Hospital-based surveillance study of rotavirus gastroenteritis in children under 5 years of age in Lebanon

•We report rotavirus epidemiology in Lebanese children aged <5 years for 2007–08.•Over 500 cases were tested for rotavirus in multi-hospital based surveillance.•Gastroenteritis attributable to rotavirus was 27.7% during the 2007–08 season.•75% rotavirus cases were in children <2 years; G4P[8]WT strain was most common.•These baseline data might guide vaccination strategies against rotavirus in Lebanon.

BackgroundRotavirus (RV) is a major cause of gastroenteritis (GE) in infants and young children globally, with rotavirus gastroenteritis (RVGE) causing dehydration due to diarrhea and frequently leading to hospitalization. Epidemiological data on RVGE in Lebanon are lacking, therefore this study aims to collect such baseline data.MethodsWe conducted multicenter, hospital-based surveillance across Lebanon to estimate the proportion of diarrheal hospitalizations attributable to RV in children under 5 years of age. Medical history, GE symptoms, treatment prior to hospitalization and demographics were obtained from medical records and parent/guardian interviews. The severity of GE episodes was determined using the 20-point Vesikari scale (score ⩾11 was considered severe). Stool samples were analyzed for RV using an enzyme immunoassay and for strain prevalence using reverse transcriptase polymerase chain reaction.ResultsBetween April 2007 and September 2008, a total of 534 subjects were enrolled, of whom 491 were included in the final analysis. GE attributable to RV was 27.7% and nearly 75% of the RVGE cases occurred in children under 2 years of age. No differences were observed between the severity of signs and symptoms in RV positive and negative subjects. Hospitalization occurred mainly between December–March and lasted for a median of 3 days. Treatment primarily consisted of intravenous rehydration and almost all subjects (96.1%) had recovered by the time of discharge. Prevalent circulating G and P types were G4 (36.9%), G1WT (29.2%), P[8]WT (77.7%) and P[4] (17.7%); the most common circulating RV strain was G4P[8]WT (36.9%).ConclusionRVGE hospitalizations are prevalent in children under 5 years of age in Lebanon. This baseline data might be useful for decision makers when initiating measures, such as vaccination, to prevent the disease.