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Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study

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 t...

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Autores principales: Rouhani, Saba, Peñataro Yori, Pablo, Paredes Olortegui, Maribel, Siguas Salas, Mery, Rengifo Trigoso, Dixner, Mondal, Dinesh, Bodhidatta, Ladaporn, Platts-Mills, James, Samie, Amidou, Kabir, Furqan, Lima, Aldo, Babji, Sudhir, Mason, Carl J., Kalam, Adil, Bessong, Pascal, Ahmed, Tahmeed, Mduma, Estomih, Bhutta, Zulfiqar A., Lima, Ila, Ramdass, Rakhi, Lang, Dennis, George, Ajila, Zaidi, Anita K. M., Kang, Gagandeep, Houpt, Eric, Kosek, Margaret N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845786/
https://www.ncbi.nlm.nih.gov/pubmed/27013692
http://dx.doi.org/10.1093/cid/ciw072
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author Rouhani, Saba
Peñataro Yori, Pablo
Paredes Olortegui, Maribel
Siguas Salas, Mery
Rengifo Trigoso, Dixner
Mondal, Dinesh
Bodhidatta, Ladaporn
Platts-Mills, James
Samie, Amidou
Kabir, Furqan
Lima, Aldo
Babji, Sudhir
Mason, Carl J.
Kalam, Adil
Bessong, Pascal
Ahmed, Tahmeed
Mduma, Estomih
Bhutta, Zulfiqar A.
Lima, Ila
Ramdass, Rakhi
Lang, Dennis
George, Ajila
Zaidi, Anita K. M.
Kang, Gagandeep
Houpt, Eric
Kosek, Margaret N.
author_facet Rouhani, Saba
Peñataro Yori, Pablo
Paredes Olortegui, Maribel
Siguas Salas, Mery
Rengifo Trigoso, Dixner
Mondal, Dinesh
Bodhidatta, Ladaporn
Platts-Mills, James
Samie, Amidou
Kabir, Furqan
Lima, Aldo
Babji, Sudhir
Mason, Carl J.
Kalam, Adil
Bessong, Pascal
Ahmed, Tahmeed
Mduma, Estomih
Bhutta, Zulfiqar A.
Lima, Ila
Ramdass, Rakhi
Lang, Dennis
George, Ajila
Zaidi, Anita K. M.
Kang, Gagandeep
Houpt, Eric
Kosek, Margaret N.
author_sort Rouhani, Saba
collection PubMed
description 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.
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spelling pubmed-48457862016-04-27 Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study Rouhani, Saba Peñataro Yori, Pablo Paredes Olortegui, Maribel Siguas Salas, Mery Rengifo Trigoso, Dixner Mondal, Dinesh Bodhidatta, Ladaporn Platts-Mills, James Samie, Amidou Kabir, Furqan Lima, Aldo Babji, Sudhir Mason, Carl J. Kalam, Adil Bessong, Pascal Ahmed, Tahmeed Mduma, Estomih Bhutta, Zulfiqar A. Lima, Ila Ramdass, Rakhi Lang, Dennis George, Ajila Zaidi, Anita K. M. Kang, Gagandeep Houpt, Eric Kosek, Margaret N. Clin Infect Dis Articles and Commentaries 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. Oxford University Press 2016-05-15 2016-03-24 /pmc/articles/PMC4845786/ /pubmed/27013692 http://dx.doi.org/10.1093/cid/ciw072 Text en © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, contact journals.permissions@oup.com.
spellingShingle Articles and Commentaries
Rouhani, Saba
Peñataro Yori, Pablo
Paredes Olortegui, Maribel
Siguas Salas, Mery
Rengifo Trigoso, Dixner
Mondal, Dinesh
Bodhidatta, Ladaporn
Platts-Mills, James
Samie, Amidou
Kabir, Furqan
Lima, Aldo
Babji, Sudhir
Mason, Carl J.
Kalam, Adil
Bessong, Pascal
Ahmed, Tahmeed
Mduma, Estomih
Bhutta, Zulfiqar A.
Lima, Ila
Ramdass, Rakhi
Lang, Dennis
George, Ajila
Zaidi, Anita K. M.
Kang, Gagandeep
Houpt, Eric
Kosek, Margaret N.
Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study
title Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study
title_full Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study
title_fullStr Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study
title_full_unstemmed Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study
title_short Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study
title_sort norovirus infection and acquired immunity in 8 countries: results from the mal-ed study
topic Articles and Commentaries
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845786/
https://www.ncbi.nlm.nih.gov/pubmed/27013692
http://dx.doi.org/10.1093/cid/ciw072
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