Salim Hendra, Karyana I Putu Gede, Sanjaya-Putra I Gusti Ngurah, Budiarsa Soetjiningsih, Soenarto Yati
Division of Gastroenterology and Hepatology, Department of Child Health, Medical School, Udayana University/Sanglah Hospital, Denpasar, Indonesia.
BMC Gastroenterol. 2014 Mar 26;14:54. doi: 10.1186/1471-230X-14-54.
Diarrhea is a major public health concern throughout the world because the prevalence of morbidity of diarrhea has not changed significantly in the past decade. It remains the third leading cause of death among children less than 5 years of age. Recent surveillance studies have shown that rotavirus is a significant cause of pediatric hospitalization and death due to diarrhea. Indonesia has limited data on risk factors, disease burden, and deaths in children due to rotavirus diarrhea. The objective of this study was to examine the above mentioned factors related to rotavirus diarrhea in hospitalized children in Sanglah Hospital, Denpasar.
A prospective cohort study was conducted at Sanglah Hospital Denpasar from April 2009 to December 2011. The present study was part of a nationwide study on Extension for Hospital-based Surveillance and Strain Characterization of Rotavirus Diarrhea Indonesia involving four hospitals throughout Indonesia as a part of the Asian Rotavirus Surveillance Network. We studied children aged <5 years who were hospitalized with acute diarrhea, and analyzed their stool samples using an immunoassay that detects the rotavirus antigen.
A total of 656 patients met the inclusion criteria for this study. Of 5805 patients under the age of 5 who were hospitalized between April 2009 and December 2011, the prevalence of diarrhea among hospitalized pediatric patients was 11.3% and the prevalence of rotavirus diarrhea was 49.8%. The male to female ratio of those affected by rotavirus was 1.6:1. The occurrence of vomiting was significantly higher in rotavirus diarrhea than in non-rotavirus diarrhea (RR, 1.4; 95% CI, 1.08 to 1.70; p = 0.004).
Diarrhea remains an important cause of hospitalization in children, and rotavirus was the most important etiology. We found that boys had a greatest risk of rotavirus infection than girls. Good nutritional status and breastfeeding provided the same protection against rotavirus and non-rotavirus diarrhea.
腹泻是一个全球性的重大公共卫生问题，因为在过去十年中腹泻的发病率并未显著改变。腹泻仍是5岁以下儿童的第三大死因。最近的监测研究表明，轮状病毒是导致儿童因腹泻住院和死亡的重要原因。印度尼西亚关于轮状病毒腹泻的危险因素、疾病负担和儿童死亡的数据有限。本研究的目的是调查登巴萨桑格拉医院住院儿童中与轮状病毒腹泻相关的上述因素。
2009年4月至2011年12月在登巴萨桑格拉医院进行了一项前瞻性队列研究。本研究是印度尼西亚全国性轮状病毒腹泻医院监测与毒株特征扩展研究的一部分，该研究涉及印度尼西亚各地的四家医院，是亚洲轮状病毒监测网络的一部分。我们研究了5岁以下因急性腹泻住院的儿童，并使用检测轮状病毒抗原的免疫分析法分析他们的粪便样本。
共有656名患者符合本研究的纳入标准。在2009年4月至2011年12月期间住院的5805名5岁以下患者中，住院儿科患者的腹泻患病率为11.3%，轮状病毒腹泻患病率为49.8%。感染轮状病毒的男女比例为1.6:1。轮状病毒腹泻患者呕吐的发生率显著高于非轮状病毒腹泻患者（RR，1.4；95%CI，1.08至1.70；p = 0.004）。
腹泻仍然是儿童住院的重要原因，轮状病毒是最重要的病因。我们发现男孩感染轮状病毒的风险比女孩更大。良好的营养状况和母乳喂养对轮状病毒腹泻和非轮状病毒腹泻提供相同的保护。
