Clinical factors predicting rotavirus diarrhea in children: A cross-sectional study from two hospitals

Table 1 Characteristics of the study population

Characteristics	Frequency		OR (95%CI)	P value
	Non-rotavirus	Rotavirus
Gender
Male	50 (29.1)	122 (70.9)	0.89 (0.52-1.53)	0.77
Female	30 (31.6)	65 (68.4)
Age (mo)
0-11	21	71	Ref	Ref
12-23	24	60	0.74 (0.38-1.46)	0.38
24-59	17	44	0.77 (0.37-1.61)	0.48
≥ 60	18	12	0.19 (0.08-0.47)	< 0.001
Nutritional status
Severely underweight	10	34	1.39 (0.63-3.08)	0.4
Underweight	14	32	0.94 (0.45-1.94)	0.86
Normoweight	41	100	Ref	Ref
Overweight	7	6	0.35 (0.11-1.11)	0.08
Obese	8	15	0.77 (0.30-1.95)	0.58
Season
Dry	32 (22.9)	108 (77.1)	0.49 (0.29-0.83)	0.01
Wet	48 (37.8)	79 (62.2)
Hospitalisation
In-patient	79 (29.7)	187 (70.3)	N/A	0.30
Intensive Care Unit	1 (100)	0 (0)
Length of stay (d)
< 3	4 (11.4)	31 (88.6)	0.27 (0.10-0.78)	0.02
≥ 3	76 (32.8)	156 (67.2)
Clinical manifestations
Diarrhea duration (d)
< 2	2 (22.2)	7 (77.8)	Ref	Ref
2-4	32 (25)	96 (75)	0.86 (0.17-4.34)	1
> 4	46 (35.4)	84 (64.6)	0.52 (0.10-2.62)	0.72
Diarrhea frequency (d)
< 3	4 (66.7)	2 (33.3)	Ref	Ref
3-4	32 (30.2)	74 (69.8)	4.63 (0.81-26.54)	0.08
> 5	44 (28.4)	111 (71.6)	5.05 (0.90-28.54)	0.07
Vomiting frequency (d)
0-3	50 (36)	89 (64)	Ref	Ref
4-5	9 (20)	36 (80)	2.25 (1.00-5.04)	0.07
> 5	21 (25.3)	62 (74.7)	1.66 (0.91-3.04)	0.13
Fever duration (d)
< 3	35 (25.4)	103 (74.6)	0.63 (0.38-1.01)	0.12
≥3	45 (34.9)	84 (65.1)
Abdominal pain
Negative	56 (25)	168 (75)	0.26 (0.14-0.52)	< 0.01
Positive	24 (55.8)	19 (44.2)
Respiratory symptoms
Negative	59 (28.8)	146 (71.2)	0.79 (0.43-1.45)	0.54
Positive	21 (33.9)	41 (66.1)
Dehydration
No dehydration	35 (46.7)	40 (53.3)	Ref	Ref
Mild-moderate	33 (20.8)	126 (79.2)	3.34 (1.85-6.10)	< 0.01
Severe	12 (36.4)	21 (63.6)	1.53 (0.66-3.55)	0.43
Treatment
Antibiotic
Negative	3 (1.7)	176 (98.3)	0.002 (0.001-0.01)	< 0.01
Positive	77 (87.5)	11 (12.5)
IV rehydration
Negative	19 (32.2)	40 (67.8)	1.15 (0.61-2.13)	0.80
Positive	61 (29.3)	147 (70.7)
Rotavirus vaccination
Negative	69 (28)	177 (72)	0.35 (0.14-0.97)	0.04
Positive	11 (52.4)	10 (47.6)
Laboratory examinations
Hemoglobin
Normal	52 (28.1)	133 (71.9)	0.75 (0.43-1.32)	0.40
Abnormal	28 (34.1)	54 (65.9)
White blood cell count
Normal	50 (24.6)	153 (75.4)	0.37 (0.21-0.67)	< 0.01
Abnormal	30 (46.9)	34 (53.1)
Basophils
Normal	63 (31.5)	137 (68.5)	1.35 (0.72-2.53)	0.43
Abnormal	17 (25.4)	50 (74.6)
Eosinophils
Normal	23 (26.1)	65 (73.9)	0.76 (0.43-1.34)	0.42
Abnormal	57 (31.8)	122 (68.2)
Band neutrophils
Normal	66 (30.7)	149 (69.3)	1.20 (0.61-2.37)	0.72
Abnormal	14 (26.9)	38 (73.1)
Segment neutrophils
Normal	9 (18.8)	39 (81.3)	0.48 (0.22-1.05)	0.09
Abnormal	71 (32.4)	148 (67.6)
Total neutrophils
Normal	10 (20.4)	39 (79.6)	0.54 (0.26-1.15)	0.15
Abnormal	70 (32.1)	148 (67.9)
Lymphocytes
Normal	13 (26)	37 (74)	0.79 (0.40-1.58)	0.61
Abnormal	67 (30.9)	150 (69.1)
Monocytes
Normal	44 (32.1)	93 (67.9)	1.24 (0.73-2.10)	0.51
Abnormal	36 (27.7)	94 (72.3)
Absolute lymphocytes count
Normal	28 (23.5)	91 (76.5)	0.57 (0.33-0.98)	0.05
Abnormal	52 (35.1)	96 (64.9)
Absolute neutrophils count
Normal	40 (23.8)	128 (76.2)	0.46 (0.30-0.79)	0.007
Abnormal	40 (40.4)	59 (59.6)
Neutrophils-to-lymphocyte ratio
Normal	33 (29.5)	4 (57.1)	0.96 (0.57-1.63)	0.99
Abnormal	77 (29.6)	183 (70.4)
Lymphocyte-to-monocyte ratio
Normal	3 (42.9)	4 (57.1)	1.79 (0.40-8.15)	0.74
Abnormal	77 (29.6)	183 (70.4)
Platelet-to-lymphocyte ratio
Normal	6 (22.2)	21 (77.8)	0.64 (0.25-1.64)	0.47
Abnormal	74 (31)	165 (69)
Erythrocyte sedimentation rate
Normal	37 (31.1)	82 (68.9)	1.1 (0.65-1.86)	0.82
Abnormal	43 (29.1)	105 (70.9)
Random blood glucose
Normal	45 (24.6)	138 (75.4)	0.46 (0.26-0.80)	0.007
Abnormal	35 (41.7)	49 (58.3)
Sodium
Normal	42 (27.5)	111 (72.5)	0.76 (0.45-1.28)	0.37
Abnormal	38 (33.3)	76 (66.7)
Potassium
Normal	33 (29.5)	79 (70.5)	0.96 (0.56-1.63)	0.99
Abnormal	47 (30.3)	108 (69.7)
Chloride
Normal	42 (29.6)	100 (70.4)	0.96 (0.57-1.63)	0.99
Abnormal	38 (30.4)	87 (69.6)
Urine and fecal tests
Urinary ketone
Negative	74 (29.8)	174 (70.2)	0.92 (0.34-2.52)	1.00
Positive	6 (31.6)	13 (68.4)
Fecal leukocytes
Negative	58 (25.9)	166 (74.1)	0.33 (0.17-0.65)	0.002
Positive	22 (51.2)	21 (48.8)

