Frequency of rota virus among children < 5 years with acute diarrhea: A hospital based study in Duhok / Iraq

Background: Rotavirus is the most important cause of diarrhea among children less than 5 years of age causing high morbidity and mortality, particularly in developing countries. Aims: The aims of the present work is to measure the prevalence of rotavirus diarrhea among children less than 5 years who visited a referral hospital suffering from acute gastroenteritis by ELISA test; and to measure the validity of ELISA test in comparison to PCR confirmatory test. Patients and Methods: Across sectional study design was adopted. Approval of the ethics committee was obtained and the procedures were carried out according to the ethical roles. The study included 310 children aged less than 5 years of both genders who diagnosed by specialist to be suffering from acute diarrhea; at a secondary care hospital in Duhok /Iraq . Stool samples were collected form those children during the period January–June, 2021, and then ELISA test was conducted for Rotavirus antigen. Information were also collected regarding: age, gender, father and mother education, crowding index in houses, urban/rural residency, feeding practice in the first year of life, vaccination to Rotavirus and attaches of diarrhea suffered in last month. The validity of ELISA test was measured by taking a sub sample of positive and negative cases who were further tested by PCR. Results: The prevalence of Rotavirus by ELISA test was found as 29%. No significant association was detected regarding age, gender, crowding index and Rotavirus infection. On the other hand there was a significant association between Rotavirus infection and; education family with higher rate among those with illiteracy or lower education and urban residency exclusive bottle feeding in the first year of life, while partial or complete vaccination gave protection to Rotavirus. The results also revealed that children who had more attacks of diarrheas in the month preceding admission had significantly lower prevalence of Rotavirus infection than those who had only one attack of diarrhea. The validity of ELISA test in comparison to PCR as gold standard was measured on 45 positive and 65 negative ELISA samples who were also tested by PCR. The results showed that the sensitivity, specificity, predictive values of a positive and a negative test, likelihood ratios of a positive and a negative were 88.89%, 100%, 100%, 92.86%, unidentified and 0.113 respectively, and the diagnostic accuracy of the ELISA test was determined as 95.45%. Conclusions: Rotavirus is an important cause of gastroenteritis, particularly among infants, in Duhok, Kurdistan Region, Iraq. All children less than 5 years who are admitted with gastroenteritis should be scanned for Rotavirus with ELISA test; which found to be a valid screening test. Also vaccination was an important measure and recommended for the control of the diseases. Background: Rotavirus is the most important cause of diarrhea among children less than 5 years of age causing high morbidity and mortality, particularly in developing countries. Aims: The aims of the present work is to measure the prevalence of rotavirus diarrhea among children less than 5 years who visited a referral hospital suffering from acute gastroenteritis by ELISA test; and to measure the validity of ELISA test in comparison to PCR confirmatory test. Patients and Methods: Across sectional study design was adopted. Approval of the ethics committee was obtained and the procedures were carried out according to the ethical roles. The study included 310 children aged less than 5 years of both genders who diagnosed by specialist to be suffering from acute diarrhea; at a secondary care hospital in Duhok, Kurdistan Region, Iraq. Stool samples were collected form those children during the period January–June, 2021, and then ELISA test was conducted for Rotavirus antigen. Information were also collected regarding: age, gender, father and mother education, crowding index in houses, urban/rural residency, feeding practice in the first year of life, vaccination to Rotavirus and attaches of diarrhea suffered in last month. The validity of ELISA test was measured by taking a sub sample of positive and negative cases who were further tested by PCR. Results: The prevalence of Rotavirus by ELISA test was found as 29%. No significant association was detected regarding age, gender, crowding index and Rotavirus infection. On the other hand there was a significant association between Rotavirus infection and; education family with higher rate among those with illiteracy or lower education and urban residency exclusive bottle feeding in the first year of life, while partial or complete vaccination gave protection to Rotavirus. The results also revealed that children who had more attacks of diarrheas in the month preceding admission had significantly lower prevalence of Rotavirus infection than those who had only one attack of diarrhea. The validity of ELISA test in comparison to PCR as gold standard was measured on 45 positive and 65 negative ELISA samples who were also tested by PCR. The results showed that the sensitivity, specificity, predictive values of a positive and a negative test, likelihood ratios of a positive and a negative were 88.89%, 100%, 100%, 92.86%, unidentified and 0.113 respectively, and the diagnostic accuracy of the ELISA test was determined as 95.45%. Conclusions: Rotavirus is an important cause of gastroenteritis, particularly among infants, in Duhok, Kurdistan Region, Iraq. All children less than 5 years who are admitted with gastroenteritis should be scanned for Rotavirus with ELISA test; which found to be a valid screening test. Also vaccination was an important measure and recommended for the control of the diseases.