosis of acute diarrhea between November 2005 and February 2006. In the course of a cross sectional descriptive study, 103 stool samples obtained from inpatients below the age of 5 years were examined for rotavirus by RT- PCR. Data on clinical manifestations, complications, administration of antibiotics, length of admission and hospital cost were obtained by means of questionnaires distributed among physicians. The statistics used were presented as percentage, mean and 95% confidence interval, while chi-square and unpaired t-test were used to establish significant differences at p < 0.05. Rotavirus was detected in 45 of 103 stool samples (43.68%, 95%CI = 33.93, 53.81). No significant differences were found between clinical manifestations of children with rotavirus infection and non-rotavirus infection as both groups displayed acute watery diarrhea (p = 0.33), fever (p = 0.80), nausea or vomiting (p = 0.08), predominant lymphocytes (p = 0.54), absence of red blood cells (p = 0.63) or white blood cells (p = 0.57) in the stool examination, moderate or severe dehydration (p = 0.06), lactose intolerance (p = 0.41), hypokalemia (p = 0.55), metabolic acidosis (0.18) Administration of antibiotics was significantly reduced for treatment of rotavirus acute diarrhea (31.1% vs 63.8%, p = 0.001). Hospital cost and length of admission were significantly reduced in rotavirus acute diarrhea (1,845.04 baht vs 2,297.00 baht, p < 0.01) (2.09 days vs 2.81 days, p < 0.001). Compared to previous studies, no differences were found in the percentage of rotavirus acute diarrhea. Rotavirus infection is a major cause for hospitalization of children below the age of 5 years with acute diarrhea. Clinical characteristics of rotavirus acute diarrhea were not significantly different from those due to other etiologies. Diagnosis of rotavirus infection should be based on various clinical manifestations and specific laboratory methods. Further studies on the cost benefit of rotavirus vaccine in Thailand ought to be performed before implementing a universal vaccination program.
为研究2005年11月至2006年2月期间武里南医院收治的诊断为急性腹泻的儿童中轮状病毒的发病率及临床表现。在一项横断面描述性研究过程中，对103例5岁以下住院患儿的粪便样本进行逆转录聚合酶链反应检测轮状病毒。通过向医生发放问卷获取有关临床表现、并发症、抗生素使用情况、住院时间及住院费用的数据。所采用的统计数据以百分比、均值及95%置信区间表示，同时采用卡方检验和非配对t检验来确定p<0.05时的显著差异。103份粪便样本中有45份检测到轮状病毒（43.68%，95%CI = 33.93, 53.81）。轮状病毒感染患儿与非轮状病毒感染患儿的临床表现无显著差异，两组均表现为急性水样腹泻（p = 0.33）、发热（p = 0.80）、恶心或呕吐（p = 0.08）、粪便检查中淋巴细胞为主（p = 0.54）、无红细胞（p = 0.63）或白细胞（p = 0.57）、中度或重度脱水（p = 0.06）、乳糖不耐受（p = 0.41）、低钾血症（p = 0.55）、代谢性酸中毒（0.18）。轮状病毒急性腹泻治疗中抗生素的使用显著减少（31.1%对63.8%，p = 0.001）。轮状病毒急性腹泻的住院费用和住院时间显著降低（1845.04泰铢对2297.00泰铢，p<0.01）（2.09天对2.81天，p<0.001）。与以往研究相比，轮状病毒急性腹泻的百分比无差异。轮状病毒感染是5岁以下儿童因急性腹泻住院的主要原因。轮状病毒急性腹泻的临床特征与其他病因引起的腹泻无显著差异。轮状病毒感染的诊断应基于各种临床表现及特定实验室方法。在实施普遍疫苗接种计划之前，应进一步研究泰国轮状病毒疫苗的成本效益。
