孟加拉国 2012-2016 年基于医院的小儿诺如病毒胃肠炎监测。

Hospital-based Surveillance for Pediatric Norovirus Gastroenteritis in Bangladesh, 2012-2016.

机构信息

icddr,b, Mohakhali, Dhaka, Bangladesh.

Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Mohakhali, Dhaka, Bangladesh.

出版信息

Pediatr Infect Dis J. 2021 Mar 1;40(3):215-219. doi: 10.1097/INF.0000000000002989.

DOI:10.1097/INF.0000000000002989

PMID:33264214

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9006183/

Abstract

BACKGROUND

Globally, noroviruses are recognized as an important cause of acute gastroenteritis (AGE), but data from low and middle-income countries are limited.

AIMS

To examine the epidemiology and strain diversity of norovirus infections among children hospitalized for AGE in Bangladesh.

METHODS

We implemented active surveillance of children <5 years of age hospitalized with AGE at 8 geographically dispersed tertiary care hospitals in Bangladesh from July 2012 to June 2016. We tested random samples of AGE cases stratified by site and age group for norovirus by real-time RT-PCR. Noro-positive specimens were genotyped. Coinfection with rotavirus was assessed based on prior EIA testing.

RESULTS

We enrolled 5622 total AGE cases, of which 1008 were tested for norovirus. Total of 137 (14%) AGE cases tested positive for norovirus (range, 11%-17% by site). Most (94%) norovirus-associated hospitalizations were among children less than 2 years of age. Norovirus was detected year-round, with higher detection from March to June (20%-38%) and November to January (9%-18%). Genogroup II (GII) noroviruses were detected in 96% of cases, and the most frequent genotypes were GII.4 Sydney [P4 New Orleans] (33%), GII.3 [P16] (20%), and GII.4 Sydney [P16] (11%). The proportion of norovirus-positive specimens was significantly greater among rotavirus-negative AGE patients compared with rotavirus-positive AGE patients (27% vs. 5%, P < 0.001). As measured by the Vesikari severity score, a similar proportion of norovirus and rotavirus positive AGE patients were considered severe (68% vs. 70%, P = 0.86).

CONCLUSIONS

Norovirus is an important cause of AGE hospitalization in Bangladeshi children with most infections caused by GII viruses.

摘要

背景

全球范围内，诺如病毒被认为是急性肠胃炎（AGE）的一个重要病因，但来自中低收入国家的数据十分有限。

目的

研究孟加拉国因 AGE 住院的儿童中诺如病毒感染的流行病学和毒株多样性。

方法

我们于 2012 年 7 月至 2016 年 6 月在孟加拉国 8 家地理位置分散的三级保健医院，对 5 岁以下因 AGE 住院的患儿开展了主动监测。我们根据地点和年龄组对 AGE 病例进行了随机抽样，通过实时 RT-PCR 检测诺如病毒。对诺阳性标本进行基因分型。根据之前的 EIA 检测评估轮状病毒的合并感染情况。

结果

我们共纳入 5622 例 AGE 总病例，其中 1008 例检测了诺如病毒。共检出 137 例（14%）诺如病毒阳性 AGE 病例（各地点检出率范围为 11%-17%）。大多数（94%）诺如病毒相关住院治疗发生在年龄小于 2 岁的儿童中。诺如病毒全年均有检出，3 月至 6 月（20%-38%）和 11 月至 1 月（9%-18%）检出率较高。96%的病例中检测到基因 II 组（GII）诺如病毒，最常见的基因型是 GII.4 Sydney[P4 New Orleans]（33%）、GII.3[P16]（20%）和 GII.4 Sydney[P16]（11%）。与轮状病毒阳性 AGE 患者相比，诺如病毒阳性 AGE 患者的诺如病毒阳性标本比例显著更高（27%比 5%，P<0.001）。根据 Vesikari 严重程度评分，诺如病毒和轮状病毒阳性 AGE 患者中被认为严重的比例相似（68%比 70%，P=0.86）。