Department of International Health, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
J Pediatr. 2012 Jul;161(1):110-5.e1. doi: 10.1016/j.jpeds.2011.12.046. Epub 2012 Feb 14.
To investigate the viral etiology, through the use of molecular methods, of acute gastroenteritis (AGE), which is a considerable public health burden in Native American infants.
From March 2002 through February 2004, AGE and non-diarrheal stools were collected from Navajo and White Mountain Apache infants who received placebo during a rotavirus vaccine trial. Case (n=247) and control (n=344) specimens were tested for enteric adenovirus, astrovirus, norovirus, rotavirus, and sapovirus with real-time polymerase chain reaction. The odds of AGE were compared with population-averaged logistic regression models.
In 65% of the cases of AGE (161/247), at least one virus was detected; norovirus (n=80, 32%) and rotavirus (n=70, 28%) were the most common. A virus was detected in 38% of control specimens (132/344). Detection of "any virus" was associated with AGE (OR=3.22; 95% CI, 2.11-4.91), as was detection of norovirus (OR=2.00; 95% CI, 1.22-3.26) and rotavirus (OR=2.69; 95% CI, 1.52-4.79).
This study highlights the significant burden of viral AGE in American Indian infants and identifies pathogen targets for future prevention efforts in this population.
通过分子方法研究急性胃肠炎(AGE)的病毒病因,AGE 是美洲原住民婴儿面临的重大公共卫生负担。
2002 年 3 月至 2004 年 2 月,在轮状病毒疫苗试验中接受安慰剂的纳瓦霍族和白山 Apache 族婴儿采集 AGE 和非腹泻粪便。用实时聚合酶链反应检测病例(n=247)和对照(n=344)标本中的肠腺病毒、星状病毒、诺如病毒、轮状病毒和 sapovirus。使用人群平均逻辑回归模型比较 AGE 的几率。
在 65%的 AGE 病例(161/247)中,至少检测到一种病毒;诺如病毒(n=80,32%)和轮状病毒(n=70,28%)最常见。在 38%的对照标本中检测到病毒(132/344)。检测到“任何病毒”与 AGE 相关(OR=3.22;95%CI,2.11-4.91),诺如病毒(OR=2.00;95%CI,1.22-3.26)和轮状病毒(OR=2.69;95%CI,1.52-4.79)也是如此。
本研究强调了病毒性 AGE 对美洲印第安婴儿的重大负担,并确定了该人群未来预防工作的病原体目标。