High Prevalence of Group A Rotavirus Among Children Under Five with Acute Diarrhea in Mogadishu: Unexpected Risk and Protective Factors, 2025

IntroductionGroup A rotavirus is the leading cause of severe diarrhea in children under five years of age. This study aimed to evaluate the prevalence and risk factors associated with Group A rotavirus infection among children under five years of age with acute diarrhea in Mogadishu, Somalia. MethodsA hospital-based cross-sectional study was conducted at two major hospitals in Mogadishu between February and March 2025. Children under five years of age with acute watery diarrhea were enrolled. A structured questionnaire was used to collect demographic data and risk factors from guardians. Stool specimens were analyzed for rotavirus antigens using an enzyme-linked immunosorbent assay. Bivariate analysis was performed using the chi-square test, and variables with p < 0.20 were entered into multivariable logistic regression to identify independent predictors of infection. ResultsAmong 279 children under five with diarrhea, 113 (40.5%) tested positive for rotavirus. In multivariable analysis, tap water was significantly protective (AOR = 0.479, p = 0.006), while handwashing was unexpectedly linked to increased risk (AOR = 2.439, p = 0.031). Other factors were not significantly associated with infection. ConclusionThe high prevalence of rotavirus and the protective link with tap water use highlight the need to improve water access and hygiene. Further investigation into hygiene practices is warranted to clarify the association with handwashing.