Paper Title
Acute Gastroenteritis Associated with Rotavirus Among Children Less Than 5 Years of Age In Nepal

Abstract
Introduction: Rotavirus gastroenteritis is a major public health problem in Nepal. This study was conducted to obtain information associated with Rotavirus gastroenteritis and to perform genotyping of rotavirus. Methods: Hospital based cross sectional study was conducted from January to December 2017 among children less than 5 years of age attending Kanti Children’s Hospital and Tribhuvan University Teaching Hospital. Rotavirus antigen detection was performed by Enzyme Linked Immunosorbent Assay (ELISA) using ProSpecT Rotavirus Microplate Assay. Rotavirus positive strains were further confirmed by genotyping using Reverse-Transcription Polymerase Chain Reaction (RT-PCR). Results: A total of 1074 stool samples were collected, of them 770 were hospitalized, and 304 were non-hospitalized cases. Incidence of rotavirus infection was 28.12% (302/1074) with infection rate higher in hospitalized (33.89%) than in non-hospitalized (13.49%) children. Rotavirus detection was higher in male (30.69%) than in female (24.31%) (p > 0.05). The highest prevalence was observed in children of age group 0-23 months (p > 0.05) with higher frequency found in the month of November, December, January, February and March (p < 0.05). On the basis of molecular analysis of rotavirus, G12P[6] (46.39%) was found to be most common strain followed by G1P[8] (35.05%), G3P[8] (7.21%) and G1P[6] (5.15%) while 4.12% was mixed infection and 1.03% was partially typed. Discussion: Rotavirus infection occurred throughout the year, but the prevalence was significantly higher during winter than summer. The children of age group 0-23 months were highly affected. In the country, G12P[6] is predominant genotype which is found to be primarily unusual. The results of genotyping are essential for introduction of rotavirus vaccine in Nepal.