Arístegui J, Ferrer J, Salamanca I, Garrote E, Partidas A, San-Martin M, San-Jose B
Unidad de Infectología Pediátrica, Hospital de Basurto, Universidad del País Vasco (UPV/EHU), Avenida de Montevideo 18, 48013, Bilbao, Vizcaya, Spain.
Pediatría, CAP Roquetes Canteres, Barcelona, Spain.
BMC Infect Dis. 2016 Oct 10;16(1):549. doi: 10.1186/s12879-016-1890-7.
Rotavirus is acknowledged as an important cause of paediatric gastroenteritis worldwide. In Spain, comprehensive data on the burden of rotavirus disease was lacking.
A prospective, multicenter, observational study was carried out, during the winter season, from October to April 2014 in selected areas of Spain (Catalonia, Basque Country, Andalusia) to estimate the frequency and characteristics of acute gastroenteritis (AGE) and rotavirus gastroenteritis (RVGE) in children ≤3 years of age seeking medical care in primary care and emergency department centres.
Of the 1087 episodes of AGE registered, 33.89 % were RVGE positive. The estimated incidence of RVGE, was 40.3 (95 % CI 36.1-44.8) episodes per 10,000 child-months in children ≤ 3 years of age and the 5-month (December-April) seasonal RVGE incidence rate was 2.01 [1.81-2.24] per 100 children. No vaccination and attending a day care centre were the main risk factors for RV infection. RVGE infected children presented more frequently with fever (63.9 % vs. 45.1 %, p = 0.009), vomiting (61.2 % vs. 44.3 %, p = 0.015), suffered more dehydration, and were hospitalised and went to the emergency room more often (41.7 % vs. 15.7 %, p <0.001) than non-RVGE infected ones. Children were usually more tired (77.5 % vs. 54.2 %, p <0.001), tearful, (47.2 % vs. 34.8 %, p <0.001), and easily irritated (76.5 % vs. 59.8 %, p <0.001), and parents were more concerned (41.7 % vs. 15.7 %, p <0.001) and suffered more working rhythm disturbances (39.0 % vs. 22.9 %, p <0.001). The cost for families of RVGE cases was significantly higher than the cost of non-RVGE infected ones (47.3 vs 36.7 euros, p = 0.011). Vaccinated children suffered less clinical symptoms and no hospitalization. Therefore, vaccination decreases the psychosocial stressors caused by the disease in the family.
Rotavirus infections are responsible for a substantial proportion of AGE cases in children ≤3 years of age in Spain attended at primary care visits. RVGE episodes are associated with greater clinical severity, greater alterations in the child´s behaviour, and higher parental distress. The outcomes of the present study recommend that routine rotavirus vaccination in infants ≤3 years of age could considerably reduce the serious burden of this potentially serious childhood disease.
轮状病毒被公认为全球小儿肠胃炎的重要病因。在西班牙，缺乏关于轮状病毒疾病负担的全面数据。
于2014年10月至4月冬季期间，在西班牙选定地区（加泰罗尼亚、巴斯克地区、安达卢西亚）开展了一项前瞻性、多中心观察性研究，以估计在初级保健和急诊科中心就医的3岁及以下儿童急性肠胃炎（AGE）和轮状病毒性肠胃炎（RVGE）的发病频率及特征。
在登记的1087例AGE病例中，33.89%为RVGE阳性。3岁及以下儿童RVGE的估计发病率为每10000儿童月40.3例（95%置信区间36.1 - 44.8），5个月（12月至4月）的季节性RVGE发病率为每100名儿童2.01例[1.81 - 2.24]。未接种疫苗和入托是RV感染的主要危险因素。与非RVGE感染儿童相比，RVGE感染儿童发热（63.9%对45.1%，p = 0.009）、呕吐（61.2%对44.3%，p = 0.015）更为频繁，脱水更严重，住院和前往急诊室的频率更高（41.7%对15.7%，p <0.001）。儿童通常更易疲倦（77.5%对54.2%，p <0.001）、爱流泪（47.2%对34.8%，p <0.001）且易激惹（76.5%对59.8%，p <0.001），家长更担忧（41.7%对15.7%，p <0.001）且工作节奏受干扰更严重（39.0%对22.9%，p <0.001）。RVGE病例家庭的费用显著高于非RVGE感染病例家庭（47.3欧元对36.7欧元，p = 0.011）。接种疫苗的儿童临床症状较轻且无需住院。因此，接种疫苗可减轻疾病给家庭带来的心理社会压力。
在西班牙初级保健就诊的3岁及以下儿童中，轮状病毒感染导致相当比例的AGE病例。RVGE发作与更高的临床严重程度、儿童行为的更大改变以及家长更大的痛苦相关。本研究结果表明，对3岁及以下婴儿进行常规轮状病毒疫苗接种可大幅减轻这种潜在严重儿童疾病的沉重负担。
