Rotaviruses are the leading cause of hospitalization for children with diarrhea worldwide. According to a systematic review published by Parashar U.D. et al. in 2003, the number of hospitalizations for children with rotavirus diarrhea from 1986 to 1999 was 22%. Comparing these data with the indicator of infant mortality due to diarrhea (2.1 million cases per year), it turned out that each year worldwide 440,000 cases of rotavirus diarrhea in children under the age of 5 years are fatal. In 1985, this indicator was around 50% (873,000 deaths). A decrease in the number of deaths from rotavirus diarrhea occurred simultaneously with a decrease in the total mortality rate for all cases of diarrhea from 4.6 million in 1982 to 1.6-2.5 million in 2000.

As the results of recent studies have shown, despite a decrease in the last 20 years, the overall infant mortality rate due to diarrhea, the number of hospitalizations of children with rotavirus diarrhea could increase. Thus, according to a prospective study carried out in hospitals in 9 Asian countries, rotavirus diarrhea in children was diagnosed in 45% of cases on average, which greatly exceeds that obtained in previous studies carried out in these countries. A larger study conducted in Vietnam between 1998 and 2000. and comprising 5,768 hospitalized children with diarrhea, the etiology of rotavirus was diagnosed in 56% of cases, which is more than twice as high as that (21%) in a study conducted in Hanoi (Vietnam) from 1981 to 1984.

To assess the role of rotaviruses in the etiology of diarrhea in children U.D. Parashar et al. A systematic review of studies was carried out for the period from 2000 to 2004. to determine the frequency of onset of the etiology of diarrhea rotaviruses in hospitalized children, as well as a comparative analysis with data from the previous review for the period from 1986 to 1999.

The analysis included studies that met the following criteria: 1) the start of the study - after 1993; 2) the duration of the study - at least 1 full calendar year; 3) at least 100 children under the age of 5 hospitalized for diarrhea have a rotavirus etiology.

For each study, the report of the cases of determination of the etiology of rotavirus of diarrhea in all children hospitalized for this pathology was determined. This indicator was compared to the volume of gross national product per capita in the country conducting the study. Subsequently, countries were divided into groups according to the volume of gross national product per capita by income category (CD) according to the World Bank (low - less than US $ 756; medium-low - US $ 756-2995 , medium-high - $ 2,996 - $ 9,265 and above - more than $ 9,265). In addition, for each CD, the mean ratio (interquartile range [MKR]) of hospitalizations of children with rotavirus diarrhea was calculated.

Next, the total average level of determination of the etiology of rotavirus for diarrhea was calculated using the weighted average of the mean values for each CD. The values determined for each group of CD corresponded to the proportion of deaths of children hospitalized for diarrhea among the countries of this group of DC, as determined on the basis of the previous analysis: 85% in the group of countries with low CD, 13% in the group of countries with low CD, 2% in the group of countries with medium-high CD and less than 1% in the group of countries with high CD. The infant mortality rate for rotavirus diarrhea was calculated as the product of the total average level of determination of the etiology of rotavirus diarrhea in hospitalized children and the total infant mortality due to diarrhea worldwide, obtained according to the latest WHO data.

The results of 41 studies were included in a systematic review. Unlike the previous review of studies published between 1986 and 1999, which found that the ratio of hospitalizations of children with rotavirus diarrhea was characterized by a certain growth tendency with an increase in the level of blood pressure, in this review , it has been shown that the frequency of determining the etiology of rotavirus increased slightly in comparison with the growth in the level of the income category.

The average level of determination of the etiology of rotavirus diarrhea in hospitalized children as a whole was 39% (MKP = 29-45%): 39% in the group of countries with low CD rates, 40% in the group of countries with medium to low level of MC, 38% in the group of countries with a high average level of CA and 44% in the group of countries with a high level of CA.

Compared to WHO data (1,566,000 deaths - an indicator of infant mortality due to diarrhea), the number of hospitalized children with rotavirus diarrhea was approximately 611,000 cases. Over 80% of all deaths from rotavirus diarrhea have been reported in a group of countries with low rates of CD (South Asia and Sub-Saharan Africa).

Compared to the results of a review of studies published between 1986 and 1999, the ratio of hospitalizations of children with rotavirus diarrhea between 2000 and 2004 is similar. increases. This phenomenon may indicate a relatively lower level of hospitalization for children with rotavirus diarrhea compared to other causes of severe diarrhea.

First of all, this can be explained by the fact that programs aimed at improving the quality of hand hygiene and compliance with health standards are probably more aimed at reducing the incidence of bacterial and parasitic diarrhea. This hypothesis is also confirmed by the fact that the number of child deaths has decreased considerably in the United States and Mexico; the decrease was greatest during the summer months, when most of the diarrhea was bacterial in nature. In both countries, peak child mortality from diarrhea in recent years has been recorded during the winter months when rotavirus infection is common. Second, oral rehydration therapy to compensate for the loss of body fluid, considered a major factor in reducing mortality from diarrhea, is often more difficult in children with rotavirus diarrhea accompanied by severe vomiting. Third, there is no specific treatment for this type of diarrhea compared to diarrhea of bacterial or parasitic etiology.