Risk Factors for Norovirus Infections and Their Association with Childhood Growth: Findings from a Multi-Country Birth Cohort Study

Abstract

The prevalence of norovirus infections in different geographical locations and their attribution to childhood diarrhea is well established. However, there are no reports showing possible relationships of different norovirus genogroups with subsequent childhood malnutrition. In this study, we attempted to establish a potential association between asymptomatic norovirus infections with childhood growth faltering during. Non-diarrheal stools were collected from 1715 children enrolled in locations in a multi-county birth cohort study across eight different geographical locations and were assessed for norovirus genogroup I (GI) and norovirus genogroup II (GII). Asymptomatic norovirus GI infections were negatively associated with monthly length-for-age Z score/LAZ (β = −0.53, 95% CI: −0.73, −0.50) and weight-for-age Z score/WAZ (β = −0.39, 95% CI: −0.49, −0.28), respectively. The burden of asymptomatic norovirus GI infections was negatively associated with LAZ (β = −0.46, 95% CI: −0.67, −0.41) and WAZ (β = −0.66, 95% CI: −0.86, −0.53) at 2 years of age, whilst the burden of asymptomatic norovirus GII infections was negatively associated with WAZ (β = −0.27, 95% CI: −0.45, −0.25) at 2 years of age. Our findings warrant acceleration in attempts to develop vaccines against norovirus GI and norovirus GII, with the aim of minimizing the long-term sequelae on childhood growth.

Prevalence and associated factors of human caliciviruses infection among patients with gastroenteritis in the Amhara National Regional State, Ethiopia

“…These ndings underscore the importance of preventive measures such as hand hygiene and public health interventions to reduce the burden of NoV infections. This nding is in agreement with different studies (22,48).…”

“…While these viruses typically cause mild and selflimiting acute infections, studies suggest that long-term infections are common among high-risk groups (20,21). Factors such as a history of contact with individuals with similar AGE, inadequate hand hygiene, lack of access to clean drinking water, consumption of raw food, absence of improved sanitation facilities, and poor environmental hygiene have been associated with an increased risk of HuCV (17,22).…”

Household Surveillance for Norovirus Gastroenteritis in a Nicaraguan Birth Cohort: A Nested Case—Control Analysis of Norovirus Risk Factors

“…Additionally, the association of norovirus AGE and living in a household with dirt floors was not unexpected, as norovirus particles have been shown to persist on floors as dust [ 18 , 19 ], and it is conceivable that porous dirt floors would be harder to disinfect than tile or other hard-surface flooring. A prior study in eight LMICs showed that improved flooring as well as higher LAZ was protective against norovirus infection in the first two years of life [ 12 ]. Our study did not collect extensive data on, and thus did not identify nutrition practices that were associated with norovirus; this could be the focus of future studies that are designed to accurately capture a diverse range of food and beverage consumption among children at risk for norovirus.…”

“…Prior studies from LMIC using cross-sectional, cohort, and case–control designs have reported that younger age, larger households, household sanitation and socioeconomic factors, eating outside the household, and having contact with another household member with AGE symptoms were risks for norovirus AGE, while studies were mixed on the benefits of breastfeeding in reducing norovirus AGE [ 8 , 9 , 10 , 11 , 12 ]. The goal of this study was to identify modifiable risk factors for norovirus AGE in a population of young Nicaraguan children, using a larger sample of symptomatic norovirus-infected children than in previous studies and assessing previously unstudied risk factors.…”

Gut biomolecules (I-FABP, TFF3 and lipocalin-2) are associated with linear growth and biomarkers of environmental enteric dysfunction (EED) in Bangladeshi children

“…However, none of the studies have correlated these non-invasive biomarkers with the composite EED score that has been proposed based on neopterin (NEO), myeloperoxidase (MPO), and alpha-1 anti-trypsin (A1AT) to diagnose EED and the findings were published earlier 7 . Several studies have also used this composite score for the better prediction of EED and intestinal inflammation [8][9][10][11][12][13] . In addition, EED score has also been found to be correlated with LCN2 in our previously published cross-sectional study in Bangladesh 14 .…”