| dc.description.abstract | Background: Rotavirus infection is the leading cause of severe acute diarrhea among children less than 5 years of age worldwide. It causes an estimated 453,000 deaths annually with over 85% of these deaths occurring in low and middle-income countries of Africa and Asia. The magnitude of rotavirus disease is un known in South Sudan
Objectives: This study aimed to determine the prevalence and factors associated with rotavirus infection among children aged 2 to 24 months with acute watery diarrhea admitted to Al-Sabah Children’s Hospital in Juba, South Sudan. In addition, it describes the clinical presentation of Children with Rotavirus infection acute watery diarrhea- aged 2 – 24 months at Al- Sabah Children’s hospital, Juba South Sudan.
Methods: This was a cross sectional hospital-based study. Three hundred and sixty-eight children aged 2 - 24 months presenting with acute diarrhea to the pediatric emergency unit in Al Sabah Children’s Hospital were enrolled after obtaining consent from their parents/ caretakers. Data were collected using a standard pretested interview administered questionnaire. The questionnaire captured the socio-demographic characteristics of children and their parents, risk factors for acute watery diarrhea associated with rotavirus infection and physical examination findings. Stool samples were collected using labeled, clean, wide mouth, leak proof plastic containers and sent to the National Public Health laboratory, in Juba on the same day. Stools were tested for rotavirus antigens using the Rotavirus ELISA, ProSpecT kit. Data were entered in Epi-data version 3.1then exported to STATA version 14 for analysis.
The descriptive results were presented in terms of Mean ± SD, medians, inter quartile range, frequencies and proportions. We used univariate and bivariate analysis to compare proportions between the outcome and the clinical presentations of children with acute diarrhea. Multivariate analysis was carried out using logistic regression. Crude odds ratio and its 95% confidence interval were reported at bivariate to assessed for the factors that were associated with presence of Rotavirus infection among children aged 2-24months with acute diarrhea and variables with a P-value ≤0.2 were added in to the multi logistic regression model and adjusted odds ratio with its 95% confidence interval were reported. Variable with a p-value <0.05 were considered to be significant and independently associated with the occurrence of Rotavirus infection.
Results: The prevalence of rotavirus infection was 36.4% (134/368), and majority 93/134(69.4%) of those with rotavirus were aged 2-12 months. At multivariate analysis, children age 2-12 months were more likely to have rotavirus diarrhea (Odds ratio and 95% CI of 2.45(1.36, 4.42), p value=0.003). A child having adolescent parents; OR 3.35{1.58, 7.10), P < 0.002), parents with primary level of education and below; OR 2.29 (1.24, 4.24), p = 0.008)
xii
and poor/ inconsistent hand washing practices; OR 4.74(2.48, 9.05), p < 0.001) were independently associated with development of rotavirus diarrhea. Of the children with rotavirus associated diarrhea presented with severe dehydration or shock (OR 19.78 (9.52, 41.11), P <0.001), and those with some dehydration OR 4.12(2.07, 8.22), p =<0.001.
Conclusion and Recommendation:
This study revealed that rotavirus infection associated diarrhea is a major public health problem affecting one in three children aged 2 – 24 months with acute diarrhea in Juba South Sudan. Most of these are infants between 2-12 months of age. Children of caretakers aged less or equal to 19years of age and who have primary level of education and below were more likely to have rotavirus infection associated diarrhea. Most of the children with rotavirus infection associated diarrhea presented with some dehydration, severe dehydration and shock, fever, passing loose stool 4-5times a day and vomiting.
The government through the ministry of health should incorporate rotavirus vaccine in the routine immunization to reduce burden of Rotavirus among children in Juba, South Sudan. Future studies should include genotyping of rotavirus, to assess rotavirus epidemiology and the potential for vaccine effectiveness, seasonality of Rotavirus and safety surveillance studies once the vaccine has been rolled out.
Health workers should routinely educate care takers about important of hand hygiene when handling food, breast feeding the child, after toilet use and after changing baby diaper
Timely identification and management of children with acute diarrhea to avoid severe dehydration and shock.
Assessment and evaluation of children with acute diarrhea for rotavirus infection should be a practice for appropriate management of children with diarrhea.
This study provides baseline data to assess the future impact of vaccination. | en_US |
