Rotavirus and Norovirus infections among acute gastroenteritis children in Morocco

Abstract

BackgroundAcute gastroenteritis is a serious cause of child mortality and morbidity in resource-limited countries. A viral etiology is most common, and rotavirus and norovirus are reported to be the leading causative agents. There are still few epidemiological data on the simultaneous occurrence of these viruses in Morocco. The aim of this study was to provide useful epidemiological data on the gastroenteritis associated with rotavirus and norovirus among children aged less than 5 years.MethodsFrom January to December 2011, 335 samples were tested for rotavirus and norovirus using enzyme-linked immunosorbent assay, reverse-transcription-polymerase chain reaction (RT-multiplex PCR) and real-time RT-PCR. Partial sequences of the norovirus were phylogenetically analyzed to determine the genotype.ResultsThe overall rates of rotavirus and norovirus infections were 26.6% and 16.1%, respectively. Mixed viral infections were detected in 9 of 335 stool specimens (2.7%).The most common genotype combination in the rotavirus strains was G1[P8] (51.7%), followed by G2[P4] (10.1%), G2[P8] (4.5%), G9[P8] (3.4%), G4[P8] (3.4%), and G1[P6] (2.3%). Among patients positive for norovirus, 42 (77.8%) tested positive for GII and 12 (22.2%) for GI. Thirty-three (78.6%) of the norovirus GII-positive cases were successfully characterized. Genotype GII.4 was the most prevalent (n = 27; 81.8%), followed by GII.3 (n = 2; 6.1%), GII.13 (n = 2; 6.1%), GII.16 (n = 1; 3%), and GII.17 (n = 1; 3%).ConclusionThis study suggests that in Morocco, norovirus is the most frequent cause of acute gastroenteritis after rotavirus, but further enteric viruses need to be integrated in the surveillance system so that a conclusion could be drawn.

Molecular Characterization of Rotavirus Strains Causing Gastroenteritis in Children under 5 Years in Cairo, Egypt

“…For example, in other studies there were differences in the number of tested samples, season of sample collection, and the sampling methods. The occurrence of the group A Rotavirus was higher in the first 12 months of life (36%) than in the other age groups, as was observed in previous studies in developing countries [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. This finding may be explained by decline of maternal antibodies with immature immune systems which protect the newborns from pathogens during the first months of life [42].…”

Selected Enteropathogens and Clinical Course in Children Hospitalized with Severe Acute Gastroenteritis in Barbados

“…In a recent study from Morocco, Norovirus was reported to be the eteopathogens in nearly a sixth of all cases of AGE in children. (24) This study failed to demonstrate that Rotavirus was the most common cause of AGE in children younger than 5 years. It is noteworthy, that Rotavirus vaccine is not a part of the government's expanded immunization program in any of the English speaking Caribbean countries including Barbados.…”

Clinical and epidemiological characteristics of norovirus gastroenteritis among hospitalized children in Lebanon

“…Regionally, in the Middle East and North Africa (MENA), several studies have recently assessed the prevalence of NoV among hospitalized children aged < 5 years (hospitalized due to signs of acute gastroenteritis). These studies were performed on a variable sample size in Egypt[30], Israel[31,32], Iran[33], Jordan[34], Kuwait[35], Libya[36,37], Morocco[38], Tunisia[39,40], Turkey[41-45] and Yemen[46]. NoV was detected in stool samples of 6%-30% of hospitalized children aged < 5 years, with GII.4 and GII.3 predominantly reported in these studies.…”