Clinical and Epidemiological Characteristics of Rotavirus- and EPEC-associated Hospitalized Infantile Diarrhoea in Basrah, Iraq

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Abstract
Rotavirus and enteropathogenic Escherichia coli (EPEC) were investigated in faecal specimens from 523 infants hospitalized for diarrhoea, and 93 healthy infants visiting maternal and child health clinics in Basrah city, Iraq, during an 8-month period. Twenty-four percent of cases and 2 percent of controls, and 12 percent of cases and none of controls were positive for rotavirus and EPEC, respectively. Peak admissions of all infantile diarrhoea cases, rotavirus cases, and EPEC cases occurred in the 2-3 months age group, although the rotavirus isolation rate was highest in the 8-9 months age group. Rotavirus admissions and isolation rates were highest during late winter and early spring. Rotavirus isolation rates were higher in cases from affluent areas (44 percent) than in cases from other areas of the city (21 percent). Rotavirus, EPEC, and other cases were not readily distinguished by their clinical features, although rotavirus cases were more likely to vomit. Intravenous fluids were administered to 94 percent of cases, but appeared to be necessary in, at most, one-third of cases. Neither antibiotics nor kaopectate was shown to shorten the duration of stay of cases in hospital and, among EPEC-positive cases, antibiotic administration was associated with longer duration of stay in hospital. The case fatality ratio was 4 percent and was significantly higher in infants with dyspnoea, convulsions or moderate-severe dehydration, and in infants who were young, female, or non-breast-fed.