article · BMJ Global Health
Diarrhoea remains a major cause of global child deaths, with rotavirus accounting for nearly a quarter of these fatalities, primarily in low- and middle-income nations. Although vaccination programmes have lowered hospitalised mortality rates, the disease burden stays substantial. An investigation of secondary clinical trial data assessed whether clinical symptoms, sociodemographic factors, or vaccination history could help clinicians identify rotaviral diarrhoea in high-risk children aged 2 to 23 months. Testing of 6,697 stool samples using quantitative PCR identified a rotavirus prevalence of 21.1 percent. Vaccination history showed only a weak, statistically non-significant link to rotavirus status. Among clinical features, only shorter diarrhoea duration correlated with the infection. Regarding social factors, parental secondary education showed a minor association. Overall, standard clinical and background factors do not reliably establish rotaviral aetiology in this vulnerable group.
Rotavirus causes significant mortality among young children in resource-limited settings. Understanding whether healthcare workers can use simple clinical markers or vaccination history to spot rotavirus helps determine triage strategies. Because this study shows that standard patient history does not reliably identify rotavirus, healthcare systems must rely on specific diagnostic testing rather than clinical assumptions.
The findings suggest that clinicians cannot rely on observational history or vaccination records to confirm rotavirus, reinforcing the need for rapid diagnostic tools in low-resource clinics. This epidemiological study does not provide an application pathway or develop a commercial product.
AI-generated from the published abstract. Always read the original work before citing.
INTRODUCTION: One of the leading causes of global child mortality continues to be diarrhoea where rotavirus contributed to about 24% of deaths among all diarrhoeal deaths, mostly in low-income and middle-income countries. Rotavirus vaccination programmes have contributed to the reduction of mortality from 24% to 19% in rotavirus infections among hospitalised children, but the burden of rotaviral diarrhoea remains high, especially in settings with undernutrition. We aimed to determine the association of rotaviral diarrhoea aetiology with prior vaccination, socioeconomic status and clinical factors in children to see their utility in clinical settings. METHODS: We analysed secondary data from a multicentre clinical trial on antibiotic impact in children with diarrhoea and increased risk of mortality. We used stored stool samples of 6697 children aged 2-23 months old, presenting to a health facility with diarrhoea and increased risk of mortality. We determined rotavirus aetiology prevalence using quantitative PCR (qPCR) and looked at its association with the patient's rotaviral vaccination status, clinical symptoms and sociodemographic characteristics. Prevalence ratios (PR) were calculated with log-binomial regression models; if they did not converge, log-Poisson models were used. RESULTS: Rotavirus prevalence of 21.1% was observed. There was a weak and statistically non-significant inverse association between rotavirus vaccination and rotaviral diarrhoea aetiology (adjusted PR: 0.71, 95% CI 0.49 to 1.03). Of the five tested clinical symptoms, shorter diarrhoea duration was associated with rotaviral aetiology (PR: 2.65; 95% CI: 1.29 to 5.45). Of the seven tested socioeconomic characteristics, only maternal and paternal secondary education compared with no formal education were associated with rotaviral aetiology (PR: 0.86; 95% CI: 0.74 to 1.00, PR: 0.87, 95% CI: 0.75 to 1.00 respectively). CONCLUSION: Rotaviral diarrhoea aetiology cannot accurately be determined with prior receipt of rotavirus vaccination among children presenting to facilities with diarrhoea and increased risk of mortality. Short diarrhoea duration and parental secondary education were associated with increased prevalence of rotaviral aetiology; however, their utility in clinical care remains unclear.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1136/bmjgh-2024-018337
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
