Rotavirus Diarrhoea among Children Aged <5 Years in Hospital Setting in Dar Es Salaam, Tanzania

Abstract

Background: Diarrhoea remains among the highest causes of death in children under 5 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 5 years but there is a paucity of studies reporting the severity 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.

Methods: A hospital-based cross-sectional study was conducted at the inpatient and outpatient paediatrics 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 used 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.

Results: A total of 314 children were included in the study with age range between 2 and 59 months. The median age was 12 months with an interquartile range of 8-19 months. 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 and 49 years (AoR 4.1, 95% CI 1.0-17.1, p-value = 0.05), geographical distribution (Ilala District, AoR 4.0, 95% CI 1.1-10.4, p-value = 0.039), poor hand hygiene (AoR 8.5, 95% CI 2.6-28.1, p-value = 0.000) and drinking bottled/home-treated water (AoR 5.4, 95% CI 1.3-22.7, p-value = 0.02).

Conclusion: Rotavirus infection is still 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.

Keywords: associated factors; rotavirus diarrhoea.