Molecular Study of Aetiology of Acute Gastroenteritis in Children of South Mumbai

Introduction: Globally, Acute Gastroenteritis (AGE) is the leading cause of morbidity and mortality among children under five years of age. Majority of diarrhoeal illness in childhood are of viral aetiology. In the era of Rotavirus vaccine, Norovirus is emerging as an important cause of AGE in children. Aim: To evaluate the aetiology of diarrhoea in children of South Mumbai. Materials and Methods: A prospective study was carried out during July 2013 at a tertiary care hospital and research centre for evaluating diarrhoea in children <= 12 years of age. Clinical details of the patients were recorded on a case record form. Severity of disease was assessed by the modified Vesikari scoring pattern. Stool samples were collected from outpatients and inpatients. Stool routine microscopy and culture were done at tertiary care hospital. Aliquots of stool samples were tested at the Research Centre for Rota Virus, Adenovirus, Norovirus and Enterovirus by Polymerase Chain Reaction (PCR). Results: A total of 51 patients were included in the study. Of these, 45.10% (23/51) were positive for viruses by real time PCR. Routine stool culture was positive for only one patient for E. coli O157. One patient had Entamoeba histolytica infection. Of 23 patients positive for viral aetiology, Norovirus was detected in 41.18% (21/51). Of the Norovirus positive children, 42.85% were <= 1 year of age. Diarrhoea followed by fever was the most common presentation. Among the Norovirus positive children, 33.33% (7/21) had moderately severe disease while 66.66 % (14/21) had mild disease. Conclusion: Norovirus was the leading cause of acute gastroenteritis in the children included in the study. This study emphasizes the need to include Norovirus in the routine diagnostic algorithm of children with AGE and paves the way for syndromic approach based testing.