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Norovirus epidemiology in South African children <5 years hospitalised for diarrhoeal illness between 2009 and 2013

  • N. A. PAGE (a1) (a2), M. J. GROOME (a3) (a4), S. NADAN (a1) (a2), R. NETSHIKWETA (a1) (a2), K. H. KEDDY (a1) (a5), B. POONSAMY (a1), J. MOYES (a6), S. WALAZA (a1), K. KAHN (a7), S. A. MADHI (a1) (a3) (a4), M. B. TAYLOR (a2), J. MANS (a2) and C. COHEN (a1)...
Summary

Public health interest in norovirus (NoV) has increased in recent years following improved diagnostics, global burden estimates and the development of NoV vaccine candidates. This study aimed to describe the detection rate, clinical characteristics and environmental features associated with NoV detection in hospitalized children <5 years with diarrhoea in South Africa (SA). Between 2009 and 2013, prospective diarrhoeal surveillance was conducted at four sites in SA. Stool specimens were collected and screened for NoVs and other enteric pathogens using molecular and serological assays. Epidemiological and clinical data were compared in patients with or without detection of NoV. The study detected NoV in 15% (452/3103) of hospitalized children <5 years with diarrhoea with the majority of disease in children <2 years (92%; 417/452). NoV-positive children were more likely to present with diarrhoea and vomiting (odds ratio (OR) 1·3; 95% confidence interval (CI) 1·1–1·7; P = 0·011) with none-to-mild dehydration (adjusted OR 0·5; 95% CI 0·3–0·7) compared with NoV-negative children. Amongst children testing NoV positive, HIV-infected children were more likely to have prolonged hospitalization and increased mortality compared with HIV-uninfected children. Continued surveillance will be important to consider the epidemic trends and estimate the burden and risk of NoV infection in SA.

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Corresponding author
*Author for correspondence: N. Page, National Institute for Communicable Diseases, Private Bag x4, Sandringham, 2131, South Africa and Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, Pretoria 0007, South Africa. (Email: nicolap@nicd.ac.za)
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Permanent address: Centre for Enteric Diseases, National Institute for Communicable Diseases, Private Bag x4, Sandringham, Johannesburg 2131, South Africa.

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References
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