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Volume 25, Number 12—December 2019
Dispatch

Multicountry Analysis of Spectrum of Clinical Manifestations of Children <5 Years of Age Hospitalized with Diarrhea

Jillian Murray, S. Yati Soenarto, Nenny S. Mulyani, Pushpa S. Wijesinghe, Evans M. Mpabalwani, Julia C. Simwaka, Belem Matapo, Jason M. Mwenda, Gayane Sahakyan, Svetlana Grigoryan, Artavazd Vanyan, Sergey Khactatryan, Jennifer Sanwogou, Lúcia Helena de Oliveira, Gloria Rey-Benito, Gagandeep Kang, Fatima Serhan, Jacqueline E. Tate, Negar Aliabadi, Adam L. CohenComments to Author , and the Global Rotavirus Surveillance Network Clinical Presentation Group
Author affiliations: World Health Organization, Geneva, Switzerland (J. Murray, F. Serhan, A.L. Cohen); Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia (S.Y. Soenarto, N.S. Mulyani); World Health Organization, South-East Asia Regional Office, New Delhi, India (P.S. Wijesinghe); University Teaching Hospital, Lusaka, Zambia (E.M. Mpabalwani, J.C. Simwaka); World Health Organization Country Office, Lusaka (B. Matapo); World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo (J.M. Mwenda); National Immunization Program, Yerevan, Armenia (G. Sahakyan); National Centre of Disease Control and Prevention, Yerevan (G. Sahakyan, S. Grigoryan, A. Vanyan); Ministry of Health of Armenia, Yerevan (G. Sahakyan, S. Grigoryan, A. Vanyan, S. Khactatryan); Immunization and Epidemiology of Vaccine-Preventable Diseases Program, Yerevan (S. Grigoryan); Pan American Health Organization, Washington, DC, USA (J. Sanwogou, L.H. de Oliveira, G. Rey-Benito); Christian Medical College, Vellore, India (G. Kang); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.E. Tate, N. Aliabadi)

Main Article

Table 1

Characteristics of children <5 y of age hospitalized for diarrhea in selected countries from the WHO-Coordinated Global Rotavirus Sentinel Surveillance Network and the Indian National Rotavirus Surveillance Network, 2009–2016*

Vaccine status and country/WHO region No. sites (no. years data) No. diarrhea cases Clinical manifestations of diarrhea
Acute watery Bloody Persistent Other, nonspecified†
Overall
 33‡ (23)
 42,632
 29,853
 358
 1,467
 10,954
Before§ 13 (8) 11,637 10,396 321 55 865
India/SEAR 7 (3) 5,261 4,940 (94) 196 (4) 20 (<1) 105 (2)
Indonesia/SEAR 5 (2) 1,995 1,695 (85) 110 (6) 35 (2) 155 (8)
Zambia/AFR 1 (3) 4,381 3,761 (86) 15 (<1) 0 (0) 605 (14)
Median proportion
 NA
 NA
 86
 4
 <1
 8
After§ 21 (15) 30,995 19,457 37 1,412 10,089
Armenia/EUR 2 (3) 8,938 7,414 (83) 0 (0) 1,412 (16) 112 (1)
Bolivia/AMR 6 (3) 4,505 3,229 (72) 0 (0) 0 (0) 1,276 (28)
El Salvador/AMR 8 (3) 13,321 5,466 (41) 0 (0) 0 (0) 7,855 (59)
Paraguay/AMR 4 (3) 1,515 1,454 (96) 0 (0) 0 (0) 61 (4)
Zambia/AFR 1 (2) 2,716 1,894 (70) 37 (1) 0 (0) 785 (29)
Median proportion
 NA
 NA
 72
 0
 0
 28
Overall median proportion NA NA 84 <1 0 11

*Values are no. (%) unless otherwise indicated. AFR, African region; AMR, Americas region; EUR, European region; SEAR, Southeast Asian region; WHO, World Health Organization; NA, not applicable.
†Other category contains admissions that did not meet criteria for acute gastroenteritis, bloody or persistent diarrhea, or the logbook information was insufficient to classify the case into a specific category.
‡Includes only 1 site for Zambia, which has data both preintroduction and postintroduction.
§Excludes year of vaccine introduction for Armenia, Bolivia, El Salvador, Paraguay, and Zambia.

Main Article

1Additional members of the Global Rotavirus Surveillance Network Clinical Presentation Group who contributed data are listed at the end of this article.

Page created: November 18, 2019
Page updated: November 18, 2019
Page reviewed: November 18, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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