Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial
Introduction One of the leading causes of global child mortality continues to be diarrhoea where rotavirus contributed to about 24% of deaths among all diarrhoeal deaths, mostly in low-income and middle-income countries. Rotavirus vaccination programmes have contributed to the reduction of mortality...
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2025-07-01
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| author | Jie Liu Christopher R Sudfeld Per Ashorn Queen Dube Tahmeed Ahmed Pratibha Dhingra Usha Dhingra Arup Dutta Sunil Sazawal Karim Manji Rodrick Kisenge Mohamed Bakari Rajiv Bahl Jonathon L Simon Naor Bar-Zeev Christopher Duggan Ayesha De Costa Nigel Cunliffe Sadia Shakoor Mohammod Jobayer Chisti Farah Naz Qamar Desiree Witte Patricia B Pavlinac Doreen Rwigi Judd L Walson Samba O Sow Shahida Qureshi Eric Houpt James Platts-mills Chifundo Ndamala Sarah Somji Abraham Samma Fadima Cheick Haidara Karen L Kotloff Emily L Deichsel Benson Singa Mohammad Tahir Yousafzai Muhammad Waliur Rahman Irin Parvin Anil Kumar Sharma Vijay Kumar Jaiswal Churchil Nyabinda Christine McGrath Maurine Anyango Kevin Mwangi Kariuki Stephanie N Tornberg-Belanger Flanon Coulibaly Jasnehta Permala-Booth Dramane Malle Latif Ndeketa Rozina Thobani Jan Mohammed Cecylia Msemwa Md Farhad Kabir |
| author_facet | Jie Liu Christopher R Sudfeld Per Ashorn Queen Dube Tahmeed Ahmed Pratibha Dhingra Usha Dhingra Arup Dutta Sunil Sazawal Karim Manji Rodrick Kisenge Mohamed Bakari Rajiv Bahl Jonathon L Simon Naor Bar-Zeev Christopher Duggan Ayesha De Costa Nigel Cunliffe Sadia Shakoor Mohammod Jobayer Chisti Farah Naz Qamar Desiree Witte Patricia B Pavlinac Doreen Rwigi Judd L Walson Samba O Sow Shahida Qureshi Eric Houpt James Platts-mills Chifundo Ndamala Sarah Somji Abraham Samma Fadima Cheick Haidara Karen L Kotloff Emily L Deichsel Benson Singa Mohammad Tahir Yousafzai Muhammad Waliur Rahman Irin Parvin Anil Kumar Sharma Vijay Kumar Jaiswal Churchil Nyabinda Christine McGrath Maurine Anyango Kevin Mwangi Kariuki Stephanie N Tornberg-Belanger Flanon Coulibaly Jasnehta Permala-Booth Dramane Malle Latif Ndeketa Rozina Thobani Jan Mohammed Cecylia Msemwa Md Farhad Kabir |
| collection | DOAJ |
| description | Introduction One of the leading causes of global child mortality continues to be diarrhoea where rotavirus contributed to about 24% of deaths among all diarrhoeal deaths, mostly in low-income and middle-income countries. Rotavirus vaccination programmes have contributed to the reduction of mortality from 24% to 19% in rotavirus infections among hospitalised children, but the burden of rotaviral diarrhoea remains high, especially in settings with undernutrition. We aimed to determine the association of rotaviral diarrhoea aetiology with prior vaccination, socioeconomic status and clinical factors in children to see their utility in clinical settings.Methods We analysed secondary data from a multicentre clinical trial on antibiotic impact in children with diarrhoea and increased risk of mortality. We used stored stool samples of 6697 children aged 2–23 months old, presenting to a health facility with diarrhoea and increased risk of mortality. We determined rotavirus aetiology prevalence using quantitative PCR (qPCR) and looked at its association with the patient’s rotaviral vaccination status, clinical symptoms and sociodemographic characteristics. Prevalence ratios (PR) were calculated with log-binomial regression models; if they did not converge, log-Poisson models were used.Results Rotavirus prevalence of 21.1% was observed. There was a weak and statistically non-significant inverse association between rotavirus vaccination and rotaviral diarrhoea aetiology (adjusted PR: 0.71, 95% CI 0.49 to 1.03). Of the five tested clinical symptoms, shorter diarrhoea duration was associated with rotaviral aetiology (PR: 