Niños Primeros en Salud, Consuelo, Dominican Republic.
Campus Universidad Central del Este, San Pedro de Macorís, Dominican Republic.
Am J Trop Med Hyg. 2024 Jan 2;110(2):339-345. doi: 10.4269/ajtmh.23-0299. Print 2024 Feb 7.
Since the rotavirus vaccine was included in the Dominican Republic's national immunization schedule in 2012, the microbiologic etiologies of acute gastroenteritis have not been described. This study aimed to determine the contribution of rotavirus as an etiology of acute gastroenteritis over a 12-month period in children under 5 years of age in both an inpatient and an outpatient setting in Consuelo, Dominican Republic. All children who were seen at Niños Primeros en Salud clinic or admitted to Hospital Municipal Dr. Angel Ponce Pinedo for acute gastroenteritis during January 2021-April 2022 were enrolled in the study. Stools were evaluated for rotavirus, enteric parasites, and pathogenic bacteria. Pathogen detection was compared between outpatients and inpatients and on the basis of child's vaccination status. From 181 children enrolled, 170 stool samples were collected, 28 (16.5%) from inpatients and 142 (83.5%) from outpatients. Rotavirus was the most commonly detected pathogen and was proportionately more common among hospitalized children, with nine (32.1%) cases among hospitalized children and 16 (11.3%) among outpatient children. (Pearson χ2 = 8.1, P = 0.004). Among patients with a positive rotavirus result, vaccination rate was lower among moderate (hospitalized) (three of six; 50%) compared with mild (outpatient) diarrhea patients (12 of 15; 80%). Giardia lamblia (10%) was the next most prevalent pathogen detected in both inpatients and outpatients using standard laboratory measures. Despite the availability of rotavirus vaccination, rotavirus remains a common cause of gastrointestinal illness among children under 5 years of age in our cohort. Incomplete vaccination status was associated with hospitalization for gastrointestinal illness.
自 2012 年轮状病毒疫苗被纳入多米尼加共和国国家免疫计划以来，急性胃肠炎的微生物病因尚未得到描述。本研究旨在确定在多米尼加共和国孔苏埃洛，在门诊和住院环境下，5 岁以下儿童在 12 个月期间轮状病毒作为急性胃肠炎病因的贡献。2021 年 1 月至 2022 年 4 月期间，在 Niños Primeros en Salud 诊所就诊或因急性胃肠炎入住 Hospital Municipal Dr. Angel Ponce Pinedo 的所有儿童均被纳入本研究。对粪便进行轮状病毒、肠道寄生虫和致病性细菌检测。比较了门诊和住院患者以及根据儿童疫苗接种状况的病原体检测结果。在纳入的 181 名儿童中，采集了 170 份粪便样本，其中 28 份（16.5%）来自住院患者，142 份（83.5%）来自门诊患者。轮状病毒是最常见的病原体，在住院儿童中比例更高，住院儿童中有 9 例（32.1%），门诊儿童中有 16 例（11.3%）。（Pearson χ2 = 8.1，P = 0.004）。在轮状病毒检测阳性的患者中，中度（住院）腹泻患者（6 例中的 3 例；50%）的疫苗接种率低于轻度（门诊）腹泻患者（15 例中的 12 例；80%）。使用标准实验室检测方法，贾第鞭毛虫（10%）是住院和门诊患者中检测到的第二大常见病原体。尽管有轮状病毒疫苗接种，但轮状病毒仍然是我们队列中 5 岁以下儿童胃肠道疾病的常见原因。不完全的疫苗接种状态与因胃肠道疾病住院有关。
