Factors associated with rota virus diarrhea in the post vaccine period as seen at Moi Teaching and Referral Hospital, Kenya

Abstract

Objectives: To describe the prevalence and factors associated with rotavirus diarrhea in the post vaccine era.

Design: Cross-sectional study.

Setting: Moi Teaching and referral Hospital, Pediatric Emergency Department.

Participants: Children ≤2 years with acute diarrhea illness. Data was collected onto an interviewer administered questionnaire and a Certest® rapid rotavirus stool antigen test done.

Main outcome measures: Socio-demographic and clinical characteristics including: Age, Gender, Rotavirus antigen test results, level of dehydration and anthropometric measurements.

Results: 311 participants with acute diarrhea were recruited, with 55.6% (173/311) being rotavirus positive. On bivariate analysis, age appropriate completion of routine vaccination (p=0.030), two doses of rotavirus vaccination (p=0.005) and nutrition status (p=0.009) were associated with a positive rotavirus test. On logistic regression, mild wasting (OR 2.581; CI 95% 1.068-6.236;p=0.035) and moderate wasting (OR 3.424; CI 95% 1.221-9.604;p=0.019) were associated with rotavirus positive diarrhea. Receiving two rotavirus vaccines (OR 0.151; CI 95% 0.032-0.709;p=0.017) and age appropriate completion of routine vaccination (OR 0.478; CI 95% 0.256-0.892;p=0.003) was protective. The peak rotavirus prevalence was during the dry season. Receiving one rotavirus vaccine, severe malnutrition and socio-demographic characteristics e.g. age, the child’s primary caregiver, overcrowding were not statistically significant. Although majority of the children with rotavirus positive diarrhea had non-severe dehydration (63%, 109/173) this was also not significant (OR 1.066; CI 95% 0.6695- 1.699;p=0.786).

Conclusion: Prevalence of Rotavirus diarrhea is still high among the under twos in our set up. Two rotavirus vaccines are needed for full protection. Advocacy and public health interventions should intensify to improve the vaccine coverage