Nutritional Status and Its Association with Rotavirus Diarrhea Among Children Aged Under 5 Years in Maharashtra, India.

objectivesDespite the introduction of rotavirus vaccines, rotavirus remains a major contributor to childhood mortality in India. The authors aimed to assess the association between nutritional status (wasting, underweight, stunting, and malnutrition) and rotavirus diarrhea severity in children aged under 5 y in Maharashtra.

methodsHospital-based surveillance was conducted on children under 5 y with acute gastroenteritis at four sentinel sites in Maharashtra from 2020 to 2023. Stool samples were tested for rotavirus using an enzyme-linked immunosorbent assay. Nutritional status was assessed according to the World Health Organization anthropometry guidelines.

resultsAmong 529 children tested, 32.7% were rotavirus positive, of whom 29.7% had wasting, 26.6% were underweight, 26.4% had stunting, and 21.5% had malnutrition. In this study, the incidence of severe to very severe diarrhea did not differ significantly between children with and without wasting (77.8% vs. 71.4%; p = 0.382), underweight and non-underweight children (74.1% vs. 73.1%; p = 0.894), children with and without stunting (75.0% vs. 72.8%; p = 0.769), or children with and without malnutrition (75.0% vs. 73.2%; p = 0.849). However, in children who had received at least one dose of ROTASIIL, the incidence of severe to very severe diarrhea was significantly lower in malnourished children than in non-malnourished children (48.1% vs. 61.6%; p = 0.032).

conclusionsOverall, nutritional status was not associated with diarrhea severity. However, among vaccinated children, the risk of severe diarrhea was significantly lower in malnourished children than in non-malnourished children.