Abstract
OBJECTIVES: To determine the prevalence of rotavirus infection and explore the association between exclusive breastfeeding (EBF) and rotavirus-related diarrhea among children under 2 years of age in Bangladesh. METHODS: A cross-sectional observational study was conducted between July 2018 and June 2020 in the Pediatric Inpatient Department of Chittagong Medical College Hospital. A total of 226 children under 2 years hospitalized with acute watery diarrhea were enrolled. Stool samples were tested for rotavirus. Data on demographics, feeding practices, vaccination, and clinical features were collected. Associations were assessed using odds ratios and statistical tests. RESULTS: Among the 226 children, 60% tested positive for rotavirus. Children aged 7-12 months had the highest infection rate (64%). EBF was significantly protective: in children ≤6 months, non-EBF was associated with a 10-fold higher risk of infection (odds ratio: 10.0; 95% confidence interval: 4.81-17.97; P =.04). For children >6 months, the risk was 9.72 times higher (P <.001). Nearly all children (98%) were unvaccinated. CONCLUSIONS: Rotavirus was highly prevalent among non-exclusively breastfed children. These findings emphasize the need to promote EBF and expand rotavirus vaccination coverage to reduce pediatric diarrheal morbidity.