Use of population-based surveillance to determine the incidence of rotavirus gastroenteritis in an Urban slum and a rural setting in Kenya

Robert F. Breiman, Leonard Cosmas, Allan Audi, William Mwiti, Henry Njuguna, Godfrey M. Bigogo, Beatrice Olack, John B. Ochieng, Newton Wamola, Joel M. Montgomery, John Williamson, Umesh D. Parashar, Deron C. Burton, Jacqueline E. Tate, Daniel Feikin

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. METHODS:: We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. RESULTS:: Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. CONCLUSIONS:: Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission.

Original languageEnglish (US)
JournalPediatric Infectious Disease Journal
Volume33
Issue numberSUPPL. 1
DOIs
StatePublished - 2014
Externally publishedYes

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Population Surveillance
Poverty Areas
Rotavirus
Kenya
Gastroenteritis
Incidence
Child Mortality
Immunization

Keywords

  • adults
  • children
  • diarrhea
  • gastroenteritis
  • impact
  • Kenya
  • population-based incidence
  • rates
  • rotavirus
  • rural
  • urban
  • vaccine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Use of population-based surveillance to determine the incidence of rotavirus gastroenteritis in an Urban slum and a rural setting in Kenya. / Breiman, Robert F.; Cosmas, Leonard; Audi, Allan; Mwiti, William; Njuguna, Henry; Bigogo, Godfrey M.; Olack, Beatrice; Ochieng, John B.; Wamola, Newton; Montgomery, Joel M.; Williamson, John; Parashar, Umesh D.; Burton, Deron C.; Tate, Jacqueline E.; Feikin, Daniel.

In: Pediatric Infectious Disease Journal, Vol. 33, No. SUPPL. 1, 2014.

Research output: Contribution to journalArticle

Breiman, RF, Cosmas, L, Audi, A, Mwiti, W, Njuguna, H, Bigogo, GM, Olack, B, Ochieng, JB, Wamola, N, Montgomery, JM, Williamson, J, Parashar, UD, Burton, DC, Tate, JE & Feikin, D 2014, 'Use of population-based surveillance to determine the incidence of rotavirus gastroenteritis in an Urban slum and a rural setting in Kenya', Pediatric Infectious Disease Journal, vol. 33, no. SUPPL. 1. https://doi.org/10.1097/INF.0000000000000094
Breiman, Robert F. ; Cosmas, Leonard ; Audi, Allan ; Mwiti, William ; Njuguna, Henry ; Bigogo, Godfrey M. ; Olack, Beatrice ; Ochieng, John B. ; Wamola, Newton ; Montgomery, Joel M. ; Williamson, John ; Parashar, Umesh D. ; Burton, Deron C. ; Tate, Jacqueline E. ; Feikin, Daniel. / Use of population-based surveillance to determine the incidence of rotavirus gastroenteritis in an Urban slum and a rural setting in Kenya. In: Pediatric Infectious Disease Journal. 2014 ; Vol. 33, No. SUPPL. 1.
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abstract = "BACKGROUND:: Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. METHODS:: We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. RESULTS:: Rotavirus was detected in 285 (9.0{\%}) of 3174 stools tested, including 122 (11.9{\%}) from children <5 years of age and 162 (7.6{\%}) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. CONCLUSIONS:: Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission.",
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AU - Mwiti, William

AU - Njuguna, Henry

AU - Bigogo, Godfrey M.

AU - Olack, Beatrice

AU - Ochieng, John B.

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AU - Montgomery, Joel M.

AU - Williamson, John

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AU - Tate, Jacqueline E.

AU - Feikin, Daniel

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N2 - BACKGROUND:: Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. METHODS:: We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. RESULTS:: Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. CONCLUSIONS:: Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission.

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