Article originalIncidence des diarrhées à rotavirus chez les enfants de 0 à 5 ans hospitalisés à Ouagadougou (Burkina Faso)Incidences of rotaviral diarrhoeas in children from 0 to 5 years hospitalized at Ouagadougou (Burkina Faso)

RésuméContexteAprès l'introduction du vaccin contre les rotavirus (Rotateq®) au Burkina Faso, le centre hospitalier universitaire pédiatrique Charles de Gaulle (CHUP-CDG) et quatre autres sites ont été choisis comme sites sentinelles de surveillance des diarrhées à rotavirus.ObjectifDéterminer l'incidence des cas de diarrhées à rotavirus au CHUP-CDG avant l'introduction du vaccin à l'échelle du pays.Patients et méthodesÉtude prospective descriptive et analytique du 1er décembre 2013 au 30 avril 2014. La population d'étude était composée d'enfants de 0 à 5 ans hospitalisés pour diarrhée aiguë. Après un examen clinique complet, la recherche virale dans les selles a été faite par immuno-chromatographie au laboratoire. Les données ont été analysées avec les logiciels Epi Info version 3.5.1.RésultatsAu total, 332 enfants ont été hospitalisés pour diarrhée aiguë dont 213 (64,2 %) cas de rotavirus. Les enfants de 1 à 11 mois représentaient 64,2 % de l'effectif. Sur le plan clinique, 19,2 % des enfants avaient reçu le vaccin contre le rotavirus. Une déshydratation (sévère ou modérée) a été notifiée chez 41,8 % des enfants de même que l'hyperthermie (80,8 %) et les vomissements (92 %). Après une analyse multivariée, on notait que l'absence de vaccination (p = 0,002) ; l'alimentation au plat familial (p = 0,02) ; les vomissements (p < 0,001) et la guérison (p = 0,007) étaient les facteurs associés à la diarrhée.ConclusionAprès l'introduction du vaccin Rotateq® au Burkina Faso, une étude prospective pourrait être menée afin d'évaluer son efficacité à l'échelle nationale.

SummaryBackgroundDiarrheic diseases are a major problem of public health, especially in developing countries. Viruses would likely be responsible for over 80 % of these cases of diarrhea and the rotaviruses would likely be the main cause of these severe forms. After the introduction of the vaccine against rotaviruses (Rotateq®), in Burkina Faso, the Charles de Gaulle Pediatric University Teaching Hospital (CHUP-CDG) was selected as a sentry site of watch of rotaviral diarrheas.ObjectivesOur work aimed at assessing the incidence of cases of rotaviral diarrhea at the CHUP-CDG.Patients and methodsThe work was a descriptive prospective study, which was conducted in the department of medicine of the CHUP-CGD from 1st December 2013 to 30 April 2014. The study population was composed by children from 0 to 5 years, who were hospitalized for acute diarrhea. After a complete clinical exam was done, a collection of stools was directed to the laboratory within an hour to find out a virus by immuno-chromatography. The data were collected and analyzed thanks to Epi Info software, 3.5.1 Word and Excel 2010, and the Chi2 statistic test was used with a threshold validity of 5 % (P < 0.05).ResultsIn total, 332 children were hospitalized for acute diarrhea and among them, there were 213 cases of rotavirus, namely 64.2 %. The average age was 9.3 months ± 4 months, with extremes of 0 and 5. Children whose age was between 1 and 11 months represented 64.2 % of the cases. The sex-ratio was 1.2. On the clinical level, 19.2 % of the children had been vaccinated against the rotavirus. The children's stools were liquid and frequent, from 4 to 10 a day in 95.8 % of the cases. Dehydration was noticed in 41.8 % of the children as well as hyperthermia (80.8 %) and vomiting (92 %). After a multivaried analysis, it was noticed that the absence of vaccination (P = 0.0002); feeding at home (P = 0.02); vomiting (P < 0.007), and recovery (P = 0.007) were the factors associated with the unexpected arrival of rotaviral diarrheas.ConclusionThe struggle against rotaviral diarrheas was mainly based on measures of prevention, that is, alimentary hygiene and vaccination. After the introduction of the rotaviral vaccine in Burkina Faso, a prospective study on a national level might be conducted in order to evaluate its effectiveness.