A prospective hospital based surveillance to estimate rotavirus disease burden in Bhutanese children under 5 years of age

Abstract

To develop an informed policy for rotavirus vaccination, this prospective study was conducted to estimate the burden of rotavirus diarrhea among children less than 5 years old attending the Department of Pediatrics, Jigme Dorji Wangchuk National Referral Hospital (JDWNRH), Thimphu, Bhutan. The duration of the study was three years, extending from February 2010 through December 2012. We estimated the frequency of hospitalization in pediatric ward and Dehydration Treatment Unit (DTU) for diarrhea and the number of events attributable to rotavirus infection among children under 5 years of age. During the study period, a total of 284 children (1 in 45) were hospitalized in pediatric ward, and 2,220 children (1 in 6 children)  in Dehydration Treatment Unit (DTU) with diarrhea among children residing in the Thimphu district. Group A rotavirus was detected in 32.5% of the stool samples from the hospitalized children in pediatric ward and 18.8% in DTU with diarrhea. Overall, 22.3% of the stool samples were rotavirus-positive, and the majority (90.8%) of them was detected in children under 2 years of age. From this study, we estimated that the annual incidence of hospitalization in ward and DTU s due to rotavirus diarrhea was 2.4/1000 (95% CI 1.7–3.4) and 10.8/1000 (95% CI 9.1–12.7) children, respectively. This study revealed that rotavirus is a major cause of diarrhea in Bhutanese children in Thimphu district and represents an important finding to policy discussions regarding the adoption of a rotavirus vaccine in Bhutan since no study has been performed previously.