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.
