Epidemiology, Clinical Presentations and Burden of Rotavirus Diarrhea in Children under Five Seen at Ramathibodi Hospital, Thailand
Utcharee Intusoma MD*, Vorasith Sornsrivichai MD, PhD**, Chuleeporn Jiraphongsa MD, PhD***, Wandee Varavithaya MD*
Affiliation : * Department of Pediatrics, Ramathibodi Hospital, Bangkok ** Epidemiology Unit, Prince of Songkla University Hospital, Hat Yai, Songkhla *** Bureau of Epidemiology, Ministry of Public Health, Nonthaburi
Background : To be able to monitor the impact of rotavirus vaccines in the future, the authors designed the
present study along with the Rotavirus Surveillance Project-Thailand.
Objective : To examine the epidemiology, clinical presentation, and direct medical cost of rotavirus-caused
diarrhea in Thailand.
Material and Method: Clinical presentations of all diarrhea cases during the study period were analyzed.
Rotavirus diarrhea was confirmed with polyacrylamide gel electrophoresis. Serological typing was charac-
terized by reverse transcription-polymerase chain reaction.
Results : Between April 2001 and March 2002, 239 under 5-year-old diarrhea cases admitted in Ramathibodi
Hospital, Thailand were identified. Clinical presentations and laboratory results were analyzed from 85
cases. Rotavirus was identified in 48.2% of the specimens. The most common serotypes were G9 (67%), G4
(23%), and G1 (2%) respectively. The most common age of rotavirus diarrhea was 12-17 months. The seasonal
peak was during November 2001 to January 2002 (the cool and dry season in Thailand). The predominant
symptoms were watery diarrhea, fever, and vomiting. Rotavirus diarrhea tended to have more dehydration and
metabolic acidosis than other causes. The G4 serotype was associated with the most severe presentations.
Conclusion : The proportion of rotavirus diarrhea in the present study was 48%. The mean direct medical cost
per episode of rotavirus diarrhea per child was 2,101 baht (~52 US $).
Keywords : Rotavirus, Surveillance, Diarrhea, Thailand
