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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2016
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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. |
format | Online Article Text |
id | pubmed-4845786 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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