Howard Leigh M, Mwape Innocent, Siwingwa Mpanji, Simuyandi Michelo, Guffey M Brad, Stringer Jeffrey S A, Chi Benjamin H, Edwards Kathryn M, Chilengi Roma
Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, D-7228 MCN; 1161 21st Ave S, Nashville, TN, 37232, USA.
Centre for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka, 10101, Zambia.
BMC Infect Dis. 2017 Jan 23;17(1):92. doi: 10.1186/s12879-017-2206-2.
The burden, clinical features, and molecular epidemiology of norovirus infection in young children in southern Africa are not well defined.
Using data from a health facility-based surveillance study of children <5 years in Lusaka Province, Zambia presenting with diarrhea, we assessed the burden of norovirus infection. A convenience sample of 454 stool specimens was tested for norovirus using reverse-transcriptase polymerase chain reaction (RT-PCR). RT-PCR positive samples underwent additional nucleotide sequencing for genogroup and genotype identification. Clinical features and severity of diarrheal illnesses were compared between norovirus-positive and -negative subjects using Chi-squared and t-tests.
Norovirus was detected in 52/454 (11.5%) specimens tested. Abdominal pain, fever, and vomiting were the most common presenting features in norovirus-associated illnesses. However, there were no significant differences in the clinical features of norovirus-positive compared to norovirus-negative illnesses. Of 43 isolates that were available for sequencing, 31 (72.1%) were genogroup II (GII) and 12 (27.9%) were genogroup I (GI). The distribution of genotypes was diverse.
Noroviruses were detected in approximately 10% of young children with diarrhea in the Lusaka Province of Zambia, with GII representing the majority of infections. These findings support the role of norovirus in symptomatic diarrhea disease in Africa. Further studies are needed to confirm these observations and to evaluate prevention strategies.
非洲南部幼儿中诺如病毒感染的负担、临床特征和分子流行病学尚不明确。
利用赞比亚卢萨卡省一项针对5岁以下腹泻儿童的医疗机构监测研究数据，我们评估了诺如病毒感染的负担。使用逆转录聚合酶链反应（RT-PCR）对454份粪便标本的便利样本进行诺如病毒检测。RT-PCR阳性样本进行额外的核苷酸测序以鉴定基因组群和基因型。使用卡方检验和t检验比较诺如病毒阳性和阴性受试者腹泻疾病的临床特征和严重程度。
在检测的454份标本中有52份（11.5%）检测到诺如病毒。腹痛、发热和呕吐是诺如病毒相关疾病最常见的表现特征。然而，与诺如病毒阴性疾病相比，诺如病毒阳性疾病的临床特征没有显著差异。在可用于测序的43株分离株中，31株（72.1%）为基因组群II（GII），12株（27.9%）为基因组群I（GI）。基因型分布多样。
在赞比亚卢萨卡省约10%的腹泻幼儿中检测到诺如病毒，其中GII占大多数感染。这些发现支持了诺如病毒在非洲有症状腹泻疾病中的作用。需要进一步研究来证实这些观察结果并评估预防策略。
