Rotavirus infections are a major cause of diarrhea in children in both developed and developing countries. Rotavirus genetics, patient immunity, and environmental factors are thought to be related to the severity of acute diarrhea due to rotavirus in infants and young children. The objective of this study was to provide a correlation between rotavirus genotypes, clinical factors and degree of severity of acute diarrhea in children under 5 years old in Surabaya, Indonesia. A cross-sectional study was conducted in children aged 1–60 months with acute diarrhea hospitalized in Soetomo Hospital, Surabaya, Indonesia from April to December 2013. Rotavirus in stool specimens was identified by ELISA and genotyping (G-type and P-type) using multiplex reverse transcription PCR. Severity was measured using the Ruuska and Vesikari scoring system. The clinical factors were investigated included patient’s age (months), hydration, antibiotic administration, nutritional state, co-bacterial infection and co-viral infection. A total of 88 children met the criteria; 80.7% were aged 6–24 months, watery diarrhea was the most common type (77.3%) and 73.6% of the subjects were co-infected with bacteria, of which pathogenic Escherichia coli was the most common (42.5%). The predominant VP7 genotyping (G-type) was G2 (31.8%) and that of VP4 genotyping (P-type) was P[4] (31.8%). The predominant rotavirus genotype was G2P[4] (19.3%); G1P[4] and G9P[4] were uncommon with a prevalence of 4.5%. There were significant differences between the common genotype and uncommon genotype with respect to the total severity score of diarrhea (p 10 times a day) (p = 0.045) in univariate analyses, but there was no significant correlation between P typing and severity of diarrhea. For combination genotyping of G and P, G2P[4] was significantly correlated with severe diarrhea in multivariate analyses (p = 0.029). There is a correlation between rotavirus genotype and severity of acute diarrhea in children. Genotype G2P[4] has the highest prevalence. G3, G4, G9 and G2P[4] combination genotype were found to be associated with severe diarrhea.

We have previously shown a difference between the gut microbiota composition of stunted and non-stunted children in East Nusa Tenggara, Indonesia. The current study aimed to perform an intervention with a probiotic, Lactiplantibacillus plantarum IS-10506, and its UHT-treated postbiotic compared to placebo in order to accomplish catch-up growth in the stunted children, possibly through modulation of the gut microbiota. Apart from the maltodextrin (placebo), probiotic, and postbiotic in chocolate milk, all groups also received a functional and nutritional biscuit and had access to newly constructed water wells as well as soap to improve hygiene. The results show that independent of treatment, the stunted children had a significantly higher increase in height and zlen (corrected for age) compared with their age- and gender-matched controls but a significantly lower increase in weight. Several potential pathogenic taxa declined in all groups, among which was Escherichia/Shigella (adjusted.p = 6.44 × 10⁻¹⁵), but so did some beneficial taxa, such as Bifidobacterium and Akkermansia. Faecalibacterium, which was already higher in the stunted children at baseline, increased independent of treatment. Changes in the relative abundance of several taxa of the microbiota correlated with the changes in anthropometric measures. In conclusion, although there was no difference between the interventions, understanding the dynamics and the role of the gut microbiota in this process might allow healthcare providers to develop targeted nutritional strategies aimed at optimizing health outcomes for children at risk of stunting, thereby addressing a critical global health issue.

Background: Diarrhea is the first cause of death for children under five years of age worldwide. In Indonesia, diarrhea cases due to rotavirus infection tend to be detected throughout the year. Purpose: The study was to determine the epidemiology of diarrhea cases due to rotavirus infection of pediatric patients in Dr. Soetomo Hospital, Surabaya based on the variables of person, place, and time. Methods: This type of research uses both descriptive and quantitative methods. The samples used were cases of rotavirus infection in toddlers in Dr. Soetomo Hospital, Surabaya in 2015–2019. Results: From 2015 to 2019, there were about 110 cases (31.98%) of acute diarrhea caused by rotavirus infection at Dr. Soetomo Hospital, Surabaya. The findings revealed that the majority of rotavirus infections (42.73%) occurred in children aged 6-11 months followed 12-23 months (35.45%) and were male (56.36%). The highest cumulative incidence was observed in August 2018 and February 2029, with a value of 1,0. Rotavirus infection was most common among children living in Gubeng sub-District, with 19 cases (17.27%). Conclusion: Epidemiological studies of rotavirus infection by person, place, and time reveal the distribution of disease cases and enable targeted interventions to respond to the disease.

Highlight:The characteristics of acute diarrhea patients among chidren in Tertiary Hospital In East Java was evaluated.The highest incidence of diarrhea was found in the 0-24 months age group, good nutritional status, male sex, and hospitalized in less than 5 days.Mild-moderate dehydration, intravenous rehydration treated, anemia, hyponatremia, and metabolic acidosis were mostly founded. Diarrhea is the second leading cause of morbidity and mortality in children under five years of age in Indonesia after pneumonia. In 2017, diarrhea became an outbreak in 12 provinces. Diarrhea in under-fives can cause several complications and can cause death if it is not treated properly. This study aimed to evaluate the characteristics of acute diarrhea patients in under-fives hospitalized in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia for six months. This study was a descriptive study with retrospective approach which evaluated all acute diarrhea patients hospitalized from July to December 2019. Patients’ data were taken from medical records and presented descriptively. Of the total 125 patients, most acute diarrhea patients were male (60%) aged 0 to 24 months (83.2%), had good nutritional status (58.4%), and hospitalized for less than 5 days (60.8%). The most degree of dehydration was mild-moderate dehydration (83.2%), mostly treated with intravenous rehydration (96.8%), the most common comorbidity was anemia (13.4%), and the most electrolyte disorder was hyponatremia (41%), while acid-base disorder was mostly metabolic acidosis (75%).

Darma A, et al. Pediatr Gastroenterol Hepatol Nutr. 2025 Sep;28(5):302-311. https://doi.org/10.5223/pghn.2025.28.5.302