Factors associated with dehydrating rotavirus diarrhea in children under five in Bangladesh: An urban-rural comparison

Rotavirus is the leading cause of dehydrating diarrhea in young children worldwide. This study aimed to identify the factors associated with dehydrating rotavirus diarrhea in children under five years of age in urban and rural Bangladesh. The study analyzed data from 7,758 children under five who presented with rotavirus diarrhea to Dhaka (urban) and Matlab (rural) hospital of icddr,b during 2009-2018, and were enrolled in the Diarrheal Disease Surveillance System. Cases were defined as children having rotavirus isolated in stool specimens presented with dehydrating diarrhea. Controls were children infected with rotavirus have no dehydration. Multivariable logistic regression models were built to identify the factors associated with dehydrating diarrhea. Among the rotavirus-infected children, 1,784 (34%) in Dhaka and 160 (6%) in Matlab had diarrhea with some or severe dehydration. The female children and age group 24-59 months age was found to be at higher risk of dehydration compared to 6-11 months age. In the multivariable logistic regression model, maternal illiteracy, vomiting, the onset of diarrhea less than 24 hours prior to presenting to the hospital, monsoon months, stunting, and wasting were significantly associated with dehydrating rotavirus diarrhea among children aged 0-59 months in Dhaka. In Matlab, monthly income, duration less than 24 hours prior to attending the hospital, and wasting had an independent significant association with dehydrating rotavirus diarrhea episodes. Considering factors diversity, educating parents and proper counselling by health care personnel during diarrhea, could lessen the severity of dehydration and the number of hospital visits later on by eliminating the modifiable risk factors among the children, which needs further studies.