Keywords
Rotavirus Infections
Child
Clinical Laboratory Technique
Dehydration
Drug Therapy
Vaccination
How to Cite
Abstract
Children under 5 years of age represent the most vulnerable group to rotavirus diarrhea, posing a challenge in terms of disease prevention, treatment, and control. This bibliographic review article analyzed the scientific literature to analyze and synthesize the available evidence on rotavirus diarrhea in children under 5 years of age. To this end, major databases were consulted, including PubMed, SciELO, and Google Scholar, due to the relevance of their publications on biomedical research. Rotavirus is a complex pathogen with high genetic variability, evolution, and immunological response. Children under 5 years of age, especially between 3 and 24 months of age, constitute the most vulnerable group to severe forms of the infection, with dehydration and electrolyte disturbances being the most frequent complications. Diagnosis should be comprehensive, combining clinical evaluation and laboratory testing. Treatment is primarily supportive, based on rehydration, maintaining nutrition, and managing symptoms. Timely assessment of the degree of dehydration is key to reducing morbidity and mortality. Vaccination is the main preventive measure, and has proven to be effective.
References
Akcaboy, M., Oguz, M. M., Acoglu, E. A., Acar, M., Zorlu, P., Hosnut, F. O., & Senel, S. (2016). Systemic manifestation of rotavirus infection in children: A report of three cases. Iranian Red Crescent Medical Journal, 18(8), e35086. https://pubmed.ncbi.nlm.nih.gov/27781124/
Anigilaje E. A. (2018). Management of Diarrhoeal Dehydration in Childhood: A Review for Clinicians in Developing Countries. Frontiers in pediatrics, 6(28). https://doi.org/10.3389/fped.2018.00028
Anwari, P., Burnett, E., Safi, N., Samsor, A., Safi, H., Chavers, T. P., Parashar, U. D., Clark, A. D., & Tate, J. E. (2024). Effectiveness and impact of monovalent rotavirus vaccination in Afghanistan: A test-negative case–control analysis. The Lancet Global Health, 12(9) https://doi.org/10.1016/s2214-109x(24)00237-7
Bibera, G. L., Chen, J., Pereira, P., & Benninghoff, B. (2020). Dynamics of G2P[4] strain evolution and rotavirus vaccination: A review of evidence for Rotarix. Vaccine, 38(35), 5591-5600. https://doi.org/10.1016/j.vaccine.2020.06.059
Bergman H, Henschke N, Hungerford D, Pitan F, Ndwandwe D, Cunliffe N, Soares-Weiser K. (2021) Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database of Systematic Reviews, 11 ( CD008521). https://doi.org/10.1002/14651858.CD008521.pub6
Burnett, E., Parashar, U., & Tate, J. E. (2018). Rotavirus Vaccines: Effectiveness, Safety, and Future Directions. Paediatric Drugs, 20(3), 223-233. https://doi.org/10.1007/s40272-018-0283-3
Burnett, E., Parashar, U. D., & Tate, J. E. (2020). Real-world effectiveness of rotavirus vaccines, 2006–19: A literature review and meta-analysis. The Lancet Global Health, 8(9), e1195-e1202. https://doi.org/10.1016/S2214-109X(20)30262-X
Cates, J. E., Amin, A. B., Tate, J. E., Lopman, B., & Parashar, U. (2021a). Do rotavirus strains affect vaccine effectiveness? A systematic review and meta-analysis. The Pediatric Infectious Disease Journal, 40(12), 1135-1143. https://doi.org/10.1097/inf.0000000000003286
Cates, J. E., Tate, J. E., & Parashar, U. (2021b). Rotavirus vaccines: Progress and new developments. Expert Opinion on Biological Therapy, 22(3), 423-432. https://doi.org/10.1080/14712598.2021.1977279
Cortese, M.M. & Haber, P. (2024). Chapter 19: Rotavirus. Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-19-rotavirus.html
Cochrane (2023). Las vacunas contra el rotavirus previenen la diarrea en bebés y niños. Cochrane Iberoamérica. https://es.cochrane.org/es/divulgacion/cochrane-responde/las-vacunas-contra-el-rotavirus-previenen-la-diarrea-en-bebes-y-ninos
Crawford, S. E., Ramani, S., Tate, J. E., Parashar, U. D., Svensson, L., Hagbom, M., Franco, M. A., Greenberg, H. B., O’Ryan, M., Kang, G., Desselberger, U., & Estes, M. K. (2017). Rotavirus infection. Nature Reviews. Disease Primers, 3, 17083. https://doi.org/10.1038/nrdp.2017.83
Di, J. B., & Gai, Z. T. (2020). Protective efficacy of probiotics on the treatment of acute rotavirus diarrhea in children: an updated meta-analysis. European Review for Medical & Pharmacological Sciences, 24(18). https://doi.org/10.26355/eurrev_202009_23057
Diallo, A. O., Wikswo, M. E., Sulemana, I., Sahni, L. C., Boom, J. A., Ramani, S., Selvarangan, R., Moffatt, M. E., Harrison, C. J., Halasa, N., Chappell, J., Stewart, L., Staat, M. A., Schlaudecker, E., Quigley, C., Klein, E. J., Englund, J. A., Zerr, D. M., Weinberg, G. A., … Parashar, U. D. (2024). Rotavirus vaccine effectiveness against severe acute gastroenteritis: 2009–2022. Pediatrics, 154(4), e2024066879. https://doi.org/10.1542/peds.2024-066879
Dian, Z., Sun, Y., Zhang, G., Xu, Y., Fan, X., Yang, X., Pan, Q., Peppelenbosch, M., & Miao, Z. (2021). Rotavirus-related systemic diseases: Clinical manifestation, evidence and pathogenesis. Critical Reviews in Microbiology, 47(5), 580-595. https://doi.org/10.1080/1040841X.2021.1907738
Fagbamigbe, A. F., Juma, J., & Kariuki, J. (2022). Barriers to utilisation of oral rehydration solution and zinc in managing diarrhoea among under-5 children in Oyo State, Nigeria. BMJ Paediatrics Open, 6(1), e001450. https://doi.org/10.1136/bmjpo-2022-001450
Florez, I. D., Al-Khalifah, R., Sierra, J. M., Granados, C. M., Yepes-Nuñez, J. J., Cuello-Garcia, C., Perez-Gaxiola, G., Zea, A. M., Hernandez, G. N., Veroniki, A.-A., Guyatt, G. H., & Thabane, L. (2016). The effectiveness and safety of treatments used for acute diarrhea and acute gastroenteritis in children: Protocol for a systematic review and network meta-analysis. Systematic Reviews, 5, 14. https://doi.org/10.1186/s13643-016-0186-8
Florez, I. D., Niño-Serna, L. F., & Beltrán-Arroyave, C. P. (2020). Acute Infectious Diarrhea and Gastroenteritis in Children. Current Infectious Disease Reports, 22(2), 4. https://doi.org/10.1007/s11908-020-0713-6
Furusho, J. K. Y., & Díaz, M. Á. V. (2023). Microbiota y microbiomaterapia en gastroenterología CMG 5. Editorial Alfil.
Gbebangi-Manzemu, D., Kampunzu, V. M., Vanzwa, H. M., Mumbere, M., Bukaka, G. M., Likele, B. B., Kasai, E. T., Mukinayi, B. M., Tonen-Wolyec, S., Ngbonda Dauly, N., & Alworong’a Opara, J. P. (2023). Clinical profile of children under 5 years of age with rotavirus diarrhoea in a hospital setting in Kisangani, DRC, after the introduction of the rotavirus vaccine: A cross-sectional study. BMC Pediatrics, 23, 193. https://doi.org/10.1186/s12887-023-04022-0
Hailu, B., Ji-Guo, W., & Hailu, T. (2021). Water, Sanitation, and Hygiene Risk Factors on the Prevalence of Diarrhea among Under-Five Children in the Rural Community of Dangila District, Northwest Ethiopia. Journal of Tropical Medicine, 2021(1), 2688500. https://doi.org/10.1155/2021/2688500
Hung, P.-J., & Chen, C.-C. (2022). Diagnostic accuracy of rotavirus antigen tests in children: A systematic review and meta-analysis. Tropical Medicine & International Health, 28(2), 136–149. https://doi.org/10.1111/tmi.13846
Indrawan, M., Chendana, J., Handoko, T. G. H., Widjaja, M., & Octavius, G. S. (2023). Clinical factors predicting rotavirus diarrhea in children: A cross-sectional study from two hospitals. World Journal of Clinical Pediatrics, 12(5), 319-330. https://doi.org/10.5409/wjcp.v12.i5.319
Iro, M. A., Sell, T., Brown, N., & Maitland, K. (2018). Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: A systematic review and meta-analysis. BMC Pediatrics, 18(1), 44. https://doi.org/10.1186/s12887-018-1006-1
Kanai, Y., & Kobayashi, T. (2021). Rotavirus reverse genetics systems: Development and application. Virus Research, 295, 198296. https://doi.org/10.1016/j.virusres.2021.198296
Rotavirus Classification Working Group: RCWG. (2021). Rotavirus Classification Working Group (RCWG). Rega Institute, Laboratory of Viral Metagenomics. https://rega.kuleuven.be/cev/viralmetagenomics/virus-classification/rcwg
Lam, F., Wentworth, L., Cherutich, P., Migiro, S., Abdala, K., Musyoka, M., Ogolla, S., Obudho, M., Mwangi, Z., Kihoto, R., Cheruiyot, C., Wariari, B., Battu, A. & Schroder, K. (2019). An evaluation of a national oral rehydration solution and zinc scale-up program in Kenya between 2011 and 2016. Journal of global health, 9(1), 010505. http://dx.doi.org/10.7189/jogh.09.010505
Laue, M. (2024). Diagnostic electron microscopy in human infectious diseases – Methods and applications. Journal of Microscopy, 299(3), 186-205. https://doi.org/10.1111/jmi.13370
LeClair, C. E., & McConnell, K. A. (2023). Rotavirus. En StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK558951/
Leli, C., Di Matteo, L., Gotta, F., Vay, D., Cavallo, V., Mazzeo, R., Busso, S., Carrabba, L., & Rocchetti, A. (2019). Evaluation of a multiplex gastrointestinal PCR panel for the aetiological diagnosis of infectious diarrhoea. Journal of Global Antimicrobial Resistance, 19, 114–120. https://doi.org/10.1080/23744235.2019.1688861
Matthijnssens, J., Attoui, H., Bányai, K., Brussaard, C. P. D., Danthi, P., del Vas, M., Dermody, T. S., Duncan, R., Fāng, Q., Johne, R., Mertens, P. P. C., Mohd Jaafar, F., Patton, J. T., Sasaya , T., Suzuki, N., & Wei, T. (2022). ICTV Virus Taxonomy Profile: Sedoreoviridae 2022. Journal of General Virology, 103(10), 001782. https://doi.org/10.1099/jgv.0.001782
Morgan, B., Lyons, E. A., Handley, A., Bogdanovic-Sakran, N., Pavlic, D., Witte, D., Mandolo, J., Turner, A., Jere, K. C., Justice, F., Ong, D. S., Bonnici, R., Boniface, K., Donato, C. M., Mpakiza, A., Meyer, A., Bar-Zeev, N., Iturriza-Gomara, M., Cunliffe, N. A., Danchin, M., & Bines, J. E. (2024). Rotavirus-specific maternal serum antibodies and vaccine responses to RV3-BB rotavirus vaccine administered in a neonatal or infant schedule in Malawi. Viruses, 16(9), 1488. https://doi.org/10.3390/v16091488
Motuma, A., Tolera, S. T., Alemu, F. K., Adare, D., Argaw, R., Birhanu, A., Shiferaw, K., Hunduma, G., Letta, S., Temesgen, S., & Ayana, D. A. (2025). Prevalence and risk factors of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis. BMC Public Health, 25(1), 1815. https://doi.org/10.1186/s12889-025-22939-2
Nichols, S. L., Haller, C., Borodavka, A., & Esstman, S. M. (2024). Rotavirus NSP2: A Master Orchestrator of Early Viral Particle Assembly. Viruses, 16(6), 814. https://doi.org/10.3390/v16060814
Organización Mundial de la Salud. (2021a). Enfermedades diarreicas.
