Loading...
Norovirus infection and acquired immunity in 8 countries: Results from the MAL-ED study
Rouhani, S Peñataro Yori, P Paredes Olortegui, M Siguas Salas, M Rengifo Trigoso, D Mondal, D Bodhidatta, L Platts-Mills, J Samie, A Kabir, F
Rouhani, S
Peñataro Yori, P
Paredes Olortegui, M
Siguas Salas, M
Rengifo Trigoso, D
Mondal, D
Bodhidatta, L
Platts-Mills, J
Samie, A
Kabir, F
Citations
Altmetric:
Genre
Journal Article
Date
2016-05-15
Advisor
Committee member
Group
Department
Permanent link to this record
Collections
Research Projects
Organizational Units
Journal Issue
DOI
10.1093/cid/ciw072
Abstract
© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. Background. Norovirus is an important cause of childhood diarrhea. We present data from a longitudinal, multicountry study describing norovirus epidemiology during the first 2 years of life. Methods. A birth cohort of 1457 children across 8 countries contributed 7077 diarrheal stools for norovirus testing. A subset of 199 children contributed additional asymptomatic samples (2307) and diarrheal stools (770), which were used to derive incidence rates and evaluate evidence for acquired immunity. Results. Across sites, 89% of children experienced at least 1 norovirus infection before 24 months, and 22.7% of all diarrheal stools were norovirus positive. Severity of norovirus-positive diarrhea was comparable to other enteropathogens, with the exception of rotavirus. Incidence of genogroup II (GII) infection was higher than genogroup I and peaked at 6-11 months across sites. Undernutrition was a risk factor for symptomatic norovirus infection, with an increase in 1 standard deviation of length-for-age z score associated with a 17% reduction (odds ratio, 0.83 [95% confidence interval,. 72-.97]; P =. 011) in the odds of experiencing diarrhea when norovirus was present, after accounting for genogroup, rotavirus vaccine, and age. Evidence of acquired immunity was observed among GII infections only: Children with prior GII infection were found to have a 27% reduction in the hazard of subsequent infection (hazard ratio, 0.727; P =. 010). Conclusions. The high prevalence of norovirus across 8 sites in highly variable epidemiologic settings and demonstration of protective immunity for GII infections provide support for investment in vaccine development.
Description
Citation
Citation to related work
Oxford University Press (OUP)
Has part
Clinical Infectious Diseases
ADA compliance
For Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu