Department of Biological Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria; Department of Biotechnology and Food Science, Durban University of Technology, Durban, South Africa.
Department of Microbiology and Biotechnology, Western Delta University, Oghara, Delta State, Nigeria.
Environ Pollut. 2021 Dec 15;291:118164. doi: 10.1016/j.envpol.2021.118164. Epub 2021 Sep 13.
The human norovirus (HNoV), on a global scale, is the prevailing cause of contagious viral gastroenteritis outbreaks, with more than 200 000 deaths annually. This study aimed at assessing specific prevalence of HNoV pollution in different water sources and their roles in the dissemination of HNoV, with a view to refocus water sources and sewage management options for policy making towards public health safety. In this regard, we conducted a systematic review and meta-analysis (SR/MA) of the prevalence of HNoV in water sources. We searched PubMed, Google Scholar, Scopus and Web of Science for studies on HNoV prevalence in water sources without temporal restriction, till January 30, 2021. We conducted a random-effects meta-analysis of the HNoV prevalence and stratified the study by water type, continent, gross national income (GNI) group and genogroup. Further, a mixed-effects meta-regression model was performed for sensitivity analysis. The literature search identified 61 studies on water source-based HNoV (WsHNoV) prevalence. The pooled WsHNoV prevalence was 31.7% (95%CI: 25.1-38.5) but varied according to water sources types; river water showing the highest estimate at 43.5% (95%CI: 33.9-53.4), followed by estuarine water (30.6%, 95%CI: 12.5-52.2), composite water (27.9%, 95%CI: 13.5-44.9), marine water (25.9%, 95%CI: 10.0-45.6), groundwater (19.7%, 95%CI: 9.4-32.3) and lake water (2.2%, 95%CI: 0-25.8). Further, the findings indicated the highest WsHNoV prevalence in Africa as 55.9% (95% CI: 28.2-81.9), followed by Asia (31.6%, 95% CI: 22.3-41.6), Europe (29.8%, 95% CI: 17.9-43.2), North America (27.7%, 95% CI: 11.2-47.6) and South America (27.1%, 95%CI: 0.09-49.4). The WsHNoV prevalence stratified by GNI group was 40.6% (95%CI: 27.9-53.9) in middle-income countries and 28.7% (95%CI: 21.7-36.1) in high-income countries respectively. The prevalence of GI, GII and GI & GII genogroup in natural water was 16.4% (95%CI: 12.0-21.3), 20.6% (95%CI: 15.7-25.8) and 12.8% (95%CI: 6.9-20.6) respectively. Evidently, prevalence of the HNoV genogroup in water sources mirrors the pattern of HNoV gastroenteritis and GII genogroup dominance worldwide. In conclusion, public health efforts against waterborne diseases should prioritize water resource/sewage management options and policies towards ardent water sources pollution prevention.
人类诺如病毒（HNoV）在全球范围内是导致传染性病毒性肠胃炎爆发的主要原因，每年导致超过 20 万人死亡。本研究旨在评估不同水源中 HNoV 污染的特定流行率及其在 HNoV 传播中的作用，以期重新关注水源和污水管理选项，为公共卫生安全制定政策。为此，我们对水源中 HNoV 流行率进行了系统评价和荟萃分析（SR/MA）。我们在没有时间限制的情况下，在 PubMed、Google Scholar、Scopus 和 Web of Science 上搜索了关于水源中 HNoV 流行率的研究，直到 2021 年 1 月 30 日。我们对 HNoV 流行率进行了随机效应荟萃分析，并按水源类型、大陆、国民总收入（GNI）组和基因群对研究进行分层。此外，还进行了混合效应荟萃回归模型进行敏感性分析。文献检索确定了 61 项关于基于水源的 HNoV（WsHNoV）流行率的研究。汇总的 WsHNoV 流行率为 31.7%（95%CI：25.1-38.5），但根据水源类型而有所不同；河水显示出最高的估计值为 43.5%（95%CI：33.9-53.4），其次是河口水（30.6%，95%CI：12.5-52.2）、复合水（27.9%，95%CI：13.5-44.9）、海水（25.9%，95%CI：10.0-45.6）、地下水（19.7%，95%CI：9.4-32.3）和湖水（2.2%，95%CI：0-25.8）。此外，研究结果表明，非洲的 WsHNoV 流行率最高，为 55.9%（95%CI：28.2-81.9），其次是亚洲（31.6%，95%CI：22.3-41.6）、欧洲（29.8%，95%CI：17.9-43.2）、北美（27.7%，95%CI：11.2-47.6）和南美（27.1%，95%CI：0.09-49.4）。按 GNI 组分层的 WsHNoV 流行率在中等收入国家为 40.6%（95%CI：27.9-53.9），在高收入国家为 28.7%（95%CI：21.7-36.1）。天然水中 GI、GII 和 GI & GII 基因群的流行率分别为 16.4%（95%CI：12.0-21.3）、20.6%（95%CI：15.7-25.8）和 12.8%（95%CI：6.9-20.6）。显然，水源中 HNoV 基因群的流行率反映了全球 HNoV 肠胃炎和 GII 基因群优势的模式。总之，针对水传播疾病的公共卫生努力应优先考虑水资源/污水管理选项，并制定政策，以防止水源严重污染。
