Viral pathogens of acute gastroenteritis in Egyptian children: role of the parechovirus

Abstract

Background and aim Human parechovirus (HPeV) has emerged as a pathogen associated with acute gastroenteritis (AGE). Aim To detect the presence of HPeV in the stool samples from Egyptian children with AGE seeking care and the possibility of its co-infection with other enteric viruses. Methodology One hundred stool samples were collected from children attending Mansoura University Children's Hospital with AGE. HPeV and astrovirus were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). At the same time, detection of rotavirus antigen and norovirus was achieved by enzyme-linked immunosorbent assay and rapid immunochromatographic method, respectively. Results The most frequently detected virus was rotavirus (39%), followed by norovirus (27%), HPeV (19%), and astrovirus (12%). Interestingly, the single infection with HPeV was 5%. Among the 19 HPeV positive samples, the co-infection of HPeV with other enteric viruses was detected in 9(43.9%) for rotavirus, 7(36.8%) for norovirus, 2(10.5%) for astrovirus, in 3(15.8%) for rotavirus and norovirus and 1(5.3%) for norovirus and astrovirus. Regarding the clinical presentation, there was no significant difference between children infected with HPeV alone and those infected with viruses other than HPeV alone; fever (p = 0.3), vomiting (p = 0.12), abdominal pain (p = 0.12), and grades of severity (P = 0.82). HPeV alone infected children were of mild severity (60%), and their main presenting symptom was fever (60%). Conclusions Detection of HPeV as a single viral pathogen in the stool of some children with AGE showed that this virus could be a causative agent of AGE in Egyptian children. Therefore, HPeV could be included as one of the viruses screened for AGE diagnosis in children in Egypt.

Detection and genetic diversity of parechoviruses in children with acute flaccid paralysis in Cameroon

“…Phylogenetic analyses assigned all study viruses to the HPeV A and specifically to the specific genotypes HPeV A-1, A-4, A-5, A-10, A-14, A-15, A-17, and A-18. This is consistent with the fact that HPeV is known to have the highest genetic diversity in Africa [ 30 , 31 , 33 , 34 ]. However, given that a proportion (9/22) of HPeV-positive samples failed to amplify by nested PCR, as in other studies, it cannot be excluded that a higher number of HPeV genotypes co-circulate in Cameroon, so far without known associated epidemics.…”

“…Nevertheless, some previous studies reported higher HPeV detection prevalence than those described here. Studies conducted in Malawi, Ghana and Egypt showed HPeV prevalences as high as 57% (427/749), 24% (164/682) and 19% (19/100), respectively; confirming that HPeV circulation may be intensive in some African countries [ 31 , 32 , 48 ]. Variations in the HPeV prevalences between studies could be explained by differences in the socio-demographic and hygienic conditions that may favour or limit enteric virus transmission between specific populations in different epidemiological settings.…”

“…In Europe and the USA, the prevalence of 1 to 7% has been reported, with a relatively higher frequency of HPeV-A1, A3, A4, A2, while genotypes HPeV-A7 to 19 have been rarely detected [27][28][29]. Extensive HPeV circulation has been documented in some African countries such as Ethiopia, Egypt and Malawi with HPeV detection rates of 10.9%, 19% and 57% respectively [30][31][32]. Despite the limited number of studies published in Africa, all known HPeV genotypes have been described in African studies [30,31,33,34].…”

Diversity of picornaviruses detected in diarrheal samples from children in Belém, Brazilian Amazon (1982–2019)

“…However, there was no statistically significant association between HPeV‐A infection and the risk of gastroenteritis 38 . In other studies conducted in children with AG, the percentage observed was lower than that obtained in the present study, as in Thailand and Egypt, with detection rates of 14.6% and 19%, respectively 39,40 …”

“…38 In other studies conducted in children with AG, the percentage observed was lower than that obtained in the present study, as in Thailand and Egypt, with detection rates of 14.6% and 19%, respectively. 39,40 Two samples from this study were classified as recombinant strains involving three types of HPeV, namely 4, 17, and 5. This finding had already been reported by Leal et al (2019) in samples from the rural area of northern Brazil.…”