Clinical features and molecular epidemiology of rotavirus and norovirus infections in Libyan children

Abstract

Rotaviruses and noroviruses are leading viral causes of diarrhoea in children. A cross-sectional study was undertaken among children aged <5 years with acute gastroenteritis at Al-Jala Children's Hospital, Tripoli, Libya, from October 2007 to September 2008. Of 1,090 fecal samples collected, 260 from inpatients and 830 from outpatients, all inpatients and approximately a third of outpatients, selected systematically, were investigated for rotavirus and norovirus infection by ELISA and real-time RT-PCR, respectively. Of 520 fecal samples examined (inpatients = 260, outpatients = 260), 164 (31.5%) had rotavirus and 91 (17.5%) had norovirus detected. Rotavirus was identified more often among inpatients than outpatients (35.8% vs. 27.3% respectively, P = 0.038). Norovirus was detected more commonly among outpatients than inpatients (21.2% vs. 13.8% respectively, P = 0.028). The peak incidence of infection with both viruses was among children aged between 6 and 11 months. The number of rotavirus cases was highest between November and June with a peak detection rate of 50% in January. Norovirus occurred most commonly from May through August with a peak detection rate of 47% in August. The most prevalent rotavirus genotypes were P[8], G9 (n = 116, 65.9%), followed by P[8],G1 (n = 49, 27.8%); a single P[9], G3 strain was detected. There were seven distinct electropherotypes among the G9 strains and all belonged to VP7 Lineage III. Among 91 noroviruses identified, 90 were genogroup II. Of 26 genogroup II noroviruses examined, all were genotype GII.4. Rotaviruses and noroviruses are both important causes of gastrointestinal infection among young children in Libya.

Molecular Characterization of Rotavirus Strains Causing Gastroenteritis in Children under 5 Years in Cairo, Egypt

“…A total of 198 diarrheal specimens were tested by ELISA for rotavirus antigen and 56 (28.3%) were positive. This finding is within the range (11-76.9%) previously detected in Egypt [22][23][24][25][26][27][28][29] and in other countries .3%), including the Middle East and North Africa [30][31][32][33][34][35][36][37][38][39][40]. The variation in prevalence rates may be attributed to different conditions which may have affected the detection rates.…”

“…For example, in other studies there were differences in the number of tested samples, season of sample collection, and the sampling methods. The occurrence of the group A Rotavirus was higher in the first 12 months of life (36%) than in the other age groups, as was observed in previous studies in developing countries [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. This finding may be explained by decline of maternal antibodies with immature immune systems which protect the newborns from pathogens during the first months of life [42].…”

Norovirus GII.17 Predominates in Selected Surface Water Sources in Kenya

“…Nucleotide sequence information on NoV GII.17 strains from Burkina Faso (Nordgren et al 2013), Morocco (KJ162374), Cameroon (Ayukekbong et al 2011) and South Africa (Murray et al 2013) are available in GenBank. Although NoV GII.17 seems to be prevalent in some parts of Africa this genotype was not identified in clinical specimens (Silva et al 2008;Abugalia et al 2011;Hassine-Zaafrane et al 2013;Huynen et al 2013;) and environmental samples (Sdiri-Loulizi et al 2010) from many other African regions and the GII.17 predominance appears to be peculiar to Kenya. Norovirus GII.17 is of clinical relevance as it has been implicated in nosocomial NoV infection (Sukhrie et al 2011) and chronic NoV infection in a kidney transplant patient (Schorn et al 2010).…”

“…The two NoV GI.1 strains (KDMarch2012-301 and KDMarch2012-304), detected in the urban Mutoine river, showed a high nucleotide sequence identity (97%) to a clinical NoV GI.1 strain (JX416391) from Burkina Faso. Except for studies in South Africa Murray 2013), Botswana (Mattison et al 2010) and Burkino Faso (Nordgren et al 2013), the occurrence of NoV GI.1 does not appear to be widely reported in Africa as no GI.1 strains were detected in diarrhoeal stool samples from children in Nairobi, Kenya (Mans et al 2014) nor in the clinical specimens (Silva et al 2008;Abugalia et al 2011;Ayukekbong et al 2011;Trainor et al 2013) or sewage samples (Sdiri-Loulizi et al 2010) from other African countries. Norovirus GI.3 however, appears to more prevalent in African regions (Ayukekbong et al 2011;Yassin et al 2012;Trainor et al 2013), including Kenya (Mans et al, 2014).…”

Role of noroviruses as aetiological agents of diarrhoea in developing countries

“…These nosocomial outbreaks are commonly reported in industrialized countries (Gastañaduy et al, 2013;Munir et al, 2014;Sukhrie et al, 2012). However, reports of nosocomial norovirus outbreaks in developing countries are limited and most studies are community based (Abugalia et al, 2011;Krumkamp et al, 2015). The wide difference in rates of reported hospital outbreaks between developed and developing countries renders the assessment of the impact of health care norovirus infection in developing countries difficult to establish.…”