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A Case-Control Study to Determine Risk Factors for Hospitalization for Rotavirus Gastroenteritis in U.S. Children

Dennehy, Penelope H. MD*; Cortese, Margaret M. MD; Bégué, Rodolfo E. MD; Jaeger, Jenifer L. MD*; Roberts, Nancy E.§; Zhang, Rongping; Rhodes, Philip PhD; Gentsch, John PhD; Ward, Richard PhD§; Bernstein, David I. MD, MA§; Vitek, Charles MD, MPH; Bresee, Joseph S. MD; Staat, Mary Allen MD, MPH§

The Pediatric Infectious Disease Journal: December 2006 - Volume 25 - Issue 12 - p 1123-1131
doi: 10.1097/01.inf.0000243777.01375.5b
Original Studies

Objective: The objective of this case-control study nested within a surveillance study conducted at 3 hospitals (Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Children's Hospital of New Orleans, New Orleans, LA; and Hasbro Children's Hospital, Providence, RI) was to identify risk factors for rotavirus gastroenteritis requiring hospitalization.

Patients: Cases were children ≤59 months of age who were admitted with acute gastroenteritis (AGE) and found to have rotavirus infection. Controls were selected from a birth certificate registry (Cincinnati and Providence) or a registry of patients from a large practice consortium in 11 locations (New Orleans).

Results: Three hundred forty-nine rotavirus-infected cases and 1242 control subjects were enrolled. Breast feeding was protective against hospitalization for rotavirus AGE for infants <6 months of age. (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.2–13.2). Low-birth-weight (<2500 g) infants had increased risk for hospitalization even beyond the first few months of life (OR, 2.8; 95% CI, 1.6–5.0). Children in child care were more likely to be hospitalized for rotavirus AGE than those cared for at home, particularly those ≥24 months of age (OR, 3.0; 95% CI, 1.8–5.3). Other characteristics associated with rotavirus AGE hospitalization were children <24 months of age covered by Medicaid or without insurance (OR, 2.1; 95% CI, 1.4–3.2) and having another child in the house <24 months of age (OR, 1.6; 95% CI, 1.1–2.3). The data suggest that maternal age <25 years (OR, 1.4; 95% CI, 1.0–2.0) and a mother with less than a high school education (OR, 1.5; 95% CI, 1.0–2.3) may also increase risk of rotavirus hospitalization.

Conclusion: There are socioeconomic and environmental factors and aspects of the child's medical and dietary history that identify children at risk for hospitalization with rotavirus AGE.

From the *Hasbro Children's Hospital and Brown Medical School, Department of Pediatrics, Division of Infectious Diseases, Providence, RI; the †Child Vaccine Preventable Diseases Branch, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA; the ‡Children's Hospital of New Orleans and Louisiana State University Health Sciences Center, New Orleans, LA; §Cincinnati Children's Hospital Medical Center and the Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH; and the ∥Respiratory and Enteric Virus Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.

Accepted for publication August 17, 2006.

Address for correspondence: Penelope H. Dennehy, MD, Rhode Island Hospital, Division of Pediatric Infectious Diseases, 593 Eddy Street, Providence, RI 02903. E-mail

© 2006 Lippincott Williams & Wilkins, Inc.