Rotavirus cause dehydrating diarrhea and death among infants and children globally, particularly in communities of the developing world. In his paper titled Malnutrition Is Associated with Protection from Rotavirus Diarrhea’. Longitudinal cohort study by (Verkerke et al., 2016) .
the aim of this study to understand the impact of nutritional status on susceptibility to rotavirus diarrhea. life. from there longitudinal studies doing for more than decade in the natural history of infants and children living in Bangladesh (Ali et al., 2003). they lead them to observe an association between better nutritional status and a risk of experiencing symptomatic rotavirus infection.
They hypothesis the nutritional status influences susceptibility to rotavirus infection in early life. Case study research done by 626 infants born in urban slum of Mirpur in Dhaka, the capital city of Bangladesh. These e infants enrolled at birth and were not vaccinated against rotavirus and experienced a high prevalence of malnutrition at birth and throughout the first 3 years of life. And Pregnant mothers are involved in the study.
subjects received free primary health care through the study community clinic throughout the duration of the study. They are collect Socioeconomic data, Exclusive and nonexclusive breastfeeding practices, Field research assistants (FRAs) were made home visits every other day to track the medical history of each infant, and referral infant with diarrheal illness to the field clinic or hospital. Parents bring their sick infants to study clinic for assessment and treatment. Mothers or family members, or FRAs reported diarrheal episodes. Within 3 h FRAs collect all stool of diarrheal episodes and transported on ice to the parasitology laboratory.
Detection of rotavirus was done as by using ProSpecT Rotavirus enzyme-linked immunosorbent assay (ELISA) for rotavirus antigen . They are assesses anthropometry measurement for maternal height and weight and calculate body mass index and assess infant Height-for-age Z-scores (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) are calculate at birth and at 3-month intervals.
In first 3 years they finding the proportion of the population that was underweight or stunted rose over to more than half. The proportion of wasted fell in the first 3 months and remained close to 10% throughout the remaining months. The total number of diarrheal episodes declined as infants aged from 339 episodes per 100 infants from birth to age one to 171 episodes per 100 children in the third year of life and 227 episodes of rotavirus-positive diarrhea were reported and collected from 190 children. The Pathogen diversity was high 36.3% of rotavirus-positive diarrheal stools coinfected with Entamoeba histolytica, Giardia lamblia, or Cryptosporidium parvum. The number of infants who experienced rotavirus-positive diarrhea declined in the second and third years of life so the overall 35.6 episodes per 100 infants in first 3 years of life and The majority (23.3 per 100 infants) were detected in first year of life and no infants experienced greater than three rotavirus-positive episodes, so it more common among younger infants and was associated with higher diarrheal severity, fever and vomiting. they observed by using a Cox regression analysis a primary rotavirus infection decreases the risk of subsequent rotavirus infection among infant in the first 3 years of life, Also overall duration of exclusive breastfeeding was significantly associated with repeated symptomatic infection, but they found exclusivity of breastfeeding protecting infants over 3-month durations by saw a trend toward decreased risk of rotavirus diarrhea associated with the self-reported practice of exclusive breastfeeding over each interval. And they observed by using longitudinal models of anthropometric Z-scores Malnutrition, stunting, and wasting reduce the risk of rotavirus infection. So by using mixed-effects modeling of anthropometric measures as predictors of rotavirus diarrhea there is significant association between better nutritional status and rotavirus infection during each 3-month interval. While better-nourished and nonwasted infants were more susceptible to rotavirus diarrhea, the each one-unit increment in HAZ ,WHZ and WAZ the risk of rotavirus diarrhea increased by 36.0% , 32% and 18% Respectively. Also they observe Seasonal peaks in rotavirus diarrhea were in the monsoon 22.9%, late autumn 20.6%, and spring 24.2% seasons. Fewer episodes were observed during the summer ,autumn and winter.
Malnourished infants living in communities with poor sanitation are at higher risk of developing environmental enteropathy (EE) a pathology of the gut associated with chronic intestinal inflammation and lead to shortening of the enterocytic villi (Korpe & Petri, 2012) it’s possible that the shortening of villi in malnourished infants may inhibit or altogether abrogate rotavirus entry and replication. And the cause of reduced efficacy of oral polio vaccines and oral rotavirus vaccines in the developing world (Levine, 2010) ,which rely on live attenuated virus for immunization may in part be due to reduced vaccine uptake among malnourished infants with EE. So they hypothesis that rotavirus and perhaps other enteric viruses are better able to replicate in the healthy enteric niche of a well-nourished infant without EE.
Finally The most important finding that support study hypothesis that better nutritional status among Bangladeshi infants was strongly associated with a higher risk of rotavirus diarrhea in the first 3 years of life in consistent for three anthropometric measures malnutrition, stunting, and wasting. In this study there is limited insights into the role of malnutrition in rotavirus disease. More studies are needed to determine the causes, such as longitudinal and case-control studies in diverse human populations are needed to confirm that this association is broadly relevant, also animal in vitro models of rotavirus infection will yield critical insights into the interactions among nutrition, immunity, microbial ecology, and enteric viruses. The Study highlights the importance of combining global vaccination efforts with nutritional interventions and programs to reduce transmission.
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