2.65; 95% CI: 1.29 to 5.45). Of the seven tested socioeconomic characteristics, only maternal and paternal secondary education compared with no formal education were associated with rotaviral aetiology (PR: 0.86; 95% CI: 0.74 to 1.00, PR: 0.87, 95% CI: 0.75 to 1.00 respectively).Conclusion Rotaviral diarrhoea aetiology cannot accurately be determined with prior receipt of rotavirus vaccination among children presenting to facilities with diarrhoea and increased risk of mortality. Short diarrhoea duration and parental secondary education were associated with increased prevalence of rotaviral aetiology; however, their utility in clinical care remains unclear. |
| format | Article |
| id | doaj-art-9fab8bf6f6d9489e80b0011e6fc7b75c |
| institution | DOAJ |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-07-01 |
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| series | BMJ Global Health |
| spelling | doaj-art-9fab8bf6f6d9489e80b0011e6fc7b75c2025-08-20T03:08:59ZengBMJ Publishing GroupBMJ Global Health2059-79082025-07-0110710.1136/bmjgh-2024-018337Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial Jie LiuChristopher R Sudfeld0Per Ashorn1Queen Dube2Tahmeed Ahmed3Pratibha DhingraUsha Dhingra4Arup DuttaSunil Sazawal5Karim Manji6Rodrick KisengeMohamed BakariRajiv Bahl7Jonathon L Simon8Naor Bar-Zeev9Christopher Duggan10Ayesha De Costa11Nigel CunliffeSadia ShakoorMohammod Jobayer Chisti12Farah Naz Qamar13Desiree WittePatricia B Pavlinac14Doreen RwigiJudd L Walson15Samba O Sow16Shahida QureshiEric Houpt17James Platts-millsChifundo NdamalaSarah Somji18Abraham SammaFadima Cheick HaidaraKaren L Kotloff19Emily L DeichselBenson Singa20Mohammad Tahir Yousafzai21Muhammad Waliur RahmanIrin ParvinAnil Kumar SharmaVijay Kumar JaiswalChurchil NyabindaChristine McGrathMaurine AnyangoKevin Mwangi KariukiStephanie N Tornberg-BelangerFlanon CoulibalyJasnehta Permala-BoothDramane MalleLatif NdeketaRozina ThobaniJan MohammedCecylia MsemwaMd Farhad KabirDepartments of Global Health and Population and Nutrition, Harvard School of Public Health, Boston, Massachusetts, USACenter for Child, Adolescent, Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandDepartment of Pediatrics, Queen Elizabeth Central Hospital, Blantyre, Southern Region, MalawiNutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, BangladeshCenter for Public Health Kinetics, New Delhi, New Delhi, IndiaCenter for Public Health Kinetics, New Delhi, New Delhi, IndiaDepartment of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic ofDepartment of Maternal, Child, and Adolescent Health and Aging, World Health Organization, Geneva, SwitzerlandDepartment of Maternal, Child, and Adolescent Health and Aging, World Health Organization, Geneva, SwitzerlandInternational Vaccine Access Center, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADivision of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, Massachusetts, USADepartment of Maternal, Newborn, Child and Adolescent Health, and Ageing, World Health Organization, Geneve, SwitzerlandNutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshDepartment of Pediatrics and Child Heath, The Aga Khan University, Karachi, PakistanDepartments of Global Health, University of Washington, Seattle, Washington, USADepartment of Global Health and Epidemiology, University of Washington, Seattle, Washington, USACentre pour le Développement des Vaccines, Bamako, MaliDepartment of Medicine, Infectious Diseases, International Health, University of Virginia, Charlottesville, Virginia, USADepartment of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic ofCenter for Vaccine Development and Global Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USACenter for Clinical Research, Kenya Medical Research Institute, Nairobi, KenyaDepartment of Pediatrics and Child Heath, The Aga Khan University, Karachi, PakistanIntroduction One of the leading causes of global child