Browsing by Author "Nakagomi, O."

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    Hospital-based study of the severity and economic burden associated with rotavirus diarrhea in Sri Lanka
    (IOS Press, 2009) Chandrasena, N.; Rajindrajith, S.; Ahmed, K.; Pathmeswaran, A.; Nakagomi, O.
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    Paediatric rota-virus diarrhoea in Sri Lanka: a preliminary report
    (Sri Lanka Medical Association, 2007) Chandrasena, T.G.A.N.; Rajindrajith, S.; Ahmed, K.; Pathmeswaran, A.; Abeyewickreme, W.; Nakagomi, O.
    OBJECTIVE: To determine the prevalence, severity and molecular epidemiology of group A rotavirus infections among children hospitalized with diarrhoea in Sri Lanka. DESIGN, SETTINGS AND METHODS: A prospective hospital-based study was conducted in the paediatric units of the Colombo North Teaching Hospital from April 2005 to February 2006. Stool samples of children admitted with diarrhoea were analysed for Group A rotavirus antigen by enzyme linked immunosorbent assay (ELISA) (Rotaclone ®). Samples positive for rotavirus were characterised by electropherotyping (PAGE) and serotyping (reverse transcription-polymerase chain reaction (RT-PCR) respectively. Severity of diarrhoea was assessed by the Vesikari severity score. RESULTS: A total of 341 children [(204 males, mean age 25.7 months (range 1-144)] were studied. Sixty seven (19.6%) had rotavirus diarrhoea. RT-PCR and PAGE were done on 58 rotavirus positive samples. Thirty one samples were PAGE positive with 6 different electropherotypes. RT-PCR revealed the presence of serotypes Gl, G2, G3, G4 and G9 in 7 (12.1%), 16 (27.6%), 2 (3.4%), 2 (3.4%) and 11 (19.0%) samples respectively. Twenty samples (34.5%) were untypable. Severity score assessed in 326 patients revealed a mean score of 13.3 and 11.4 in rotavirus positive and negative diarrhoeas respectively (p<0.05). Presence, frequency and duration of vomiting and duration of diarrhoea were significantly higher in rotavirus infections (p<0.05). CONCLUSIONS: Rotavirus is an important agent of severe paediatric diarrhoea in Sri Lanka. Molecular analysis indicates genetic diversity among group A rotavirus. This study reports for the first time G9 type rotavirus infection in Sri Lanka.
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    Paediatric rotavirus diarrhoea in Sri Lanka: a preliminary report
    (Sri Lanka College of Paediatricians, 2007) Chandrasena, T.G.A.N.; Rajindrajith, S.; Ahmed, K.; Pathmeswaran, A.; Abeyewickreme, W.; Nakagomi, O.
    BACKGROUND: Group A rotavirus is the leading cause of acute gastroenteritis in children. Serotypes Gl, G2, G3 and G4 are mainly responsible for human infections. Strain characterization and serotype distribution of rotavirus in a country is an importaa determinant of future vaccine strategy. Information in this regard is scarce in Sri Lanka. OBJECTIVES: To determine the prevalence, severity and molecular epidemiology of rotavirus diarrhoea among children hospitalized with diarrhoea in Sri Lanka. DESIGN, SETTING AND METHOD: A prospective hospital-based study was conducted in the paediatric units of the North Colombo Teaching Hospital from April 2005-February 2006. Stool samples of children admitted with diarrhoea were analyzed for Group A rotavirus antigen by enzyme linked immunosorbent assay (EL1SA) (Rotaclone). Samples positive for rotavirus were characterized electropherotyping (PAGE) and serotyping (reverse transcription-poiymerase chain reaction (RT-PCR)) respectively. Severity of diarrhoea was assessed by the Vesikari severity score. RESULTS: A total of 341 children [204 males mean age 25.7 months (range 1-144)] were studied. Sixty seven (19.6%) had rotavirus diarrhoea. RT-PCR and PAGE were done on 58 rotavirus positive samples. Thirty one were PAGE positive with 6 different electropherotypes. RT-PCR revealed the presence of serotypes Gl, G2, G3, G4 and G9 in 7 (12.1%), 16 (27.6%),2 (3.4%), 2 (3.4%), and 11 (19.0%) samples respectively. Twenty (34.5%) were untypable. Severity score, assessed in 326 patients, revealed a mean score of 13.3 and 11.4 in rotavirus positive and negative patients respectively (p=0.05). Presence frequency and duration of vomiting and duration of diarrhoea were significantly higher in rotavirus diarrhoea (p<0.05). CONCLUSIONS: Rotavirus is an important agent of severe paediatric diarrhoea in Sri Lanka. Molecular analysis indicates genetic diversity among group A rotavirus in Sri Lanka. This study reports for the first time of G9 type rotavirus infection in Sri Lanka.
