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Rotavirus Mortality Confirmed by Etiologic Identification in Venezuelan Children With Diarrhea

Pérez-Schael, Irene MSc*; Salinas, Belén MD†; González, Rosabel BS*; Salas, Hans MD, MSc‡; Ludert, Juan Ernesto PhD§; Escalona, Marisol MD∥; Alcalá, Ana BS§; Rosas, María Alejandra MD†; Materán, Mercedes MD, MSc†

Pediatric Infectious Disease Journal:
doi: 10.1097/01.inf.0000260252.48129.86
Original Studies

Background: Hospital-based studies to determine the etiology of deaths from diarrhea are scarce. In this study, we specifically analyzed deaths due to rotavirus to assess the rotavirus impact on diarrhea mortality.

Methods: To determine the rotavirus proportion contributing to mortality due to diarrhea, we analyzed data obtained from a hospital-based mortality surveillance, conducted over 7 years, in the Ciudad Hospitalaria Dr. Enrique Tejera, Valencia, Venezuela. Rotavirus was identified in stool samples collected from children who died of diarrhea, by a confirmatory ELISA and/or reverse transcription polymerase chain reaction.

Results: Our results show that rotavirus (21%; 21/100) is the leading cause of death due to diarrhea among children <5 years of age; rotavirus also has an important impact (2%; 21/1336) on deaths from all causes in this age group. Shigella spp. (19%; 13/69) was the second most important cause of death, followed by calicivirus (6%; 3/53). Furthermore, this study documents a seasonal pattern in the deaths due to rotavirus (odds ratio 3.28; 95% confidence interval 1.13–9.76).

Conclusions: For Venezuela, it is estimated that approximately 300 children <5 years of age die of rotavirus each year, which means that 1 in 1800 children die by the age of 5. Rotavirus was found to be the main cause of death due to diarrhea, which supports previous estimations. This is the first study to present data of cause-specific mortality due to diarrhea based on hospital surveillance of diarrhea etiologies.

Author Information

From the *Instituto de Biomedicina, Fuvesin, Ministerio de Salud y Universidad Central de Venezuela, Caracas, Venezuela; †Ciudad Hospitalaria Dr. Enrique Tejera, Insalud, Universidad de Carabobo, Valencia, Venezuela; ‡Instituto Nacional de Higiene Rafael Rangel, Universidad Central de Venezuela, Caracas, Venezuela; §Centro de Microbiología y Biología Celular, IVIC, Caracas, Venezuela; and ∥Ciudad Hospitalaria Dr. Enrique Tejera, Insalud, Valencia, Venezuela.

Accepted for publication January 30, 2007.

Address for correspondence: Irene Pérez Schael, Instituto de Biomedicina-Fuvesin, Apartado Postal 4043, Carmelitas, Caracas 1010 A, Venezuela. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.