60 identified as this website at least good agreement [25]. All analyses were completed

using Intercooled Stata 11.1 for Windows (Version 11.1 College Station, TX; StataCorp LP; 2011). In Africa and Asia, of 3814 and 906 participants, respectively, with stool specimen results and clinical data, approximately 14.7% (559/3814) and 22.8% (207/906) of AGE episodes, respectively, were rotavirus-positive; 16.3% (139/854) in Ghana, 11.6% (50/430) in Kenya, 14.6% (370/2530) in Mali, 22.0% (166/753) in Bangladesh, and 26.8% (41/153) in Vietnam. In Africa, approximately 66% (370/559) of the rotavirus-positive cases were from Mali, 25% (139/559) from Ghana, and 9% (50/559) from Kenya. In Asia, 80% (166/207) of rotavirus-positive cases were from Bangladesh and 20% (41/207) from Vietnam. Less than 5% of participants experienced more than one rotavirus-positive episode

(i.e. two or three episodes). Overall, VSS and CSS mean scores within each region and each scoring system were significantly higher for RVGE cases as compared to non-rotavirus GE cases (Africa: VSS, 10.1 vs. 7.5; CSS, 9.9 vs. 7.2; Asia: VSS, 10.9 vs. 7.8; CSS, 10.3 vs. 7.1; p-value ≤ 0.001). Proportionally more rotavirus-positive episodes were captured in Africa as compared to Asia, but, based on similar distributions between regions, participant episodes were just as likely to receive a severe score in Asia as they were in Africa for the CSS, but not the VSS ( Fig. 1, Table 2). When compared within gender and age, the mean VSS and CSS for LEE011 research buy rotavirus-positive episodes did not differ statistically, while within hospitalized

cases and site there was a significant difference ( Table 2). The Mali site had a lower mean score for both the VSS and the CSS than the other sites. The mean score for hospitalized cases was lower for both the VSS and CSS in Asia as compared to Africa. Among the five common items contained within both scoring systems, the VSS provided proportionally higher scores for each item in Africa and Asia as compared to the CSS, with the exception of temperature (Table 3). The VSS to CSS ratio of the number of gastroenteritis episodes with an item score of 3 was greater than 1.0 for every scoring system item, except maximum medroxyprogesterone temperature, indicating that it was easier to gain a higher item score for these symptoms using the VSS. This is consistent with how the scoring system would have been expected to perform given that, in the VSS, a value of 3 is reached with a lower frequency of episodes or number of days of duration (Table 1). The CSS and VSS did not result in uniform categorization of severe gastroenteritis among rotavirus-positive gastroenteritis episodes in either trial. Using the traditional definitions for severity, within Africa and Asia, respectively, 40.6% (227/559) and 56.