Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
BMC Infect Dis. 2024 Sep 27;24(1):1053. doi: 10.1186/s12879-024-09988-5.
Noroviruses (NoVs) are the leading cause of diarrheal disease among all age groups worldwide, with an increased burden in developing countries. As there is no surveillance, epidemiological data is limited in Ethiopia. Hence, this study aimed to investigate the prevalence and associated factors of NoV infection among patients with diarrhea in the Amhara National Regional State, Ethiopia.
A prospective health facility-based cross-sectional study was conducted from May 2021 to November 2021. A total of 550 study participants of all age groups with symptoms of diarrhea were proportionately assigned to the four study areas, area with three health facilities. Study participants were systematically sampled in each health facility. A fecal sample from each case was collected. The RNA was extracted and tested for NoV by one-step RT-PCR. Sociodemographic and other variables were gathered using a pre-tested questionnaire. A descriptive analysis was performed. Both binary and multiple logistic regressions were utilized to identify factors associated with NoV infection. Variables with a p-value < 0.05 in the final model were considered statistically significant.
Five hundred nineteen out of 550 samples were analyzed (94.4% response rate). The overall prevalence of NoV was 8.9% (46/519). The positivity rates were higher among the elderly (33.3%) and under-5 children (12.5%). Both genogroup I and genogroup II (GII) were identified, with GII being the predominant, at 82.6% (38/46). Of all participants, only 20% reported a history of vomiting. Norovirus infection was more prevalent among participants from Debre Tabor (AOR = 4, 95%CI: 1.2-14) and Bahir Dar areas (AOR = 3.6, 95%CI: 1.04-11) compared to Debre Markos. Additionally, older adults (AOR = 7, 95% CI: 2-24) and under-5 children (AOR = 3.5, 95% CI: 2.8-12) were disproportionately affected compared to adults. The previous history of diarrhea (AOR = 3.6, 95% CI: 1.7-7) was a significant factor contributing to NoV infections. Moreover, the odds of NoV infection were higher among individuals with a high frequency of diarrhea (AOR = 15.3, 95%CI: 7.6-43) and vomiting (AOR = 3.5, 95%CI: 1.5-8).
The prevalence of NoV was considerably high, with the predominance of NoV-GII. The positivity rate was higher among the extreme age groups and varied across the study areas. To obtain a comprehensive understanding of the virus`s epidemiology and its genetic diversity, further research is warranted.
诺如病毒（NoV）是全球所有年龄段人群腹泻病的主要病因，在发展中国家的负担加重。由于没有监测，埃塞俄比亚的流行病学数据有限。因此，本研究旨在调查埃塞俄比亚阿姆哈拉州地区腹泻患者中 NoV 感染的流行率和相关因素。
本前瞻性基于卫生机构的横断面研究于 2021 年 5 月至 2021 年 11 月进行。总共按比例分配了 550 名各年龄段有腹泻症状的研究参与者到四个研究区域，每个区域有三个卫生机构。在每个卫生机构中对每个病例进行系统抽样。采集每个病例的粪便样本。使用一步 RT-PCR 提取 RNA 并检测 NoV。使用预先测试的问卷收集社会人口统计学和其他变量。进行描述性分析。使用二项和多项逻辑回归来确定与 NoV 感染相关的因素。最终模型中 p 值 < 0.05 的变量被认为具有统计学意义。
对 550 个样本中的 519 个进行了分析（响应率 94.4%）。NoV 的总体流行率为 8.9%（46/519）。老年人（33.3%）和 5 岁以下儿童（12.5%）的阳性率较高。均鉴定出 I 型和 II 型（GII）诺如病毒，其中 GII 占主导地位，为 82.6%（38/46）。所有参与者中，只有 20%的人报告有呕吐史。与德布雷塔博尔（AOR=4，95%CI：1.2-14）和巴希尔达（AOR=3.6，95%CI：1.04-11）地区相比，德布雷马克斯地区的 NoV 感染在 Debre Tabor 和 Bahir Dar 地区的参与者中更为普遍。此外，与成年人相比，老年人（AOR=7，95%CI：2-24）和 5 岁以下儿童（AOR=3.5，95%CI：2.8-12）受到的影响不成比例。腹泻的既往史（AOR=3.6，95%CI：1.7-7）是导致 NoV 感染的重要因素。此外，腹泻（AOR=15.3，95%CI：7.6-43）和呕吐（AOR=3.5，95%CI：1.5-8）频率较高的个体 NoV 感染的几率更高。
NoV 的流行率相当高，以 NoV-GII 为主。阳性率在极端年龄组中较高，且在各研究地区之间存在差异。为了全面了解该病毒的流行病学及其遗传多样性，需要进一步研究。
