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在坦桑尼亚姆万扎,五岁以下接种轮状病毒疫苗的儿童中,腹泻持续时间延长可预测腺病毒感染。

Adenovirus Infection Is Predicted by Prolonged Duration of Diarrhea among Rotavirus-Vaccinated Children below Five Years of Age in Mwanza, Tanzania.

作者信息

Msanga Delfina R, Masoza Tulla S, Mahamba Dina, Kwiyolecha Elizabeth, Rwezaula Raphael, Charles Happiness, Kessy Regan, Silago Vitus, Mshana Stephan E, Mirambo Mariam M

机构信息

Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.

Department of Pediatrics & Child Health, College of Health Sciences, University of Dodoma, P.O. Box 395, Dodoma, Tanzania.

出版信息

Int J Pediatr. 2020 Sep 14;2020:9303216. doi: 10.1155/2020/9303216. eCollection 2020.

Abstract

Diarrhea is the commonest cause of morbidity and mortality in many resource-limited countries including Tanzania among children below five years of age. A significant number of diarrhea cases associated with severe dehydration are still being reported among children despite five years of rotavirus vaccine implementation in Tanzania necessitating the need to investigate other causes of diarrhea in this population. This study is aimed at determining the prevalence of human adenovirus infection and associated factors among rotavirus-vaccinated children with acute diarrhea in Mwanza, Tanzania. A cross-sectional study was conducted from June to August 2017 involving 137 children less than two years of age admitted with acute diarrhea in the health facilities located in Mwanza, Tanzania. Sociodemographic and other relevant information were collected using standardized rotavirus surveillance tool adopted from WHO. Stool specimens were collected and tested for human adenovirus antigen using immunochromatographic tests. Data were analyzed by using STATA version 13. The median age of enrolled children was 12 (IQR 8-17) months. The prevalence of human adenovirus was found to be 46 (33.6%, 95% CI: 25-41). By multivariable logistic regression analysis, only prolonged duration of diarrhea (OR: 1.619, 95% CI: 1.142-2.295, = 0.007) was found to predict human adenovirus infection among rotavirus-vaccinated children with acute diarrhea. A significant proportion of rotavirus-vaccinated children with prolonged acute diarrhea have adenovirus infection. There is a need to consider other viral pathogens as potential cause of diarrhea especially in this postrotavirus vaccination period.

摘要

腹泻是包括坦桑尼亚在内的许多资源有限国家五岁以下儿童发病和死亡的最常见原因。尽管坦桑尼亚已实施轮状病毒疫苗接种五年,但仍有大量儿童因腹泻导致严重脱水的病例被报告,这就需要对该人群腹泻的其他原因进行调查。本研究旨在确定坦桑尼亚姆万扎地区接种轮状病毒疫苗的急性腹泻儿童中人类腺病毒感染的患病率及相关因素。2017年6月至8月进行了一项横断面研究,纳入了坦桑尼亚姆万扎地区医疗机构收治的137名两岁以下急性腹泻儿童。使用世界卫生组织采用的标准化轮状病毒监测工具收集社会人口统计学和其他相关信息。采集粪便标本,采用免疫层析试验检测人类腺病毒抗原。使用STATA 13版软件进行数据分析。纳入儿童的中位年龄为12(四分位间距8 - 17)个月。发现人类腺病毒的患病率为46(33.6%,95%可信区间:25 - 41)。通过多变量逻辑回归分析,仅腹泻持续时间延长(比值比:1.619,95%可信区间:1.142 - 2.295,P = 0.007)被发现可预测接种轮状病毒疫苗的急性腹泻儿童中的人类腺病毒感染。相当一部分接种轮状病毒疫苗且急性腹泻持续时间延长的儿童感染了腺病毒。尤其在这个轮状病毒疫苗接种后的时期,有必要考虑其他病毒病原体作为腹泻的潜在病因。

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