Sapovirus prevalence in children less than five years of age hospitalised for diarrhoeal disease in South Africa, 2009-2013
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Date
Authors
Page, Nicola Anne
Groome, Michelle J.
Murray, Tanya Y.
Nadan, Sandrama
Netshikweta, Rembuluwani
Keddy, Karen H.
Poonsamy, Bhavani
Moyes, Jocelyn
Walaza, Sibongile
Kahn, Kathleen
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
BACKGROUND : Although sapovirus (SaV) has been detected in 2.2–12.7% of gastroenteritis cases globally,there are limited data on SaV epidemiology. OBJECTIVES : Describe the epidemiology, clinical characteristics and factors associated with SaV gastroen-teritis in hospitalised children <5 years of age in South Africa.Study design: Between 2009 and 2013 during prospective diarrhoeal surveillance, stool specimens werecollected from four sites and screened for SaVs and associated enteric pathogens using ELISA, microscopy,conventional and real-time PCR. Epidemiological and clinical data were compared in patients withor without SaV. Odds ratios were assessed by bivariate and stepwise multivariable logistic regressionanalysis. RESULTS : Sapoviruses were detected in 7.7% (238/3103) of children admitted to hospital and 11.4% (9/79)of deaths. Sapovirus was detected more commonly in children 19–24 months compared to <6 months(aOR = 2.3; p = 0.018) and in males (aOR = 2.0; p = 0.001). Additional factors associated with SaV detectionincluded residing with ≥ 7 inhabitants compared to ≤3 (aOR = 2.2; p = 0.011) and concomitant norovirusinfections (aOR = 3.0; p = 0.003). HIV-infected children with SaV were more likely to have bloody stools(aOR = 16.8; p < 0.001), low birth weight (<2.5 kg; aOR = 5.8; p = 0.007) and live in environments withoutflush toilets (aOR = 8.1; p = 0.003) compared to HIV-uninfected children. CONCLUSIONS : Sapoviruses, which are perceived to cause mild diarrhoea, were detected in hospitalisedchildren and diarrhoeal deaths in South Africa. Determinants increasing the odds of SaV included over-crowding and concomitant infections while HIV-infected children with SaV displayed bloody stools, lowbirth weight and reduced access to proper sanitation. Mitigation strategies against SaV infections includeimproved sanitation.
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Keywords
Caliciviruses, Children <5 years, Viral gastroenteritis, Hospitalised, South Africa (SA), Sapoviruses (SaVs)
Sustainable Development Goals
Citation
Page, N, Groome, MJ, Murray, TY, Nadan, S, Netshikweta, R, Keddy, KH, Poonsamy, B, Moyes, J, Walaza, S, Kahn, K, Kuonza, L, Taylor, MB, Madhi, SA & Cohen, C 2016, 'Sapovirus prevalence in children less than five years of age hospitalised for diarrhoeal disease in South Africa, 2009-2013', Journal of Clinical Virology, vol. 78, pp. 82-88.