Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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The Epidemiological Trend of Rotavirus Gastroenteritis in Children in a Single Center from 2004 to 2012: A Retrospective Study

2004-2012년 소아 로타바이러스 위장관염의 역학적 추세에 관한 단일 기관 연구

  • Lee, Hae Sung (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Kim, Dong Yeon (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Kim, Jung Are (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Choi, Soo-Han (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center)
  • 이해성 (한전의료재단 한전병원 소아청소년과) ;
  • 김동연 (한전의료재단 한전병원 소아청소년과) ;
  • 김정아 (한전의료재단 한전병원 소아청소년과) ;
  • 최수한 (한전의료재단 한전병원 소아청소년과)
  • Received : 2014.06.17
  • Accepted : 2014.09.01
  • Published : 2014.12.25
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Abstract

Purpose: This study was performed to investigate the epidemiological trend of rotavirus acute gastroenteritis (RV-AGE) in children. Methods: A retrospective review was performed in patients (1 month to 18 years of age) with acute gastroenteritis at KEPCO Medical Center from September 2004 to August 2013. Comparative analyses were performed based on periods: pre-vaccine (2004-2006) and post-vaccine (2008-2012) in all patients; 2004-2006 (period A), 2007-2009 (period B) and 2010-2012 (period C) in patients under 5 years of age. Results: Proportion of RV-AGE decreased from 25.0% (337/1,346) in pre-vaccine period to 20.8% (459/2,210) in post-vaccine period (rate ratio (RR), 0.83 [95% CI, 0.73-0.93]; P=0.0029). The median age of patients with RV-AGE in post-vaccine period (2.6 years) was significantly (P<0.0001) higher than that in pre-vaccine period (1.6 years). In patients hospitalized with AGE, proportion of RV-AGE was significantly reduced in patients 6 to 23 months old (RR, 0.62 [95% CI, 0.51-0.75]; P<0.0001). Significant decline in proportion of RV-AGE was observed in patients under 5 years of age: period A, 26.9% (308/1,144); period B, 22.7% (295/1,299); period C, 20.6% (186/902) (P =0.0007). After the introduction of rotavirus vaccine, a significant decreasing trend of RV-AGE proportion was observed in patients 6 to 11 months old (P =0.0018) and 12 to 23 months old (P =0.0152). Conclusion: Decrease in RV-AGE proportion and increase in age of patients with RV-AGE were observed after the introduction of rotavirus vaccine in this single center study. Continued and systematic surveillance is needed to assess the impact of rotavirus vaccine.

목적: 본 연구는 국내 로타바이러스 백신 도입 전후 시기의 지역사회 소아 로타바이러스 위장관염의 역학에 대하여 조사하고자 하였다. 방법: 2004년 9월부터 2013년 8월까지 한전병원에서 급성 위장염 환자 중 로타바이러스 분변 항원검사를 시행했던 1개월 이상 18세 이하 환자를 후향적으로 분석하였다. 전체 환자에서 백신 도입 전(2004-2006년) 및 도입 이후(2008-2012년) 시기로 구분하여 비교 분석하였고, 5세 미만 환자에서는 백신 전(2004-2006년), 이행(2007-2009년), 백신 후(2010-2012년) 시기로 구분하여 비교 분석하였다. 결과: 전체 대상 환자에서 로타바이러스 위장관염 비율은 백신 도입 전 시기 25.0% (337/1,346)에서 도입이후 시기 20.8% (459/2,210)로 유의한 감소를 보였다(비율비, 0.83, [95% CI, 0.73-093]; P=0.0029). 백신 도입 이후 시기의 로타바이러스 위장관염 환자의 중앙연령은 2.6세로 도입 전 시기 1.6세 보다 유의하게 높았다(P<0.0001). 급성 위장관염 입원 환자 중 로타바이러스 감염 비율은 6-23개월 환자들에서 유의한 감소를 보였다(비율비, 0.62, [95% CI, 0.51-0.75]; P<0.0001). 5세 미만 환자들에서 백신 전, 이행, 백신 후 시기의 로타바이러스 위장관염의 비율은 각각 26.9% (308/1,144), 22.7% (295/1,299), 20.6% (186/902)로 유의한 감소추세를 보였다(P =0.0007). 백신 도입 이후 각 연도별 추세에서, 6-11개월(P=0.0018)과 12-23개월(P=0.0152) 환자군에서 유의한 감소 추세를 보였다. 결론: 단일기관 연구에서 로타바이러스 백신 도입 이후 로타바이러스 위장염 환자의 비율 감소와 연령 상승을 확인하였다.

Keywords

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