Olson Daniel, Lamb Molly M, Lopez Maria R, Paniagua-Avila Maria A, Zacarias Alma, Samayoa-Reyes Gabriela, Cordon-Rosales Celia, Asturias Edwin J
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
Center for Global Health, Colorado School of Public Health, Aurora, Colorado.
Am J Trop Med Hyg. 2017 Sep;97(3):944-948. doi: 10.4269/ajtmh.16-1003. Epub 2017 Jul 19.
We examined burden and factors associated with norovirus (NoV) acute gastroenteritis (AGE) among children in rural Guatemala. Children age 6 weeks to 17 years were enrolled into three AGE surveillance groups, using two-stage cluster sampling: a prospective participatory syndromic surveillance (PSS) cohort and two cross-sectional rapid active sampling (RAS) surveys, conducted from April 2015 to February 2016. Epidemiologic and NoV testing data were used to identify factors associated with NoV infection, AGE, and NoV+ AGE. The three cross-sectional surveys (PSS enrollment visit, RAS Survey 1, and RAS Survey 2) enrolled 1,239 children, who reported 134 (11%) AGE cases, with 20% of AGE and 11% of non-AGE samples positive for NoV. Adjusted analyses identified several modifiable factors associated with AGE and NoV infection. The cross-sectional RAS surveys were practical and cost-effective in identifying population-level risk factors for AGE and NoV, supporting their use as a tool to direct limited public health resources toward high-risk populations.
我们调查了危地马拉农村地区儿童中与诺如病毒(NoV)急性胃肠炎(AGE)相关的负担及因素。采用两阶段整群抽样法,将6周龄至17岁的儿童纳入三个AGE监测组:一个前瞻性参与性症状监测(PSS)队列以及两项横断面快速主动抽样(RAS)调查,研究于2015年4月至2016年2月进行。利用流行病学和NoV检测数据来确定与NoV感染、AGE以及NoV+AGE相关的因素。三项横断面调查(PSS入组访视、RAS调查1和RAS调查2)共纳入了1239名儿童,这些儿童报告了134例(11%)AGE病例,其中20%的AGE样本和11%的非AGE样本NoV检测呈阳性。校正分析确定了几个与AGE和NoV感染相关的可改变因素。横断面RAS调查在确定AGE和NoV的人群水平风险因素方面既实用又具有成本效益,支持将其用作一种工具,以便将有限的公共卫生资源导向高危人群。