Predominance of norovirus GI.4 from children with acute gastroenteritis in Jambi, Indonesia, 2019

Abstract

Norovirus (NoV) is one of the most important viral causes of acute gastroenteritis (AGE) in children worldwide. Only a few studies have reported AGE with NoV‐positive in some cities in Indonesia. This study aimed to investigate the incidence and clinical characteristic of NoV infection, and also genotype distribution of NoV in children with AGE in Jambi, as the capital and the largest city of Jambi province, Indonesia. Stool samples were collected from children (≤15 years of age) with AGE at three participating hospitals in Jambi from February to April 2019. The detection of NoV and its genotyping were carried out by reverse‐transcriptase polymerase chain reaction and direct sequencing. Of the 91 stool samples collected, 14 (15.4%) were positive for NoV. Fever, vomiting, and severe diarrhea were commonly observed in AGE with NoV, while level of dehydration was statistically significant difference between children with NoV‐positive and those with NoV‐negative. The most prevalent genotype was GI.4 (42.9%), followed by GII.6 (28.6%) and some other genotypes. Interestingly, this study found the predominance of GI.4, differed from previous reports in Indonesia. Continuously investigation of the circulating genotype is needed to control the NoV‐infected AGE.

Norovirus: Facts and Reflections from Past, Present, and Future

“…A recent meta-analysis found that the highest frequency of NoV infection occurred in infants less than 12 months of age [24]. A second study of hospitalized patients in Indonesia found the highest frequency of NoV infection in those under 24 months of age [34]. In a summary of 10 community-based birth cohort studies, NoV-associated AGE was relatively uncommon in infants under 6 months of age [25].…”

“…Yet, birth cohort studies conducted in low-and middle-income countries have demonstrated that 66-90% of the children experienced at least one NoV infection and 30-70% experienced NoV-associated AGE in early childhood, with an estimated incidence for NoV-associated AGE of 14 to 66 per 100 child years [25]. Male predominance has been often reported [24,33], with the highest rates of NoV AGE during winter or rainy seasons [34][35][36].…”

“…Selected recent publications on the genotype distribution of human NoVs in various locations and the main variants identified, focused on both sporadic episodes and outbreaks, are detailed in Table 1. These studies differed in various aspects, such as their design (prospective, sometimes population-based, vs. retrospective analysis), age of participants, sporadic cases vs. outbreak-based studies, and/or hospitalized vs. community cases [33,34,43,[48][49][50][51][52][53][54][55][56]. Although the relative prevalence of NoV genotypes varied among studies and locations, genotype GII.4 was the most common among all studies.…”

“…Although the relative prevalence of NoV genotypes varied among studies and locations, genotype GII.4 was the most common among all studies. Recombinant strains and GII.4 variants were reported frequently [24,32,33,43,[45][46][47]49,54,56] and most of the studies documented changes in the dominant strains during the study period [33][34][35]45,53], with the emerging strain occasionally causing more severe disease [33]. Some differences in the epidemiologic features of the genotypes were observed.…”

Molecular epidemiology and genetic diversity of norovirus infection in children hospitalized with acute gastroenteritis in East Java, Indonesia in 2015–2019

“…Epidemiological studies estimated that worldwide, noroviruses may cause >1 million hospitalizations and up to 200,000 deaths annually in children <5 years old (Ahmed et al, 2014;Bányai et al, 2018). In Indonesia, norovirus gastroenteritis occurs sporadically in children with a prevalence of 15 to 61%, and hospitalization is often required for the patients (Hakim et al, 2018;Nirwati et al, 2019;Athiyyah et al, 2020;Wulandari et al, 2020).…”