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Distribution of GI and GII norovirus genotypes (capsid and polymerase combined) in Sub-Saharan Africa. (a) Relative frequencies of GI genotypes among a total of 42 GI norovirus positive samples from nine studies. GI.7 and GI.3 norovirus infections were more common than any other GI genotype. (b) Relative frequencies of GII genotypes among a total of 368 GII norovirus positive samples from nine studies. GII.4 (65.2%) was the most prevalent genotype. Und: undefined. Rest: GII.e, GII.8, GII.11, GII.13, GII.14, and GII.15.
Source publication
Noroviruses are a leading cause of acute sporadic gastroenteritis worldwide. In Sub-Saharan Africa, information regarding norovirus infections in children is scarce. A systematic review of studies performed between 1993 and June 2015 was conducted to establish the genotypic distribution and prevalence of norovirus infections in children (≤17) in Su...
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Norovirus (NoV) causes about one-fifth of all cases of foodborne diseases and is a foremost cause of domestically acquired foodborne acute gastroenteritis and outbreaks. NoV infections are often associated with the consumption of contaminated fresh and ready-to-eat produce, fresh and frozen berries, raw/undercooked bivalve mollusks and products whi...
Prolonged norovirus shedding may occur in certain patients, such as organ transplant recipients. We established a mouse model for persistent norovirus infection [using mouse norovirus (MNV.CR6 strain). The nucleoside viral polymerase inhibitor 2’ -
C
-methylcytidine (2CMC) [but not by favipiravir (T-705)] reduced viral shedding to undetectable leve...
Noroviruses are significant etiological agents of acute gastroenteritis (AGE) across all age groups, especially in children under 5 years of age. Although the prevalence of norovirus infection is known to have increased in various countries, in India there are few reports pertaining to the norovirus disease burden. We investigated the epidemiology...
Norovirus is the leading cause of viral gastroenteritis worldwide, and there are no approved vaccines or therapeutic treatments for chronic or severe norovirus infections. The structural characterisation of the norovirus protease and drug development has predominantly focused upon GI.1 noroviruses, despite most global outbreaks being caused by GII....
Background. Human secretor-status is a strong susceptibility factor for norovirus infection in immunocompetent people. The predominant norovirus genotype GII.4 almost exclusively infects secretors and is also associated with more severe symptoms. However, it is not known to what extent this also applies to immunocompromised individuals. Our objecti...
Citations
... GII.6-17, GII.20 and GII.21) were identified in the pre-vaccination studies. In the post-vaccination studies, 3 genotypes [4,5,63,[67][68][69]. Genotypic diversity is a well-documented feature of norovirus epidemiology [68,70]. ...
... The distribution of the different genotypes shows that GII.4 is by far the predominant genotype in both pre-and post-vaccination studies, with combined prevalence of 66.84% and 51.24% respectively. These results are similar to those of previous studies conducted in Africa, which reported GII.4 prevalence of 54.1% [68] and 65.2% [67]. Other recent meta-analysis reported similar prevalence of 59.3% [65] and 52% [66]. ...
Noroviruses are the second leading cause of death in children under the age of 5 years old. They are responsible for 200 million cases of diarrhoea and 50,000 deaths in children through the word, mainly in low-income countries. The objective of this review was to assess how the prevalence and genetic diversity of noroviruses have been affected by the introduction of rotavirus vaccines in Africa. PubMed, Web of Science and Science Direct databases were searched for articles. All included studies were conducted in Africa in children aged 0 to 5 years old with gastroenteritis. STATA version 16.0 software was used to perform the meta-analysis. The method of Dersimonian and Laird, based on the random effects model, was used for the statistical analyses in order to estimate the pooled prevalence’s at a 95% confidence interval (CI). Heterogeneity was assessed by Cochran’s Q test using the I2 index. The funnel plot was used to assess study publication bias. A total of 521 studies were retrieved from the databases, and 19 were included in the meta-analysis. The pooled norovirus prevalence’s for pre- and post-vaccination rotavirus studies were 15% (95 CI, 15–18) and 13% (95 CI, 09–17) respectively. GII was the predominant genogroup, with prevalence of 87.64% and 91.20% respectively for the pre- and post-vaccination studies. GII.4 was the most frequently detected genotype, with rates of 66.84% and 51.24% respectively for the pre- and post-vaccination studies. This meta-analysis indicates that rotavirus vaccination has not resulted in a decrease in norovirus infections in Africa.
