TY - JOUR
T1 - Rotavirus A infection in children under five years old with a double health problem: undernutrition and diarrhoea - a cross-sectional study in four provinces of Mozambique
AU - Chissaque, Assucenio
AU - Cassocera, Marta
AU - Gasparinho, Carolina
AU - Langa, Jeronimo Souzinho
AU - Loforte Bauhofer, Adilson Fernando
AU - Chilaule, Jorfelia Jose
AU - Joao, Eva Dora
AU - Munlela, Benilde Antonio
AU - Monteiro Sambo, Julia Assiat
AU - Boene, Simone Salvador
AU - Djedje, Marlene Bernardo
AU - Anapakala, Elda Muianga
AU - Guimaraes, Esperanca Lourenco
AU - Bero, Diocreciano Matias
AU - Manhique-Coutinho, Lena Vania
AU - Cossa-Moiane, Idalecia
AU - Kellogg, Timothy A.
AU - Pires Goncalves, Luzia Augusta
AU - de Deus, Nilsa
N1 - FTX; DOAJ; (CC BY 4.0)
PY - 2021
Y1 - 2021
N2 - Background: Mozambique has a high burden of group A rotavirus (RVA) infection and chronic undernutrition. This study aimed to determine the frequency and potential risk factors for RVA infection in undernourished children under 5 years old with diarrhoea in Mozambique.Methods: The analysis was conducted using data from March 2015 to December 2017, regarding children under 5 years old with at least one type of undernutrition. Anthropometric measures were used to calculate indices of weight-for-age, weight-for-height and height-for-age through the Z-Scores. RVA results were extracted from the National Diarrhoea Surveillance database. Descriptive statistics, chi-square test was used for qualitative variables and organized in contingency tables and 95% Confidence Intervals (CI) were considered for the calculation of RVA infection proportion and in the multiple logistic regression models to estimate the adjusted odds ratios (AOR).Results: Of the 842 undernourished children included in the analysis, 27.2% (95% CI: 24.3-30.3%) were positive for RVA. The rate of RVA infection was 42.7% (95% CI: 38.0-47.5%) in the pre-vaccine period, with great reduction to 12.2% (95% CI: 9.4-15.6%) in the post-vaccine period. Most of the RVA undernourished children had severe wasting (33.3%) and severe stunting (32.0%). The risk of infection was significantly high in children from 0 to 11 months (p-value <0.001) when compared to the age group of 24-59 months. A higher proportion of RVA infection was detected in households with five or more members (p-value = 0.029). Similar proportions of RVA were observed in children fed only by breast milk (34.9%) and breast milk with formula (35.6%). A higher proportion of undernourished HIV-positive children co-infected with RVA (7.4%) was observed.Conclusions: The frequency of RVA infection in undernourished children declined following the introduction of the vaccine in Mozambique. Beyond the temporal variation, Maputo province, age and crowded households were also associated to RVA infection. A high proportion of RVA infection was observed in children with severe wasting and a triple burden of disease: undernutrition, RVA and HIV, highlighting the need to conduct follow-up studies to understand the long-term impact of these conditions on children's development.
AB - Background: Mozambique has a high burden of group A rotavirus (RVA) infection and chronic undernutrition. This study aimed to determine the frequency and potential risk factors for RVA infection in undernourished children under 5 years old with diarrhoea in Mozambique.Methods: The analysis was conducted using data from March 2015 to December 2017, regarding children under 5 years old with at least one type of undernutrition. Anthropometric measures were used to calculate indices of weight-for-age, weight-for-height and height-for-age through the Z-Scores. RVA results were extracted from the National Diarrhoea Surveillance database. Descriptive statistics, chi-square test was used for qualitative variables and organized in contingency tables and 95% Confidence Intervals (CI) were considered for the calculation of RVA infection proportion and in the multiple logistic regression models to estimate the adjusted odds ratios (AOR).Results: Of the 842 undernourished children included in the analysis, 27.2% (95% CI: 24.3-30.3%) were positive for RVA. The rate of RVA infection was 42.7% (95% CI: 38.0-47.5%) in the pre-vaccine period, with great reduction to 12.2% (95% CI: 9.4-15.6%) in the post-vaccine period. Most of the RVA undernourished children had severe wasting (33.3%) and severe stunting (32.0%). The risk of infection was significantly high in children from 0 to 11 months (p-value <0.001) when compared to the age group of 24-59 months. A higher proportion of RVA infection was detected in households with five or more members (p-value = 0.029). Similar proportions of RVA were observed in children fed only by breast milk (34.9%) and breast milk with formula (35.6%). A higher proportion of undernourished HIV-positive children co-infected with RVA (7.4%) was observed.Conclusions: The frequency of RVA infection in undernourished children declined following the introduction of the vaccine in Mozambique. Beyond the temporal variation, Maputo province, age and crowded households were also associated to RVA infection. A high proportion of RVA infection was observed in children with severe wasting and a triple burden of disease: undernutrition, RVA and HIV, highlighting the need to conduct follow-up studies to understand the long-term impact of these conditions on children's development.
KW - Animals
KW - Breast Feeding
KW - Child Nutrition Disorders/epidemiology
KW - Child, Preschool
KW - Comorbidity
KW - Cross-Sectional Studies
KW - Diarrhea/epidemiology
KW - Family Characteristics
KW - Feces/virology
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Malnutrition/epidemiology
KW - Mozambique/epidemiology
KW - Prevalence
KW - Risk Factors
KW - Rotavirus Infections/epidemiology
KW - Rotavirus Vaccines/therapeutic use
KW - Rotavirus/immunology
U2 - 10.1186/s12879-020-05718-9
DO - 10.1186/s12879-020-05718-9
M3 - A1: Web of Science-article
C2 - 33407207
SN - 1471-2334
VL - 21
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 18
ER -