Abstract:
BACKGROUND: Viral gastroenteritis remains a major cause of hospitalisation in young
children. This study aimed to determine the distribution and diversity of enteric viruses in children
≤5 years, hospitalised with gastroenteritis at Kalafong Provincial Tertiary Hospital, Pretoria, South
Africa, between July 2016 and December 2017. METHODS: Stool specimens (n = 205) were screened
for norovirus GI and GII, rotavirus, sapovirus, astrovirus and adenovirus by multiplex RT-PCR.
HIV exposure and FUT2 secretor status were evaluated. Secretor status was determined by FUT2
genotyping. RESULTS: At least one gastroenteritis virus was detected in 47% (96/205) of children.
Rotavirus predominated (46/205), followed by norovirus (32/205), adenovirus (15/205), sapovirus
(9/205) and astrovirus (3/205). Norovirus genotypes GI.3, GII.2, GII.3, GII.4, GII.7, GII.12, GII.21,
and rotavirus strains G1P[8], G2P[4], G2P[6], G3P[4], G3P[8], G8P[4], G8P[6], G9P[6], G9P[8] and
sapovirus genotypes GI.1, GI.2, GII.1, GII.4, GII.8 were detected; norovirus GII.4[P31] and rotavirus
G3P[4] predominated. Asymptomatic norovirus infection (GI.3, GI.7, GII.4, GII.6, GII.13) was detected
in 22% of 46 six-week follow up stools. HIV exposure (30%) was not associated with more frequent or
severe viral gastroenteritis hospitalisations compared to unexposed children. Rotavirus preferentially
infected secretor children (p = 0.143) and norovirus infected 78% secretors and 22% non-secretors.
CONCLUSION: Rotavirus was still the leading cause of gastroenteritis hospitalisations, but norovirus
caused more severe symptoms.