... Although GII NoVs show a higher prevalence in human and account for most of the NoV outbreaks globally (Kroneman et al., 2008), the prevalence of GI NoV had increased from 7.8% to 37.3% over the past decade (Hasing et al., 2013). For instance, GI NoV variants were widely detected in sub-Saharan Africa from 1993 to 2015 (Munjita, 2015). In southern China, GI.9, GI.2, and GI.3 were the most common GI NoV strains among asymptomatic carriers in coastal oyster farms (Wang et al., 2018). ...
Introduction
Herd immunity against norovirus (NoV) is poorly understood in terms of its serological properties and vaccine designs. The precise neutralizing serological features of genotype I (GI) NoV have not been studied.
Methods
To expand insights on vaccine design and herd immunity of NoVs, seroprevalence and seroincidence of NoV genotypes GI.2, GI.3, and GI.9 were determined using blockade antibodies based on a 5-year longitudinal serosurveillance among 449 residents in Jidong community.
Results
Correlation between human histo-blood group antigens (HBGAs) and GI NoV, and dynamic and persistency of antibodies were also analyzed. Seroprevalence of GI.2, GI.3, and GI.9 NoV were 15.1%–18.0%, 35.0%–38.8%, and 17.6%–22.0%; seroincidences were 10.0, 21.0, and 11.0 per 100.0 person-year from 2014 to 2018, respectively. Blockade antibodies positive to GI.2 and GI.3 NoV were significantly associated with HBGA phenotypes, including blood types A, B (excluding GI.3), and O⁺; Lewis phenotypes Leb+/Ley+ and Lea+b+/Lex+y+; and secretors. The overall decay rate of anti-GI.2 antibody was -5.9%/year (95% CI: -7.1% to -4.8%/year), which was significantly faster than that of GI.3 [-3.6%/year (95% CI: -4.6% to -2.6%/year)] and GI.9 strains [-4.0%/year (95% CI: -4.7% to -3.3%/year)]. The duration of anti-GI.2, GI.3, and GI.9 NoV antibodies estimated by generalized linear model (GLM) was approximately 2.3, 4.2, and 4.8 years, respectively.
Discussion
In conclusion, enhanced community surveillance of GI NoV is needed, and even one-shot vaccine may provide coast-efficient health benefits against GI NoV infection.
... Norovirus (NoV) is a small single-stranded non-enveloped RNA virus that belongs to the family Calciviridae that causes viral acute gastroenteritis outbreaks worldwide [1,2]. It was first discovered in 1968 and is the second most common cause of viral acute gastroenteritis (AGE) in children under 5 years of age, after rotavirus [3,4]. ...
Purpose:
Norovirus gastroenteritis, known to cause 'winter vomiting disease' is increasingly being identified as a major cause of viral gastroenteritis worldwide. The impact and prevalence of this viral disease are lacking in many parts of India including northeast India. This study aimed to determine the prevalence and association of norovirus gastroenteritis among under-five-year-old hospitalized children in two cities in northeast India (Dibrugarh in Assam & Dimapur in Nagaland).
Materials and methods:
A retrospective analysis of 407 randomly selected diarrheal stool samples was conducted using a commercial multiplex probed-based real-time RT-PCR assay capable of detecting six-viral gastroenteritis pathogens including Norovirus GI, Norovirus GII, Rotavirus, Human Adenovirus, Human Astrovirus, and Sapovirus.
Results:
Results showed that norovirus was detected in 18.4% of the samples (75/407; 95% CI: 14.8%-22.5%), with norovirus genogroup II being the predominant group in 97.3% of norovirus cases. A significant association of norovirus diarrhea was found with seasonality, with higher prevalence in colder months compared to warmer months (22.4% vs 9.1%, p-value:0.002). Additionally, 66.7% (50/75) of cases of norovirus gastroenteritis had reported vomiting as the major symptom and had a shorter duration of diarrhea (p-value 0.03). Co-infections with other viral pathogens were seen in 45.9% (187/407) of the cases. The detection of rotavirus was 67.1% (273/407), human adenovirus (45.9%; 187/407), sapovirus and astrovirus (5.9%, 24/407 each), and norovirus GI (0.5%, 2/407) among the cases.
Conclusion:
This study reports the prevalence of norovirus gastroenteritis in northeast India and further highlights that norovirus gastroenteritis is responsible for substantial cases of hospitalization of under-five years children in the region.
