A Case-Control Study to Determine Risk Factors for Hospitalization for Rotavirus Gastroenteritis in U.S. Children

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Objective:The objective of this case-control study nested within a surveillance study conducted at 3 hospitals (Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Children's Hospital of New Orleans, New Orleans, LA; and Hasbro Children's Hospital, Providence, RI) was to identify risk factors for rotavirus gastroenteritis requiring hospitalization.Patients:Cases were children ≤59 months of age who were admitted with acute gastroenteritis (AGE) and found to have rotavirus infection. Controls were selected from a birth certificate registry (Cincinnati and Providence) or a registry of patients from a large practice consortium in 11 locations (New Orleans).Results:Three hundred forty-nine rotavirus-infected cases and 1242 control subjects were enrolled. Breast feeding was protective against hospitalization for rotavirus AGE for infants <6 months of age. (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.2–13.2). Low-birth-weight (<2500 g) infants had increased risk for hospitalization even beyond the first few months of life (OR, 2.8; 95% CI, 1.6–5.0). Children in child care were more likely to be hospitalized for rotavirus AGE than those cared for at home, particularly those ≥24 months of age (OR, 3.0; 95% CI, 1.8–5.3). Other characteristics associated with rotavirus AGE hospitalization were children <24 months of age covered by Medicaid or without insurance (OR, 2.1; 95% CI, 1.4–3.2) and having another child in the house <24 months of age (OR, 1.6; 95% CI, 1.1–2.3). The data suggest that maternal age <25 years (OR, 1.4; 95% CI, 1.0–2.0) and a mother with less than a high school education (OR, 1.5; 95% CI, 1.0–2.3) may also increase risk of rotavirus hospitalization.Conclusion:There are socioeconomic and environmental factors and aspects of the child's medical and dietary history that identify children at risk for hospitalization with rotavirus AGE.

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