https://www.who.int/es/news-room/fact-sheets/detail/diarrhoeal-disease
Organización Mundial de la Salud. (2021b) Rotavirus vaccines: WHO position paper - July 2021. Recuperado 29 de agosto de 2025. https://www.who.int/publications/i/item/WHO-WER9628
Organización Mundial de la Salud. (2021c) Update of a systematic review and meta-analysis of the safety, effectiveness and efficacy of childhood schedules using Rotavirus vaccines. https://www.who.int/publications/m/item/review-meta-analysis-rotavirus-vaccines
Organización Mundial de la Salud (2024) Enfermedades diarreicas. https://www.who.int/es/news-room/fact-sheets/detail/diarrhoeal-disease
Organización Panamericana de la Salud. (2021) Rotavirus. https://www.paho.org/es/temas/rotavirus
Parker, E. P. K., Bronowski, C., Sindhu, K. N. C., Babji, S., Benny, B., Carmona-Vicente, N., Chasweka, N., Chinyama, E., Cunliffe, N. A., Dube, Q., Giri, S., Grassly, N. C., Gunasekaran, A., Howarth, D., Immanuel, S., Jere, K. C., Kampmann, B., Lowe, J., Mandolo, J., ... Iturriza-Gómara, M. (2021). Impact of maternal antibodies and microbiota development on the immunogenicity of oral rotavirus vaccine in African, Indian, and European infants. Nature Communications, 12, 7288. https://doi.org/10.1038/s41467-021-27074-1
Reyes-Hernández, K. L., López-Cruz, G., Romero-Feregrino, R., Ávila-Correa, A., Reyes-Hernández, D. P., Luévanos-Velázquez, A., Reyes-Gómez, U., Perea-Martínez, A., Reyes-Hernández, M. U., & Santamaría-Arza, C. (2017). Rotavirus en el recién nacido: Análisis de 32 casos de adquisición comunitaria. Boletín Clínico del Hospital Infantil del Estado de Sonora, 34(2). https://www.medigraphic.com/pdfs/bolclinhosinfson/bis-2017/bis172b.pdf
Rogawski, E. T., Platts-Mills, J. A., Colgate, E. R., Haque, R., Zaman, K., Petri, W. A., & Kirkpatrick, B. D. (2018). Quantifying the impact of natural immunity on rotavirus vaccine efficacy estimates: a clinical trial in Dhaka, Bangladesh (PROVIDE) and a simulation study. The Journal of infectious diseases, 217(6), 861-868. https://doi.org/10.1093/infdis/jix668
Rosettie, K. L., Vos, T., Mokdad, A. H., Flaxman, A. D., Khalil, I., Troeger, C., & Weaver, M. R. (2018). Indirect Rotavirus Vaccine Effectiveness for the Prevention of Rotavirus Hospitalization: A Systematic Review and Meta-Analysis. The American Journal of Tropical Medicine and Hygiene, 98(4), 1197-1201. https://doi.org/10.4269/ajtmh.17-0705
Soares-Weiser, K., Bergman, H., Henschke, N., Pitan, F., & Cunliffe, N. (2019). Vaccines for preventing rotavirus diarrhoea: vaccines in use. The Cochrane database of systematic reviews, 2019(10), CD008521. https://doi.org/10.1002/14651858.CD008521.pub5
Soboksa, N. E., Gari, S. R., Hailu, A. B., & Mengistie Alemu, B. (2021). Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia. Environmental Health Insights, 15, 1178630221999635. https://doi.org/10.1177/1178630221999635
Sun, Z.-W., Fu, Y., Lu, H.-L., Yang, R.-X., Goyal, H., Jiang, Y., & Xu, H.-G. (2021). Association of Rotavirus Vaccines With Reduction in Rotavirus Gastroenteritis in Children Younger Than 5 Years: A Systematic Review and Meta-analysis of Randomized Clinical Trials and Observational Studies. JAMA Pediatrics, 175(7), e210347. https://doi.org/10.1001/jamapediatrics.2021.0347
Tapisiz, A., Bedir Demirdag, T., Cura Yayla, B. C., Gunes, C., Ugraş Dikmen, A., Tezer, H., Baran Aksakal, N., Bozdayi, G., & Ozkan, S. (2019). Rotavirus infections in children in Turkey: A systematic review. Reviews in Medical Virology, 29(1), e2020. https://doi.org/10.1002/rmv.2020
Velázquez, R. F., Linhares, A. C., Muñoz, S., Seron, P., Lorca, P., DeAntonio, R., & Ortega-Barria, E. (2017). Efficacy, safety and effectiveness of licensed rotavirus vaccines: A systematic review and meta-analysis for Latin America and the Caribbean. BMC Pediatrics, 17(1), 14. https://doi.org/10.1186/s12887-016-0771-y
Willame, C., Vonk Noordegraaf-Schouten, M., Gvozdenović, E., Kochems, K., Oordt-Speets, A., Praet, N., van Hoorn, R., & Rosillon, D. (2018). Effectiveness of the Oral Human Attenuated Rotavirus Vaccine: A Systematic Review and Meta-analysis—2006–2016. Open Forum Infectious Diseases, 5(11), ofy292. https://doi.org/10.1093/ofid/ofy292
Zhang, J. N. (2018). Efficacy of adjuvant zinc gluconate therapy for infantile rotavirus enteritis diarrhea. Journal of Hainan Medical University, 24(3), 57-60. https://web.archive.org/web/20201125154133id_/http://www.hnykdxxb.com/PDF/201803/15.pdf
Zubairi, M. B. A., Naqvi, S. K., Ali, A. A., Sharif, A., Salam, R. A., Hasnain, Z., Soofi, S., Ariff, S., Nisar, Y. B., & Das, J. K. (2024). Low-osmolarity oral rehydration solution for childhood diarrhoea: A systematic review and meta-analysis. Journal of Global Health, 14, 04166. https://doi.org/10.7189/jogh.14.04166
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