Norovirus infections in young children in Lusaka Province, Zambia: clinical characteristics and molecular epidemiology

Abstract

BackgroundThe burden, clinical features, and molecular epidemiology of norovirus infection in young children in southern Africa are not well defined.MethodsUsing data from a health facility-based surveillance study of children <5 years in Lusaka Province, Zambia presenting with diarrhea, we assessed the burden of norovirus infection. A convenience sample of 454 stool specimens was tested for norovirus using reverse-transcriptase polymerase chain reaction (RT-PCR). RT-PCR positive samples underwent additional nucleotide sequencing for genogroup and genotype identification. Clinical features and severity of diarrheal illnesses were compared between norovirus-positive and -negative subjects using Chi-squared and t-tests.ResultsNorovirus was detected in 52/454 (11.5%) specimens tested. Abdominal pain, fever, and vomiting were the most common presenting features in norovirus-associated illnesses. However, there were no significant differences in the clinical features of norovirus-positive compared to norovirus-negative illnesses. Of 43 isolates that were available for sequencing, 31 (72.1%) were genogroup II (GII) and 12 (27.9%) were genogroup I (GI). The distribution of genotypes was diverse.ConclusionsNoroviruses were detected in approximately 10% of young children with diarrhea in the Lusaka Province of Zambia, with GII representing the majority of infections. These findings support the role of norovirus in symptomatic diarrhea disease in Africa. Further studies are needed to confirm these observations and to evaluate prevention strategies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2206-2) contains supplementary material, which is available to authorized users.

Study of Clinical Characteristics and Clinical Complications of Norovirus gastroenteritis in Admitted Children to the Hospital

“…Like the study of Zambia, in the current study, fever, diarrhea and vomiting were the most common complications in Norovirus-associated diseases. Nevertheless, there was no clear difference with Norovirus negative subjects in this regard [21]. Previous use of antibiotics and sex between two types of Norovirus infections and non-Norovirus infections did not show a significant difference in the present study.…”

vAetiology of Diarrhoea in Children Under Five in Zambia Detected Using Luminex xTAG Gastrointestinal Pathogen Panel

“…The more sensitive PCR detection methods would no doubt pick up greater frequencies of rotavirus infections if applied to the same samples. As we previously showed [21], comorbidity is common in our environment and indeed our results here further reveal the multiplicity of enteric pathogens potentially contributing to disease. The question of the clinical relevance of isolated pathogens in diarrhoeal stools thus still remains important warranting further interrogation.…”

Virological and Epidemiological Features of Norovirus Infections in Brazil, 2017–2018

“…As expected, we found a predominance of norovirus GII (89.1%) compared to GI (10.9%). Several studies performed worldwide have demonstrated the same pattern of GII genotypes predominance among the norovirus infections, with GII detection rates varying between 72.1% and 94.9% [ 38 , 39 , 40 ]. In Latin American, studies performed in Chile and Bolivia detected GII percentages of 85% and 97.8%, respectively, among patients with AGE [ 6 , 41 ].…”