The incidence and clinical presentation of infantile rotavirus diarrhoea in Sierra Leone

Abstract

Objectives
An effective vaccine is needed to protect against severe rotavirus disease, an important causes of gastroenteritis. Since there is no data for incidence and antigenic diversity of rotavirus infection in Sierra Leone, we studied its epidemiology to enable the design of an effective vaccine strategy.

Methods
Children between the ages of three months and three years, presenting with gastroenteritis, at the Ola During Children’s Hospital in Freetown, Sierra Leone were enrolled. Stool specimens were tested in South Africa using polyacrylamide gel electrophoresis to confirm rotavirus infection.

Results
Over a five-month period 143 children presenting with gastroenteritis were recruited. Stool samples obtained from 128 study subjects were tested for the presence of rotavirus; 45% were aged between three and nine months (mean age 10,85 months); 48; 38% stool samples tested positive for rotavirus. The incidence of rotavirus infection is 20% higher in boys; a gender difference confirmed elsewhere in West Africa. The rotavirus positive incidence peaked in August coinciding with the rainy season. About 90% of the rotavirus positive patients had severe diarrhoea, compared with only about two thirds of the patients whose diarrhoea was not caused by rotavirus; this difference was statistically significant.

Conclusions
There is a high incidence of rotavirus infection in Sierra Leone causing 38% of the gastroenteritis in this study. Patients with rotavirus gastroenteritis almost all had severe diarrhoea. The high incidence of rotavirus infection and the severity of the disease presentation make the institution of a rotavirus vaccine programme in Sierra Leone imperative.