Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2023; 12(5): 319-330
Published online Dec 9, 2023. doi: 10.5409/wjcp.v12.i5.319
Clinical factors predicting rotavirus diarrhea in children: A cross-sectional study from two hospitals
Michelle Indrawan, Jason Chendana, Tan Gabriella Heidina Handoko, Melanie Widjaja, Gilbert Sterling Octavius
Michelle Indrawan, Jason Chendana, Tan Gabriella Heidina Handoko, Melanie Widjaja, Gilbert Sterling Octavius, Department of Pediatric, Universitas Pelita Harapan, Banten 15811, Indonesia
Author contributions: Octavius GS and Widjaja M designed the research study; Indrawan M, Chendana J, Handoko TGH, and Octavius GS performed the research; Indrawan M and Chendana J gathered and analyzed the data; Indrawan M, Chendana J, Octavius GS, and Handoko TGH wrote the draft; All authors have read, edited and approved the final manuscript.
Institutional review board statement: This study protocol was approved by the Committee on Ethics at the University of Pelita Harapan, Tangerang, Indonesia, with Code Ethic No. 430/FK-UPH/Ext./V/2019.
Informed consent statement: The ethical board exempted informed consent due to the retrospective nature of our study. Identities were removed entirely, and data were analysed anonymously.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: Data is available upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gilbert Sterling Octavius, MD, MM, Doctor, Researcher, Department of Pediatric, Universitas Pelita Harapan, Jl. Jend. Sudirman No. 20 Bencongan, Kec. Klp. Dua, Kabupaten Tangerang, Banten 15811, Indonesia. sterlinggilbert613@hotmail.com
Received: July 19, 2023
Peer-review started: July 19, 2023
First decision: August 31, 2023
Revised: September 7, 2023
Accepted: September 25, 2023
Article in press: September 25, 2023
Published online: December 9, 2023
Processing time: 141 Days and 12.9 Hours
Abstract
BACKGROUND

Rotavirus is still a significant contributing morbidity and mortality in pediatric patients.

AIM

To look at clinical signs and symptoms and laboratory findings that can predict rotavirus gastroenteritis compared to non-rotavirus gastroenteritis.

METHODS

This was a cross-sectional study with medical records obtained from December 2015 to December 2019. Inclusion criteria for this study include all hospitalised pediatric patients (0-18 years old) diagnosed with suspected rotavirus diarrhea. The receiver operating curve and Hosmer-Lemeshow test would be used to assess the final prediction findings' calibration (goodness of fit) and discrimination performance.

RESULTS

This study included 267 participants with 187 (70%) rotavirus-diarrhea cases. The patients were primarily male in both rotavirus (65.2%) and non-rotavirus (62.5%) groups. The median age is 1.33 years old (0.08-17.67 years old). Multivariate analysis shows that wet season (ORadj = 2.5; 95%CI: 1.3-4.8, Padj = 0.006), length of stay (LOS) ≥ 3 days (ORadj = 5.1; 95%CI: 1.4-4.8, Padj = 0.015), presence of abdominal pain (ORadj = 3.0; 95%CI: 1.3-6.8, Padj = 0.007), severe dehydration (ORadj = 2.9; 95%CI: 1.1-7.9, Padj = 0.034), abnormal white blood cell counts (ORadj = 2.8; 95%CI: 1.3-6.0, Padj = 0.006), abnormal random blood glucose (ORadj = 2.3; 95%CI: 1.2-4.4, Padj = 0.018) and presence of fecal leukocytes (ORadj = 4.1, 95%CI: 1.7-9.5, Padj = 0.001) are predictors of rotavirus diarrhea. The area under the curve for this model is 0.819 (95%CI: 0.746-0.878, P value < 0.001), which shows that this model has good discrimination.

CONCLUSION

Wet season, LOS ≥ 3 d, presence of abdominal pain, severe dehydration, abnormal white blood cell counts, abnormal random blood glucose, and presence of fecal leukocytes predict rotavirus diarrhea.

Keywords: Rotavirus; Pediatric; Gastroenteritis; Diarrhea; Indonesia

Core Tip: Rotavirus gastroenteritis accounted for 19.11% of diarrheal deaths worldwide in 2019 and is still a leading cause of morbidity and mortality, especially in children under five. This cross-sectional study involving 267 children found that wet season (ORadj = 2.5; 95%CI: 1.3-4.8, Padj = 0.006), length of stay ≥ 3 d (ORadj = 5.1; 95%CI: 1.4-4.8, Padj = 0.015), presence of abdominal pain (ORadj = 3.0; 95%CI: 1.3-6.8, Padj = 0.007), severe dehydration (ORadj = 2.9; 95%CI: 1.1-7.9, Padj = 0.034), abnormal white blood cell counts (ORadj = 2.8; 95%CI: 1.3-6.0, Padj = 0.006), abnormal random blood glucose (ORadj = 2.3; 95%CI: 1.2-4.4, Padj = 0.018) and presence of fecal leukocytes (ORadj = 4.1, 95%CI: 1.7-9.5, Padj = 0.001) are predictors of rotavirus diarrhea.