Page, Nicola AnneGroome, Michelle J.Murray, Tanya Y.Nadan, SandramaNetshikweta, RembuluwaniKeddy, Karen HelenaPoonsamy, BhavaniMoyes, JocelynWalaza, SibongileKahn, KathleenKuonza, Lazarus R.Taylor, Maureen B.Madhi, Shabir A.Cohen, Cheryl2016-06-212016-05Page, 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, doi : 10.1016/j.jcv.2016.03.013.1386-6532 (print)1873-5967 (online)10.1016/j.jcv.2016.03.013http://hdl.handle.net/2263/53268BACKGROUND : 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 were collected 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 with or without SaV. Odds ratios were assessed by bivariate and stepwise multivariable logistic regression analysis. 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 detection included residing with ≥ 7 inhabitants compared to ≤3 (aOR = 2.2; p = 0.011) and concomitant norovirus infections (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 without flush toilets (aOR = 8.1; p = 0.003) compared to HIV-uninfected children. CONCLUSIONS : Sapoviruses, which are perceived to cause mild diarrhoea, were detected in hospitalised children 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, low birth weight and reduced access to proper sanitation. Mitigation strategies against SaV infections include improved sanitation.en© 2016 Elsevier B.V. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in Journal of Clinical Virology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Clinical Virology, vol. 78, pp. 82-88, 2016. doi :10.1016/j.jcv.2016.03.013.CalicivirusesChildren <5 yearsViral gastroenteritisHospitalisedSouth Africa (SA)Sapoviruses (SaVs)Postprint Article