Epidemiology and genotype diversity of norovirus infections among children aged <5 years following rotavirus vaccine introduction in Blantyre, Malawi



Hungerford, Daniel ORCID: 0000-0002-9770-0163, Jere, khuzwayo ORCID: 0000-0003-3376-8529, Bar-Zeev, Naor, Harris, John ORCID: 0000-0001-9606-9480, Cunliffe, Nigel ORCID: 0000-0002-5449-4988 and Iturriza-Gomara, Miren ORCID: 0000-0001-5816-6423
(2020) Epidemiology and genotype diversity of norovirus infections among children aged <5 years following rotavirus vaccine introduction in Blantyre, Malawi. Journal of Clinical Virology, 123.

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Abstract

Background Following rotavirus vaccine introduction, norovirus has emerged as a significant pathogen associated with acute gastroenteritis among children in some high- and middle-income countries. In a case-control study following rotavirus vaccination in Malawi, we used PCR to test for multiple enteric pathogens in fecal samples from children aged <5 years hospitalized with diarrhea, and from asymptomatic community controls (Iturriza-Gómara et al. 2019). Objectives To describe the epidemiology and genotype diversity of norovirus infections among infants and young children in Blantyre, Malawi, following rotavirus vaccine introduction in 2012. Study Design We analysed data from the case-control study to assess annual and age-specific norovirus prevalence and the presence of co-infection. Norovirus-containing specimens were amplified by PCR and sequenced to determined genotype. Results Norovirus prevalence in cases was similar for each complete year of study (11.4% in 2013, 9.3% in 2014 and 11.2% in 2015). Prevalence of norovirus among children aged <6 months, 6-11 months , 12-23 months and 24+ months was 15.3% (11/72), 13.3% (44/331), 11.0% (24/219) and 6.6% (4/61) respectively in cases and 6.7% (2/30), 13.1% (30/229), 4.2% (8/192) and 7.1 (5/70) in controls. Co-pathogens were commonly detected in norovirus positive cases (77/83) and controls (44/45). Norovirus GII.4 was the most commonly identified genotype, comprising 48% and 41% of genotyped strains among cases and controls, respectively. Conclusions Norovirus disease prevalence was unchanged during the study period, and was greatest amongst infants. Frequent co-infection and asymptomatic shedding suggests intense community transmission of norovirus and other enteric pathogens in this low-income, African setting.

Item Type: Article
Uncontrolled Keywords: Norovirus, Diarrhea, Enteric, Rotavirus, Vaccine, Case-control
Depositing User: Symplectic Admin
Date Deposited: 17 Dec 2019 10:43
Last Modified: 19 Jan 2023 00:12
DOI: 10.1016/j.jcv.2019.104248
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3066784