Interpretation of Rotavirus-positivity Patterns Across India.

bjective: To analyze variation in rotavirus-positivity using simple alternative statistical measures. Methods: Hospital-based rotavirus surveillance among children admitted with acute gastroenteritis between 2005 and 2009. Prevalence, adjusted proportions and symmetrized index were calculated. Results: Rotavirus prevalence was 40% (range 37% - 44%). Adjusted proportion analysis revealed higher level of deviation from annual prevalence in seasons (December – February and September – November); age groups (<12 months and 12-23 months) and regions (East and South). Analysis of symmetrized index revealed higher estimates of variation in all years, except in 2006. Conclusion: Proposed statistical measures are useful as refined measures to study extent of disease spread in surveillance programmes, aiding evaluation of the load and pattern of disease burden in different regions over time.

Profile and Trends of Rotavirus Gastroenteritis in Under-five Children in India (2012-2014): Preliminary Report of the Indian National Rotavirus Surveillance Network.

Objective: To estimate the burden of rotavirus-associated gastroenteritis in India. Methods: Hospital-based surveillance network was established, with clinical evaluation and laboratory testing for rotavirus among children aged below 5 years hospitalized with acute gastroenteritis. Results: Between September 2012 and December 2014, stool samples from 10207 children were tested and rotavirus was detected in 39.6% of cases. Infections were more commonly seen among younger children (<2 years). Detection rates were higher during cooler months of September – February. Among rotavirus infected-children, 64.0% had severe or very severe disease. G1P[8] was the predominant rotavirus genotype (62.7%) observed during the surveillance period. Conclusions: Surveillance data highlights the high rotavirus disease burden and emphasizes the need for close monitoring to reduce morbidity and mortality associated with rotavirus gastroenteritis in India.

Expanded Indian National Rotavirus Surveillance Network in the Context of Rotavirus Vaccine Introduction.

Objective: To extend a nation-wide rotavirus surveillance network in India, and to generate geographically representative data on rotaviral disease burden and prevalent strains. Design: Hospital-based surveillance. Setting: A comprehensive multicenter, multi-state hospital based surveillance network was established in a phased manner involving 28 hospital sites across 17 states and two union territories in India. Patients: Cases of acute diarrhea among children below 5 years of age admitted in the participating hospitals. Results: During the 28-month study period between September 2012 and December 2014, 11898 children were enrolled and stool samples from 10207 children admitted with acute diarrhea were tested; 39.6% were positive for rotavirus. Highest positivity was seen in Tanda (60.4%) and Bhubaneswar (60.4%) followed by Midnapore (59.5%). Rotavirus infection was seen more among children aged below 2 years with highest (46.7%) positivity in the age group of 12-23 months. Cooler months of September – February accounted for most of the rotavirus-associated gastroenteritis, with highest prevalence seen during December – February (56.4%). 64% of rotavirus-infected children had severe to very severe disease. G1 P[8] was the predominant rotavirus strain (62.7%) during the surveillance period. Conclusions: The surveillance data highlights the high rotaviral disease burden in India. The network will continue to be a platform for monitoring the impact of the vaccine.