Prevalence of Rotavirus Infection among Hospitalized Children Under Five Years of Age with Acute Diarrhea in Mogadishu, Somalia

Abstract

Introduction: Rotavirus is a leading cause of severe diarrhea in children under five worldwide, resulting in significant morbidity and mortality, especially in low-income countries. It is highly contagious, transmitted through contaminated hands and objects, and commonly causes hospitalizations due to dehydration. Vaccination is the key preventive measure, as no specific treatment beyond rehydration exists. This study focuses on the burden of rotavirus among hospitalized children with acute watery diarrhea in Mogadishu, Somalia, aiming to provide insights for improved diagnosis, treatment, and prevention. Methods: This cross-sectional study investigates the prevalence of rotavirus infection among children under five hospitalized with acute watery diarrhea at Mogadishu Somali Türkiye Training and Research Hospital from April to June 2024. A sample of 167 participants was selected using simple random sampling. Data collection involved structured questionnaires for demographic and clinical details, and enzyme immunoassays for rotavirus detection in stool samples. Statistical analysis, including descriptive statistics and logistic regression, will be conducted using SPSS to calculate prevalence and identify predictors of infection. Ethical approval and informed consent were obtained. Results: The prevalence of rotavirus among children hospitalized with gastroenteritis was observed to be 33.5%. Analysis revealed notable associations with several risk factors: children whose primary drinking water source was bottled water exhibited an unadjusted prevalence ratio 2.415 times higher compared to those using tap water. Severe dehydration was significantly linked with a lower unadjusted prevalence ratio of 0.342 compared to mild dehydration. Furthermore, children who missed their vaccinations demonstrated an unadjusted prevalence ratio 6 times higher, indicating a statistically significant association. Discussion: The study identified a 33.5% prevalence of rotavirus among children with gastroenteritis. It found that drinking bottled water significantly increases the risk of infection compared to tap water. Severe dehydration was less common in rotavirus-positive cases, while fever and vomiting were strongly associated with the infection. Missing the rotavirus vaccination emerged as a major risk factor, though being vaccinated did not significantly affect the risk. Interestingly, factors such as gender, residence, and socio-economic status did not show a significant association with rotavirus infection, suggesting that specific symptoms and vaccination status are more critical in understanding the prevalence and risk factors for rotavirus among these children.