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    Projected cost- effectivenes of rotavirus vaccination in Sri Lanka
    (The Bulletin of the Sri Lanka College of Microbiologists, 2007) Chandrasena, T.G.A.N.; Rajindrajith, S.; Gunawardane, R.; Adhihetty, D.; Ahmed, K.; Pathmeswaran, A.; Nakagomi, O.
    OBJECTIVES: The disease and economic burden of rotavirus infection among children hospitalised for gastroenteritis in Sri Lanka was assessed, in anticipation of the availability of new rotavirus vaccines. METHODS: A prospective gastroenteritis case surveillance was conducted between April 2005-October 2006 at the paediatric units of the Colombo North Teaching Hospital. Stool samples of children admitted with diarrhoea were screened for group A rotavirus antigens by enzyme-immuno assay (ElA)(Rotaclone®).Information regarding medical and non- medical costs during the event was obtained among randomly selected rotavirus cases (n=45) through an interviewer administered questionnaire. Cost effectiveness of universal rotavirus vaccination was investigated assuming a cost Of ≤ US$.7 per vaccine dose (two dose regime) in accordance with the World Bank cost effectiveness standard for low-income countries. RESULTS: Total of 606 children (335 males)[ mean age 27.3 months,(range 1-144) were analyzed. 116 (19.1%) had rotavirus antigens. The prevalence among the 0-5 years age group was 20.8. The average cost per episode of rotavirus gastroenteritis was Rs. 3004(US$ 27). Estimated initial and recurrent expenditure of universal vaccination was US$ 23.7 and five million respectively. Costs saved through averting rotavirus diarrhoea hospitaljsations per year (assuming a vaccine of 100% efficacy) were US$ 0.21 million. Deaths averted were eight per year. CONCLUSION: Universal rotavirus vaccination at 5 US$.7 per dose may not be cost-saving in Srilanka. However decisions regarding vaccine use should be based not only on whether the intervention provides cost savings but also on the value of preventing associated morbidity and mortality.
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    Rotavirus infections with multiple emerging genotypes in Sri Lanka
    (Springer-Verlag, 2010) Ahmed, K.; Batuwanthudawe, R.; Chandrasena, T.G.A.N.; Mitui, M.T.; Rajindrajith, S.; Galagoda, G.; Pun, S.B.; Uchida, R.; Kunii, O.; Moji, K.; Abeysinghe, N.; Nishizono, A.; Nakagomi, O.
    Rotavirus diarrhea is an important cause of child mortality in developing countries, but studies on this diarrhea are scarce in Sri Lanka. A prospective study conducted in Sri Lanka on rotavirus infection among children in a hospital setting (n = 611) versus children residing in tsunami camps (n = 52) showed that prevalence of rotavirus infection was comparable, 21.9 and 20%, respectively. The hospital and camps were located in different districts. Analysis of the genotypes of 122 rotaviruses from the hospital and 12 from the camps indicated that G9P[8] was associated with 35 and 33%; G12P[8/nt] with 14.7 and 33%; G3P[8/4/nt] with 17 and 8% and G1P[8/4] with 6.5 and 16.7%. Rotaviruses with G2P[8/4/6] and G4P[8/4] were hospital-associated only, and some rotaviruses (9 and 8% from the hospital and the camps, respectively) were G- and P-nontypable. We conclude from the present study that multiple emerging genotypes were prevalent in Sri Lanka, and children in camps were at risk of developing diarrhea due to rotaviruses