Laboratory Approaches and Risk Factors Associated with Rotavirus Infection in Children with Gastroenteritis in Delta Egypt

Rota virus is a well-known cause of acute diarrhea among children. Its laboratory diagnosis is crucial to guide the clinical management and prevention of its spread. Many methods (using ELISA for Ag and Antibodies, Tissue cultures, and PCRs) are available to diagnose rotavirus infection. The present study aimed to evaluate EIA, tissue culture and RT-PCR used for detection of rotavirus in stool of children in Egypt.

Stool samples were obtained from 92 children complaining of acute diarrhea, diagnosed as gastroenteritis and admitted to Mansoura University Children's Hospital. The samples were assayed for rotavirus antigens by EIA technique using standard diagnostic rotavirus kit, Tissue culture by using MA104 cell line and RT- PCR. Demographic and clinical data of the children and parents were recorded.

The frequency of Rota virus-positive cases by EIA, tissue culture and PCR was 44.6%, 40.2% and 48.9%, respectively. Sensitivity, Specificity, PPV and NPV for EIA and tissue culture were as follow; 91.1%, 95.7%, 84%, 90.7% and 82.2%, 100%, 94.5, 82% respectively. Rotavirus were detected in stool of 45 (48.9%) children with acute diarrhea, 91.1% of positive cases of rotavirus gastroenteritis were under 2 years of age with highest prevalence in children 7–12 months of age. Rotavirus-associated diarrhea peaked in autumn and winter. Regression analysis demonstrated that Children not currently breast fed were at a higher risk of rotavirus diarrhea (OR 0.3, 95% CI 0.11–0.85, P=0.02) than breastfed children. Sever dehydration and vomiting (OR 1.4, 95% CI 0.06–2.6, P=0.03 and OR 1.66, 95%CI 0.74–3.7, P=0.021) were found to be significantly presented in the RVP patients.

Generally, EIA is sufficiently sensitive for the screening of rotavirus-associated diarrhea. However, it may not be sensitive enough to detect virus with shedding of very few viral particles in stools. Thus, in such cases, a more sensitive assay, such as PCR, is recommended.