Moyo Sabrina, Hanevik Kurt, Blomberg Bjørn, Kommedal Oyvind, Vainio Kirsti, Maselle Samuel, Langeland Nina
Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway; Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Tanzania.
Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway; Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Infect Genet Evol. 2014 Aug;26:340-7. doi: 10.1016/j.meegid.2014.06.013. Epub 2014 Jun 21.
This study investigated and reports norovirus diarrhoea, genetic diversity and associated clinical symptoms, HIV status and seasonality in a paediatric population of Tanzania. Stool specimens and demographic/clinical information, were prospectively collected from 705 hospitalised children with diarrhoea (cases) and 561 children without diarrhoea (controls) between 2010 and 2011. Norovirus detection was done by real-time RT-PCR. Genotype was determined using Gel-based and real time RT-PCR methods and sequencing targeting the polymerase and the capsid region respectively. Norovirus was detected in 14.3%, 181/1266 children. The prevalence of norovirus was significantly higher in cases (18.3%, 129/705) than in controls, (9.2%, 52/561), P<0.05. Except for one child who had double infection with GI and GII all 129 cases had GII. Among controls, 23.1% had GI and 76.9% had GII. Norovirus GII.4 was significantly more prevalent in cases 87.9% than in controls 56.5%. Other genotypes detected in both cases and controls were GII.21, GII.16 and GII.g. The highest numbers of norovirus were detected in April 2011. The number of norovirus detected was significantly higher during the first than second year of life (109/540, 20.2% vs. 20/165, 12.1%). The prevalence of norovirus in HIV-positive and negative children was (21.2%, 7/33) and (10.3%, 40/390, P=0.05) respectively, regardless of diarrhoea symptoms. No significant difference in gender, parent's level of education or nutritional status with norovirus infection was observed within cases or controls. This study confirms the significant role of norovirus infection, especially GII.4 in diarrhoeic children who need hospitalisation and adds knowledge on norovirus epidemiology in the African region.
本研究调查并报告了坦桑尼亚儿科人群中诺如病毒腹泻、基因多样性及相关临床症状、HIV 感染状况和季节性。2010 年至 2011 年期间，前瞻性收集了 705 例腹泻住院儿童（病例组）和 561 例无腹泻儿童（对照组）的粪便标本以及人口统计学/临床信息。通过实时 RT-PCR 进行诺如病毒检测。分别使用基于凝胶的方法和实时 RT-PCR 方法以及针对聚合酶和衣壳区域的测序来确定基因型。在 1266 名儿童中有 181 名（14.3%）检测到诺如病毒。病例组中诺如病毒的患病率（18.3%，129/705）显著高于对照组（9.2%，52/561），P<0.05。除 1 名儿童同时感染 GI 和 GII 外，所有 129 例病例均为 GII 型。在对照组中，23.1%为 GI 型，76.9%为 GII 型。诺如病毒 GII.4 在病例组中的患病率（87.9%）显著高于对照组（56.5%）。在病例组和对照组中均检测到的其他基因型为 GII.21、GII.16 和 GII.g。2011 年 4 月检测到的诺如病毒数量最多。出生第一年检测到的诺如病毒数量显著高于第二年（109/540，20.2%对 20/165，12.1%）。无论有无腹泻症状，HIV 阳性和阴性儿童中诺如病毒的患病率分别为（21.2%，7/33）和（10.3%，40/390，P = 0.05）。在病例组或对照组中，未观察到性别、父母教育程度或营养状况与诺如病毒感染之间存在显著差异。本研究证实了诺如病毒感染，尤其是 GII.4 在需要住院治疗的腹泻儿童中的重要作用，并增加了非洲地区诺如病毒流行病学的知识。
