International Center for Diarrheal Disease Research (ICDDR,B), Dhaka, Bangladesh.
Center for Disease Control and Prevention, Atlanta, Georgia, USA.
J Infect Dis. 2023 Oct 3;228(7):818-828. doi: 10.1093/infdis/jiad274.
Norovirus is a major cause of endemic acute gastroenteritis (AGE) worldwide. We described the epidemiology, risk factors, and genotypic distribution of noroviruses among hospitalized patients of all ages in Bangladesh.
From March 2018 to October 2021, 1250 AGE case patients and controls (age, sex, season, and site matched) were enrolled at 10 hospitals. Demographic and clinical information was collected; real-time reverse-transcriptase polymerase chain reaction (RT-PCR) used to test stool specimens, and positive samples were genotyped.
Norovirus was detected in 9% of cases (111 of 1250) and 15% (182 of 1250) of controls. Eighty-two percent of norovirus-positive cases were in children <5 years old. Norovirus-positive AGE hospitalizations occurred year-round, with peaks in April and October. Risk factors for norovirus included age <5 years (adjusted odds ratio, 3.1 [95% confidence interval, 1.9-5.2]) and exposure to a patient with AGE in the 10 days before enrollment (3.8 [1.9-7.2]). GII.3[P16] and GII.4 Sydney[P16] were the predominant genotypes.
We highlight the burden of norovirus in hospital settings. Young age and recent exposure to a patient with AGE were risk factors for norovirus. A high prevalence of norovirus among controls might represent asymptomatic reinfections or prolonged shedding from a previous infection; carefully designed longitudinal studies are needed to improve our understanding of norovirus infections in Bangladesh.
诺如病毒是全球范围内导致地方性急性胃肠炎（AGE）的主要原因。我们描述了孟加拉国所有年龄段住院患者中诺如病毒的流行病学、危险因素和基因型分布。
从 2018 年 3 月到 2021 年 10 月，在 10 家医院招募了 1250 名 AGE 病例患者和对照者（年龄、性别、季节和地点匹配）。收集人口统计学和临床信息；使用实时逆转录聚合酶链反应（RT-PCR）检测粪便标本，阳性样本进行基因分型。
在 1250 例病例和 1250 例对照中，分别检测到 9%（111 例）和 15%（182 例）的诺如病毒。82%的诺如病毒阳性病例发生在<5 岁的儿童中。诺如病毒阳性 AGE 住院发生在全年，4 月和 10 月达到高峰。诺如病毒的危险因素包括年龄<5 岁（调整后的优势比，3.1 [95%置信区间，1.9-5.2]）和在入组前 10 天接触 AGE 患者（3.8 [1.9-7.2]）。GII.3[P16]和 GII.4 Sydney[P16]是主要基因型。
我们强调了诺如病毒在医院环境中的负担。年龄较小和最近接触 AGE 患者是诺如病毒的危险因素。对照者中诺如病毒的高患病率可能代表无症状再感染或先前感染的持续排毒；需要精心设计的纵向研究来提高我们对孟加拉国诺如病毒感染的认识。