... It is worth noting that our short study period may not have fully captured the true frequency of gastroenteritis within the population which varies by season and country within sub-Saharan Africa. 27 Although data on pediatric comorbidity and mortality in LMIC are limited, comorbidity has been demonstrated to increase odds of death, particularly in children with pneumonia. 28,29 The presence of any comorbidity increased odds of death within our cohort. ...
Objectives
Data on triage practices of children admitted to Princess Marina Hospital in Gaborone, Botswana is limited. The inpatient triage, assessment, and treatment score was developed for low resource settings to predict mortality in children. We assess its performance among children admitted to Princess Marina Hospital and their demographic, clinical, and risk factors for death.
Methods
This was a secondary data analysis of a prospective cohort study comprising 299 children ages 1 month to 13 years admitted June to September 2018. Descriptive statistics, bivariate analysis, and multivariate logistic regression were used. Sensitivity and specificity data were generated for the inpatient triage, assessment, and treatment score.
Results
Thirteen children died (13/284, 4.6%). Comorbidity (adjusted odds ratio 4.0, p = 0.020) and high inpatient triage, assessment, and treatment score (adjusted odds ratio 5.0, p = 0.017) increased odds of death. The area under the receiver operating characteristic curve was 0.81. Using inpatient triage, assessment, and treatment cutoff of 4, the sensitivity, specificity, and likelihood ratio were 31%, 94%, and 5.0, respectively.
Conclusion
Implementing the inpatient triage, assessment, and treatment score in low resource settings may improve identification, treatment, and evaluation of the sickest children.
... Genogroup II is by far the most frequently reported genogroup comprising about 27 genotypes. According to some previous studies, GII.4 is the predominant genotype responsible for about 55-97% of the disease burden [6,7] with an increased evolution rate due to accumulated mutations in the capsid region [8]. As a result of this, different GII. ...
... Our finding was, however, slightly lower than a previous report in Africa that reported an overall prevalence of 9.7% (95% CI 8.4-11.1) among asymptomatic groups [13], and a review in Sub-Saharan Africa children was (9.2%) [6]. The difference might be due to the time frame when the review was conducted. ...
... The same is true for the previous review conducted in Africa where GII strains represented 88.5% of all detected NoVs, and GI strains 3.4% [13]. In contrast to our finding, a lower prevalence of GII (76.4%), with an increased prevalence of GI NoVs (21.7%) was reported in the previous review done in Sub-Saharan countries [6]. The same is true for the previous review done in Africa from studies published between 1990 and 19:115 2013 that is 81% (95% CI 73-87%) for GII and, 18% (95% CI 12-24%) for GI. ...
Background
Noroviruses are the leading cause of acute gastroenteritis in all age groups globally. The problem is magnified in developing countries including Africa. These viruses are highly prevalent with high genetic diversity and fast evolution rates. With this dynamicity, there are no recent review in the past five years in Africa. Therefore, this review and meta-analysis aimed to assess the prevalence and genetic diversity of noroviruses in Africa and tried to address the change in the prevalence and genetic diverisity the virus has been observed in Africa and in the world.
Methods
Twenty-one studies for the pooled prevalence, and 11 out of the 21 studies for genetic characterization of norovirus were included. Studies conducted since 2006, among symptomatic cases of all age groups in Africa, conducted with any study design, used molecular diagnostic methods and reported since 2015, were included and considered for the main meta-analysis. PubMed, Cochrane Library, and Google Scholar were searched to obtain the studies. The quality the studies was assessed using the JBI assessment tool. Data from studies reporting both asymptomatic and symptomatic cases, that did not meet the inclusion criteria were reviewed and included as discussion points. Data was entered to excel and imported to STATA 2011 to compute the prevalence and genetic diversity. Heterogeneity was checked using I² test statistics followed by subgroup and sensitivity analysis. Publication bias was assessed using a funnel plot and eggers test that was followed by trim and fill analysis.
Result
The pooled prevalence of norovirus was 20.2% (95% CI: 15.91, 24.4). The highest (36.3%) prevalence was reported in Ghana. Genogroup II noroviruses were dominant and reported as 89.5% (95% CI: 87.8, 96). The highest and lowest prevalence of this genogroup were reported in Ethiopia (98.3%), and in Burkina Faso (72.4%), respectively. Diversified genotypes had been identified with an overall prevalence of GII. 4 NoV (50.8%) which was followed by GII.6, GII.17, GI.3 and GII.2 with a pooled prevalence of 7.7, 5.1, 4.6, and 4.2%, respectively.
Conclusion
The overall pooled prevalence of norovirus was high in Africa with the dominance of genogroup II and GII.4 genotype. This prevalence is comparable with some reviews done in the same time frame around the world. However, in Africa, an in increasing trained of pooled prevalence had been reported through time. Likewise, a variable distribution of non-GII.4 norovirus genotypes were reported as compared to those studies done in the world of the same time frame, and those previous reviews done in Africa. Therefore, continuous surveillance is required in Africa to support future interventions and vaccine programs.
... The virus belongs to the family of Caliciviridae. NoV is single-stranded, small non-enveloped RNA [3,4]. The first track-down Norovirus was linked with a human eruption of gastroenteritis in Norwalk, Ohio. ...
Norovirus (NoV) is one of the oldest recognized diseases and the leading causal pathogen for acute gastroenteritis (AGE) worldwide. Though numerous studies have been reported on NoV disease, limited research has explored the publication trends in this area. As a result, the objective of this work was to fill the void by conducting a bibliometric study in publication trends on NoV studies as well as discovering the hotspots. The Web of Science central assemblage database was hunted for publications from 1991 to 2021 with "norovirus" in the heading. Microsoft Excel 2016, VOSviewer, R Bibliometrix, and Biblioshiny packages were deployed for the statistical analysis of published research articles. A total of 6021 published documents were identified in the Web of Science database for this thirty-year study period (1991-2021). The analyses disclosed that the Journal of Medical Virology was the leading journal in publications on norovirus studies with a total of 215 published articles, the Journal of Virology was the most cited document with 11,185 total citations. The United States of America (USA) has the most significant productivity in norovirus publications and is the leading country with the highest international collaboration. Analysis of top germane authors discovered that X. Jiang (135) and J. Vinje (119) were the two top relevant authors of norovirus publications. The commonly recognized funders were US and EU-based, with the US emerging as a top funder. This study reveals trends in scientific findings and academic collaborations and serves as a leading-edge model to reveal trends in global research in the field of norovirus research. This study points out the progress status and trends on NoV research. It can help researchers in the medical profession obtain a comprehensive understanding of the state of the art of NoV. It also has reference values for the research and application of the NoV visualization methods. Further, the research map on AGE obtained by our analysis is expected to help researchers efficiently and effectively explore the NoV field.
... 5%) in our study in 2009 and were genetically very close to strains that had been detected in Senegal in 1976 12 and Burkina Faso in 2011.Among GI viruses, GI.3 has been most frequently detected in developing countries.15 In sub-Saharan Africa, children under 17 years of age were mostly infected with GI.7 viruses (33%) followed by GI.3 and GI.5 with 21% and 17%, respectively.16 ...
Norovirus is the leading cause of sporadic and epidemic acute gastroenteritis (AGE) in children and adults around the world. We investigated the molecular diversity of noroviruses in a paediatric population in Senegal between 2007-2010 prior to rotavirus vaccine implementation. Stool samples were collected from 599 children under 5 years of age consulting for AGE in a hospital in Dakar. Specimens were screened for noroviruses using the Allplex™ GI-Virus Assay. Positive samples were genotyped after sequencing of conventional RT-PCR products. Noroviruses were detected in 79 (13.2%) of the children, with GII.4 (64%) and GII.6 (10%) as the most frequently identified genotypes. Our study describes the distribution of genotypes between 2007 and 2010 and should be a baseline for comparison with more contemporary studies. This could help decision makers on possible choices of norovirus vaccines in the event of future introduction.
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... Noroviruses are considered a major cause of viral gastroenteritis across all age groups worldwide [41]. Among African children, the impact and epidemiology of norovirus infections remain scarcely investigated [42]. Our results highlight the role of viruses in childhood diarrhoea affecting inhabitants of a low-income country. ...
Background
Childhood diarrhoea, a major cause of morbidity and mortality in low-income regions, remains scarcely studied in many countries, such as Guinea-Bissau. Stool sample drying enables later qPCR analyses of pathogens without concern about electricity shortages.
Methods
Dried stool samples of children under five years treated at the Bandim Health Centre in Bissau, Guinea-Bissau were screened by qPCR for nine enteric bacteria, five viruses, and four parasites. The findings of children having and not having diarrhoea were compared in age groups 0–11 and 12–59 months.
