Rotavirus Diarrhoea Among Children Aged Less Than Five Years In Hospital Setting In Dar Es Salaam, Tanzania

Abstract

ABSTRACT Background: Among the global efforts that have been made to reduce childhood mortality due to diarrhoea is the development of a rotavirus vaccine; however, diarrhoea remains among the highest causes of death in children under five years of age in developing countries. Before the introduction of rotavirus vaccine in Tanzania rotavirus infection was the leading cause of severe diarrhoea in children below the age of five years but there is a paucity of studies reporting the magnitude of this infection after the introduction of rotavirus vaccine. This hospital-based study reports the proportion of children with rotavirus associated diarrhoea in Dar es Salaam, its severity and associated factors. Objectives: To determine the proportion as well as clinical severity and identify associated factors for Rotavirus-associated diarrhoea among children less than five years of age in hospital settings in Dar es Salaam. Methods: A hospital based cross-sectional study was conducted at the inpatient and outpatient paediatric departments of the selected health facilities from September 2018 to February 2019. A total of 314 children meeting inclusion criteria were enrolled into the study. A structured questionnaire was administered to collect demographic and medical history, anthropometric measurements were taken and a stool sample was collected from each patient for Rotavirus antigen detection using CTK Biotech Onsite rotavirus antigen rapid test Data Analysis: Data entry, cleaning and analysis were done using SPSS software version 20. Overall proportion of children with Rotavirus infection was calculated and Contingency tables were constructed for bivariate analysis to explore factors associated with Rotavirus infection. Chi-square and Fisher’s exact tests were used to determine significance difference between responses. Multivariate logistic regression was used to assess the risk factors; the model permitted determination of having rotavirus infection in relation to associated factors. Factors with p-value less than 0.05 were considered significantly associated with rotavirus diarrhoea. Results: A total of 314 children were included in the study with age range between 2-59 months. The median age was 12 months with an interquartile range of 8-19 months. Proportion of Rotavirus diarrhoea among studied participants was found to be 10.5%. The most significant symptoms of Rotavirus diarrhoea were vomiting (p value=0.018) and severe dehydration (p value=0.000). Independent associated factors of Rotavirus diarrhoea included; Age of mother between 35- 49years (AoR 4.1, 95%CI 1.0-17.1, p value=0.05), Geographical distribution (Ilala District, vi AoR 4.0, 95%CI 1.1-10.4, p value=0.039), Mother not washing hands before feeding the child or preparing child’s meal (AoR 8.5, 95% CI 2.6-28.1, p value=0.000) and drinking bottled/treated water(AoR 5.4, 95%CI 1.3-22.7, p value=0.02). Conclusion and recommendation: Rotavirus infection was noted to be prevalent and severe among children with diarrhoea. The difference in prevalence among the districts is also of concern and hence larger community based cohort studies are needed to assess the association of Rotavirus diarrhoea with the geographical variation across districts and regions. Improving sanitation and hygiene through health education amongst households is crucial for disease prevention.