These data underscore the need for the use of a standardized scoring system to make data comparable between different study populations and is particularly relevant in the context of determining vaccine efficacy against “severe” rotavirus R428 research buy diarrhoea. Ease of use and the lack of inclusion of behavioural characteristics which can be variably reported make the Vesikari score more deployable in the field, but it is important to define protocol driven use to ensure comparability across studies. Overall, children with rotavirus gastroenteritis
had more severe, longer disease associated with vomiting than children with non-rotavirus gastroenteritis  and , but required shorter hospitalization . A shorter duration of admission but greater severity at Selleck GSK1120212 admission and the higher rates of hypernatremia indicate an illness where dehydration is rapid, but recovery with appropriate rehydration is also rapid. The decision to hospitalize the child is based mainly on the requirement for supervised oral or intravenous rehydration as determined by the consulting physician. Though economic considerations can also influence decisions on hospitalizations, the study hospital has a policy of providing free treatment to deserving patients with acute illness, and hence socio-economic status is unlikely to have played a role. Distance
from healthcare influences access, but would not result in unnecessary hospitalization. The high number of children requiring intravenous rehydration for both rotavirus and non-rotavirus gastroenteritis was due to the study design and enrolment criteria where a child was included only if he/she presented with diarrhoea requiring hospitalization for at least 6 h for supervised oral rehydration or any duration of intravenous rehydration. In this setting, most cases presenting with mild dehydration requiring only oral rehydration
solution were treated in the emergency rooms and discharged within 6 h. Fever, lethargy and extra-intestinal symptoms GPX6 associated with rotavirus in some studies were not seen  and . Although antigenemia and viremia have been reported in children with rotavirus gastroenteritis, their clinical consequence remains unclear . Testing for antigenemia was carried out for a subset of this population in another study and the lack of an association with extraintestinal symptoms was reported . Extra-intestinal symptoms in rotavirus disease have been tracked for several years, and relatively high rates of extraintestinal symptoms associated with gastroenteritis have been noted, as in this report. In part, these may be due to a selection bias, since a referral hospital is more likely to receive and admit children with complications. However, the data presented here and additional data do not indicate an association with rotaviral etiology.