Severity and treatment level of acute gastroenteritis with rotavirus in children under 5 years in INDONESIA

Abstract

Rotavirus diarrhea causing gastroenteritis in children under five years is an important
issue that urgently needs to be addressed globally. Delay in management of rotavirus
diarrhea can be fatal. Diagnostic tool for detecting rotavirus is, therefore, needed.
However, until now the gold standard diagnostic tools are expensive, often not available
and affordable in health care settings. The aim of the study was to compare the Vesikari
clinical severity score of rotavirus-positive with rotavirus-negative in hospitalized children
with acute gastroenteritis. Furthermore, the difference of the level of treatment between
rotavirus-positive with rotavirus-negative was also evaluated. This was a cross sectional
study that using secondary data from medical records of five general teaching hospital in
Indonesia. Subjects were children aged <5 years with acute watery diarrhea admitted to
the hospital. Statistical analysis used was chi square test, U-Mann Whitney, and Kruskal
Wallis. The results showed that the patient with rotavirus positive have higher dehydration
(80.2%) compared to rotavirus negative (70%). The severity level of clinical feature was
higher in diarrhea due to rotavirus positive than non rotavirus (11.47± 2.89 vs 10.41
± 2.70; p<0.000). The level of treatment was higher in rotavirus positive. The majority
had treatment plan C (47.7%) higher than plan B and A (45.6% and 30.9%; p<0.050).
This was opposite with patient with rotavirus negative that majority had treatment in
plan A (69.1%) higher than plan B and C (54.4% and 52.3%) (p<0.001). In conclusion,
the severity of gastroentrities in children under 5 years using vesikari score are higher in
diarrhea due to rotavirus positive than non rotavirus. The treatment level plan C is higher
than plan B and A in diarrhea due to rotavirus. This is opposite with non rotavirus majority
have treatment in plan A higher than plan B and C.