Department of Clinical Infection, Microbiology & Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
J Med Virol. 2013 Jul;85(7):1299-306. doi: 10.1002/jmv.23589.
Despite the increasing recognition of noroviruses as major pathogens associated with community-acquired diarrhoea in children, there are few studies from Africa. Long-term surveillance studies of rotavirus gastroenteritis in Malawian children have provided an opportunity to undertake a study of the importance and epidemiological features of norovirus infection in this population. Faecal specimens were collected from children <5 years of age admitted to hospital with acute diarrhoea, as well as from a comparison group of diarrhoea-free children, in Blantyre, Malawi between 1997 and 2007. Norovirus was detected using real-time PCR and strains genotyped by nucleotide sequence analysis. Norovirus was detected in 220/1,941 (11.3%) faecal specimens, comprising genogroup GI (1.8%), GII (9.4%) and mixed GI/GII (0.1%). The median age of children with norovirus was 6 months (range, 0-48 months). Norovirus was detected throughout the year, with peaks at the end of the rainy season (March) and towards the end of the dry season (August-November). Norovirus GII.4 was the most commonly detected genotype accounting for 70% of strains characterised, followed by GII.2 (6%), GII.6 (4%) and GII.12 (4%). Sub typing of GII.4 noroviruses demonstrated local circulation of strains prior to their subsequent detection in association with global epidemics of gastroenteritis. The prevalence of norovirus in children without diarrhoea was similar to the level in cases. This largest study to date of norovirus infection in African children indicates the potential role of paediatric surveillance in predicting the emergence of norovirus strains with global epidemic potential.
尽管诺如病毒越来越被认为是导致儿童社区获得性腹泻的主要病原体，但来自非洲的研究却很少。马拉维儿童轮状病毒胃肠炎的长期监测研究为研究该人群中诺如病毒感染的重要性和流行病学特征提供了机会。1997 年至 2007 年期间，在马拉维布兰太尔，从因急性腹泻住院的 5 岁以下儿童以及无腹泻的对照组儿童中收集粪便标本。使用实时 PCR 检测诺如病毒，并用核苷酸序列分析对毒株进行基因分型。在 1941 份粪便标本中检测到 220 份（11.3%）诺如病毒，包括基因组 GI（1.8%）、GII（9.4%）和混合 GI/GII（0.1%）。携带诺如病毒的儿童的中位年龄为 6 个月（0-48 个月）。诺如病毒全年均可检测到，雨季末（3 月）和旱季末（8-11 月）出现高峰。检测到的基因型主要是 GII.4，占 70%，其次是 GII.2（6%）、GII.6（4%）和 GII.12（4%）。GII.4 诺如病毒的亚型分析表明，在随后与全球胃肠炎流行相关的检测之前，当地存在病毒循环。无腹泻儿童的诺如病毒流行率与病例相似。这是迄今为止在非洲儿童中进行的最大规模的诺如病毒感染研究，表明儿科监测在预测具有全球流行潜力的诺如病毒株出现方面具有潜在作用。
