Molecular Study of Norovirus in Pediatric Patients with Gastroenteritis

Abstract

Aim: The aim of the present study was to detect the prevalence of norovirus and genotypes determination by real-time PCR among children below 18 years as an etiology of acute gastroenteritis and to compare rapid detection of norovirus by Enzyme-Linked Immunoassay (ELISA) to virus detection by real-time PCR. Methods: The research was a cross-sectional study conducted on children below 18 years complaining of community-acquired acute gastroenteritis. A stool sample was subjected to direct-antigen detection by ELISA for norovirus and molecular study by real-time polymerase chain reaction. Results: The study included 200 children with acute gastroenteritis with a mean age of 6.7±3.8 years. Norovirus antigen was detected by EIA in 34.5% and by real-time PCR in 30.5% of studied children with genotype GII, the predominant detected genotype (80.97%). Both real-time PCR and antigen detection of norovirus were positive in 43 (70.5%) of the children and negative in 113(81.3%) of the studied children. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for antigen detection by ELISA were 70.5%, 81.3%, 62.3%, 86.3% and 78%, respectively. Comparison between patients positive for norovirus and those negative for norovirus by real-time PCR revealed non-significant difference as regards age, sex, the season of occurrence and residence. Conclusion: The present study highlights that norovirus prevalence is common among pediatric patients with gastroenteritis above 5 years with GII genotype as the prevalent genotype. There was a significant correlation between positive and negative results of antigen detection of norovirus by ELISA and detection of RNA of norovirus by real-time PCR in stool samples. However, the screening for norovirus by ELISA has limited sensitivity and needs to be associated with a molecular method for accurate diagnosis of sporadic cases of gastroenteritis.

Pooled prevalence and genetic diversity of norovirus in Africa: a systematic review and meta-analysis

“…2017 South Africa South Africa Cohort < 5 Multiplex PCR 205 32 28 [ 26 ] Nxele et al (2017) June–August 2014 South Africa South Africa Cross-sectional < 5 Rt-qPCR 182 41 None [ 62 ] Molondo et al (2020) August 2017–Oct. 2018 South Africa South Africa Cross-sectional < 5 Rt-qPCR 80 13 4 [ 27 ] Tatay et al (2018) June–May 2017 Sudan North Africa Cross-sectional < 5 Rt-qPCR 66 19 None [ 63 ] Elsayed et al (2019) Jan. 2018–May 2019 Egypt North Africa Cross-sectional < 18 Rt-qPCR 200 61 None [ 64 ] Lartey et al (2020) Jan. 2008–Dec. 2017 Ghana West Africa Surveillance ...…”