Tiholova Mayda, Gopala Kusuma, Berberova Magda, Strokova-Stoilova Margarita, Tafalla Monica
MD, Department of Infectious Diseases, Medical University Sofia, Bulgaria.
GSK Pharmaceuticals Ltd., Bangalore, India.
Germs. 2016 Sep 1;6(3):97-105. doi: 10.11599/germs.2016.1095. eCollection 2016 Sep.
Rotavirus (RV) causes a high proportion of acute gastroenteritis (AGE) cases, especially among children under the age of five years old. This surveillance study was undertaken to study the incidence and severity of rotavirus gastroenteritis (RVGE) in primary care settings in Bulgaria over a one-year period.
In this prospective, observational study of AGE cases in children under five years of age presenting in the primary care setting over a one year period, stool samples were collected and tested for RV using a rapid visual immunochromatographic test kit. After the first visit, parents monitored their child for about two weeks and reported the symptoms experienced by the child during the follow-up period to the physician in a follow-up phone call. The percentage of RVGE cases among AGE was calculated and the severity of AGE (according to the 20-point Vesikari scale) was assessed by the physician based on the symptoms reported by the parents. The seasonality of RVGE was also studied.
The proportion of RVGE among the 624 AGE cases examined was 25.5%. Severe AGE was experienced by 81.8% RV-positive and 54.6% RV-negative children (p-value <0.001) and a third of all severe AGE cases occurred in RV-positive patients. A multivariate logistic regression analysis of the determinants of hospitalization indicated that severity of disease and RV-positivity were the statistically significant variables explaining hospitalization of AGE cases; even controlling for severity, RV-positive patients were more often hospitalized than RV-negative ones. RVGE cases occurred throughout the year, with peaks during August and September.
Our study emphasizes that RV is an important cause of AGE in children under five presenting in primary care settings in Bulgaria and a disproportionately high proportion of severe AGE cases may be attributed to RV infections.
NCT01733849.
轮状病毒（RV）导致了很大比例的急性胃肠炎（AGE）病例，尤其是在五岁以下儿童中。这项监测研究旨在调查保加利亚初级保健机构中一年内轮状病毒胃肠炎（RVGE）的发病率和严重程度。
在这项针对初级保健机构中五岁以下儿童AGE病例的前瞻性观察研究中，收集粪便样本并使用快速视觉免疫层析检测试剂盒检测RV。首次就诊后，家长对孩子进行约两周的监测，并在随访电话中将孩子在随访期间出现的症状报告给医生。计算AGE中RVGE病例的百分比，并由医生根据家长报告的症状评估AGE的严重程度（根据20分的维西卡里量表）。还研究了RVGE的季节性。
在624例接受检查的AGE病例中，RVGE的比例为25.5%。81.8%的RV阳性儿童和54.6%的RV阴性儿童经历了严重AGE（p值<0.001），所有严重AGE病例中有三分之一发生在RV阳性患者中。对住院决定因素的多因素逻辑回归分析表明，疾病严重程度和RV阳性是解释AGE病例住院的统计学显著变量；即使控制了严重程度，RV阳性患者比RV阴性患者更常住院。RVGE病例全年都有发生，在8月和9月达到高峰。
我们的研究强调，RV是保加利亚初级保健机构中五岁以下儿童AGE的重要病因，且严重AGE病例中不成比例的高比例可能归因于RV感染。
NCT01733849。