N/A: Not applicable.

Table 2 Descriptive values of the laboratory findings

Variable	Reference range	Non rotavirus	Rotavirus
Hemoglobin (g/dL)	10.5-14.0	13.49 (± 16.0)	13.0 (± 11.3)
White blood cell count (109 L)	6.0-17.5	14.54 (4.21-42.07)	11.72 (2.86-38.6)
Basophils (%)	0-0.75	0 (0-1)	0 (0-1)
Eosinophils (%)	1-3	0 (0-5)	0 (0-5)
Band neutrophils (%)	3-5	3 (2-12)	3 (1-8)
Segment neutrophils (%)	54-62	62 (20-90)	51 (15-92)
Total neutrophils (%)	58-66	65 (23-93)	54 (18-95)
Lymphocytes (%)	25-33	27 (3-69)	37 (3-75)
Monocytes (%)	3-7	7 (3-13)	7 (1-15)
Absolute lymphocyte count	4000-10500	3354.6 (290.1-15356)	4232.8 (459-24532.2)
Absolute neutrophils count	1500-8500	8662 (1768.7-32814.6)	6100 (972.4-27898)
Neutrophil-to-lymphocyte ratio	Male: 1.48-6.37; Female: 1.22-5.59	2.5 (0-31)	2 (0-32)
Lymphocyte-to-monocyte ratio	Male: 11.12-26.82; Female: 16.08-28.18	4.29 (0.38-16.50)	5.29 (0.50-54)
Platelet-to-lymphocyte ratio	Male: 132.07-178.53; Female: 132.46-181.90	96.7 (20.5-722)	98 (15.89-969)
Thrombocyte count (μ/mm3)	150000-350000	350000 (109800-1099000)	381000 (115000-1094000)
Erythrocyte sedimentation rate (mm/hour)	0-10	12 (2-215)	14 (1-68)
Random blood glucose (mg/dL)	60-100	94.5 (48-238)	85 (15-160)
Sodium (mmol/L)	134-143	136 (113-154)	135 (124-165)
Potassium (mmol/L)	4.1-5.3	4 (1.6-5.9)	4 (1.4-7.1)
Chloride (mmol/L)	98-106	100 (34.5-134)	101 (9.7-141)

Table 3 Results from multivariate logistic regression analysis for rotavirus diarrhea

Values	ORadj (95%CI)	P valueadj
Wet season	2.5 (1.3-4.8)	0.006
Length of stay ≥ 3 d	5.1 (1.4-4.8)	0.015
Fever lasts ≥ 3 d	1.9 (0.97-3.5)	0.06
Abdominal pain	3.0 (1.3-6.8)	0.007
Mild-moderate dehydration	1.2 (0.4-3.5)	0.75
Severe dehydration	2.9 (1.1-7.9)	0.034
Abnormal white blood cell counts	2.8 (1.3-6.0)	0.006
Abnormal absolute neutrophil counts	1.9 (0.9-3.8)	0.072
Abnormal random blood glucose	2.3 (1.2-4.4)	0.018
Presence of fecal leukocytes	4.1 (1.7-9.5)	0.001

CI: Confidence intervals; OR: Odds ratio, OR_adj: Adjusted odds ratio.