Rotavirus mortality confirmed by etiologic identification in Venezuelan children with diarrhea

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. 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. 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). 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. (authors)