Epidemiology, clinical presentations and burden of rotavirus diarrhea in children under five seen at Ramathibodi Hospital, Thailand.

BACKGROUND To be able to monitor the impact of rotavirus vaccines in the future, the authors designed the present study along with the Rotavirus Surveillance Project-Thailand. OBJECTIVE To examine the epidemiology, clinical presentation, and direct medical cost of rotavirus-caused diarrhea in Thailand MATERIAL AND METHOD Clinical presentations of all diarrhea cases during the study period were analyzed Rotavirus diarrhea was confirmed with polyacrylamide gel electrophoresis. Serological typing was characterized by reverse transcription-polymerase chain reaction. RESULTS Between April 2001 and March 2002, 239 under 5-year-old diarrhea cases admitted in Ramathibodi Hospital, Thailand were identified Clinical presentations and laboratory results were analyzed from 85 cases. Rotavirus was identified in 48.2% of the specimens. The most common serotypes were G9 (67%), G4 (23%), and GI (2%) respectively. The most common age of rotavirus diarrhea was 12-17 months. The seasonal peak was during November 2001 to January 2002 (the cool and dry season in Thailand). The predominant symptoms were watery diarrhea, fever, and vomiting. Rotavirus diarrhea tended to have more dehydration and metabolic acidosis than other causes. The G4 serotype was associated with the most severe presentations. CONCLUSION The proportion of rotavirus diarrhea in the present study was 48%. The mean direct medical cost per episode of rotavirus diarrhea per child was 2,101 baht (approximately 52 US $).