mortality continues to be diarrhoea where rotavirus contributed to about 24% of deaths among all diarrhoeal deaths, mostly in low-income and middle-income countries. Rotavirus vaccination programmes have contributed to the reduction of mortality from 24% to 19% in rotavirus infections among hospitalised children, but the burden of rotaviral diarrhoea remains high, especially in settings with undernutrition. We aimed to determine the association of rotaviral diarrhoea aetiology with prior vaccination, socioeconomic status and clinical factors in children to see their utility in clinical settings.Methods We analysed secondary data from a multicentre clinical trial on antibiotic impact in children with diarrhoea and increased risk of mortality. We used stored stool samples of 6697 children aged 2–23 months old, presenting to a health facility with diarrhoea and increased risk of mortality. We determined rotavirus aetiology prevalence using quantitative PCR (qPCR) and looked at its association with the patient’s rotaviral vaccination status, clinical symptoms and sociodemographic characteristics. Prevalence ratios (PR) were calculated with log-binomial regression models; if they did not converge, log-Poisson models were used.Results Rotavirus prevalence of 21.1% was observed. There was a weak and statistically non-significant inverse association between rotavirus vaccination and rotaviral diarrhoea aetiology (adjusted PR: 0.71, 95% CI 0.49 to 1.03). Of the five tested clinical symptoms, shorter diarrhoea duration was associated with rotaviral aetiology (PR: 2.65; 95% CI: 1.29 to 5.45). Of the seven tested socioeconomic characteristics, only maternal and paternal secondary education compared with no formal education were associated with rotaviral aetiology (PR: 0.86; 95% CI: 0.74 to 1.00, PR: 0.87, 95% CI: 0.75 to 1.00 respectively).Conclusion Rotaviral diarrhoea aetiology cannot accurately be determined with prior receipt of rotavirus vaccination among children presenting to facilities with diarrhoea and increased risk of mortality. Short diarrhoea duration and parental secondary education were associated with increased prevalence of rotaviral aetiology; however, their utility in clinical care remains unclear.https://gh.bmj.com/content/10/7/e018337.full |
| spellingShingle | Jie Liu Christopher R Sudfeld Per Ashorn Queen Dube Tahmeed Ahmed Pratibha Dhingra Usha Dhingra Arup Dutta Sunil Sazawal Karim Manji Rodrick Kisenge Mohamed Bakari Rajiv Bahl Jonathon L Simon Naor Bar-Zeev Christopher Duggan Ayesha De Costa Nigel Cunliffe Sadia Shakoor Mohammod Jobayer Chisti Farah Naz Qamar Desiree Witte Patricia B Pavlinac Doreen Rwigi Judd L Walson Samba O Sow Shahida Qureshi Eric Houpt James Platts-mills Chifundo Ndamala Sarah Somji Abraham Samma Fadima Cheick Haidara Karen L Kotloff Emily L Deichsel Benson Singa Mohammad Tahir Yousafzai Muhammad Waliur Rahman Irin Parvin Anil Kumar Sharma Vijay Kumar Jaiswal Churchil Nyabinda Christine McGrath Maurine Anyango Kevin Mwangi Kariuki Stephanie N Tornberg-Belanger Flanon Coulibaly Jasnehta Permala-Booth Dramane Malle Latif Ndeketa Rozina Thobani Jan Mohammed Cecylia Msemwa Md Farhad Kabir Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial BMJ Global Health |
| title | Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial |
| title_full | Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial |
| title_fullStr | Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial |
| title_full_unstemmed | Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial |
| title_short | Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the ABCD trial |
| title_sort | is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors including rotavirus vaccination status a secondary cross sectional analysis of the abcd trial |
| url | https://gh.bmj.com/content/10/7/e018337.full |
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