Results
Of the 429 children– 228 with and 201 without diarrhoea– 96.9% and 93.5% had bacterial, 62.7% and 44.3% viral, and 52.6% and 48.3% parasitic pathogen findings, respectively. Enteroaggregarive Escherichia coli (EAEC; 60.5% versus 66.7%), enteropathogenic E . coli (EPEC; 61.4% versus 62.7%), Campylobacter (53.2% versus 51.8%), and enterotoxigenic E . coli (ETEC; 54.4% versus 44.3%) were the most common bacterial pathogens. Diarrhoea was associated with enteroinvasive E . coli (EIEC)/ Shigella (63.3%), astrovirus (75.0%), norovirus GII (72.6%) and Cryptosporidium (71.2%). The only pathogen associated with severe diarrhoea was EIEC/ Shigella (p<0.001). EAEC was found more frequent among the infants, and EIEC/ Shigella , Giardia duodenalis and Dientamoeba fragilis among the older children.
Conclusions
Stool pathogens proved common among all the children regardless of them having diarrhoea or not.
... In another study performed by Munjita, the genotypic distribution and prevalence of NoV infections in children less than 17 years with symptomatic and nonsymptomatic gastroenteritis in sub-Saharan Africa were established using the results of studies published between 1993 and 2015. 24 According to the results of this study, the prevalence of NoV infection among 8399 children was 12.6%, and the most frequent genotypes were GII.4, GI.7 and GI.3. ...
In the post rotavirus vaccine era, norovirus (NoV) plays an increasingly important role in epidemic and sporadic gastroenteritis among children. This study was designed to provide an updated meta‐analytic review of the prevalence of NoV among paediatric patients with gastroenteritis and to clarify the relationship between NoV infection and gastroenteritis. Systematic searches of the literature for potentially relevant studies were carried out from 1 January 2015 to 29 May 2020. The inverse variance method was chosen for weighting of the studies, and the random‐effects model was used to analyse data. To determine the association between NoV infection and gastroenteritis in children, pooled odds ratio (OR) and its 95% confidence interval (CI) were computed for case–control studies. The pooled prevalence of NoV infection among 12,0531 children with gastroenteritis from 45 countries across the world was 17.7% (95% CI: 16.3%–19.2%). There were 28 studies with a case–control design, and the pooled prevalence of NoV infection among 11,954 control subjects was 6.7% (95% CI: 5.1%–8.8%). The pooled OR of the association of NoV infection and gastroenteritis was 2.7 (95% CI: 2.2–3.4). The most common NoV genotypes were GII.4 (59.3%) and GII.3 (14.9%). The highest frequency of NoV was found in the age group below 1 year. Our findings indicated a substantial burden of gastroenteritis caused by NoV globally, with GII.4 and GII.3 the major genotypes responsible for the majority of NoV‐associated gastroenteritis cases among children. Younger age and male sex can be considered risk factors for NoV‐associated gastroenteritis among children.
... Though GII variants show a higher prevalence in humans with multiple NoV genotypes co-circulating (Ramani et al., 2014;Saito et al., 2014), an increase of GI NoV activity from 7.8% to 37.3% was observed in the last decade (Hasing et al., 2013). The distribution of GI variants as the most predominant strain was reported in sub-Saharan Africa with GI.7 (33%), GI.3 (21%), and GI.5 (17%) from 1993 to 2015 (Munjita, 2015). Moreover, a study investigating the prevalence and characteristics of asymptomatic NoV infection suggested GI.9, GI.2, and GI.3 accounted for 39.7% asymptomatic infection among people living around oyster farms in south China (Wang et al., 2018). ...
Characterizing diversity and the antigenic relatedness of norovirus remains a primary focus in understanding its biological properties and vaccine designs. The precise antigenic and serological features of GI genotypes have not been studied. The study represented an investigation on a gastroenteritis outbreak related to GI.3 norovirus and the three most detected GI genotypes, GI.2 (belonging to immunotype B), GI.3 and GI.9 (belonging to immunotype C), were selected to characterize their phylogenetic relationship, HBGA binding profiles and antigenic relatedness within (intra-immunotype), and between (inter-immunotypes) genotypes using mouse sera and patient’s serum samples from the GI.3 related outbreak. Wide HBGA binding profiles and evolution of binding affinity were observed in the three GI genotypes studied. A low specific blockade antibody to GI.3 in the population generated the pool of susceptible individuals and supported virus spread in the outbreak. We found strong blockade immune response in homologous strains, moderate intra-immunotype blockade but weak inter-immunotypes blockade in humans following GI.3 norovirus infections. These findings further support the immunotypes grouping and will be valuable for optimizing the design of norovirus vaccine.
