title: Detection and molecular characterisation of noroviruses in hospitalised children in Malawi, 1997-2007.
abstract: Despite the increasing recognition of noroviruses as major pathogens associated with community-acquired diarrhoea in children, there are few studies from Africa. Long-term surveillance studies of rotavirus gastroenteritis in Malawian children have provided an opportunity to undertake a study of the importance and epidemiological features of norovirus infection in this population. Faecal specimens were collected from children <5 years of age admitted to hospital with acute diarrhoea, as well as from a comparison group of diarrhoea-free children, in Blantyre, Malawi between 1997 and 2007. Norovirus was detected using real-time PCR and strains genotyped by nucleotide sequence analysis. Norovirus was detected in 220/1,941 (11.3%) faecal specimens, comprising genogroup GI (1.8%), GII (9.4%) and mixed GI/GII (0.1%). The median age of children with norovirus was 6 months (range, 0-48 months). Norovirus was detected throughout the year, with peaks at the end of the rainy season (March) and towards the end of the dry season (August-November). Norovirus GII.4 was the most commonly detected genotype accounting for 70% of strains characterised, followed by GII.2 (6%), GII.6 (4%) and GII.12 (4%). Sub typing of GII.4 noroviruses demonstrated local circulation of strains prior to their subsequent detection in association with global epidemics of gastroenteritis. The prevalence of norovirus in children without diarrhoea was similar to the level in cases. This largest study to date of norovirus infection in African children indicates the potential role of paediatric surveillance in predicting the emergence of norovirus strains with global epidemic potential.
authors.affiliation: Department of Clinical Infection, Microbiology & Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Eamonn
authors.initials: E
authors.lastname: Trainor
authors.forename: Ben
authors.initials: B
authors.lastname: Lopman
authors.forename: Miren
authors.initials: M
authors.lastname: Iturriza-Gomara
authors.forename: Winifred
authors.initials: W
authors.lastname: Dove
authors.forename: Bagrey
authors.initials: B
authors.lastname: Ngwira
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakagomi
authors.forename: Toyoko
authors.initials: T
authors.lastname: Nakagomi
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.forename: Nigel
authors.initials: N
authors.lastname: Cunliffe
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology*; D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008295:Malawi / Q000453:epidemiology; D008297:Male; D017720:Molecular Epidemiology; D029322:Norovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D012621:Seasons; D017422:Sequence Analysis, DNA
keywords: Malawi; gastroenteritis; norovirus
references.citation: J Med Virol. 2010 Aug;82(8):1442-8
references.pmid: 20572088
references.citation: J Med Virol. 2007 May;79(5):544-51
references.pmid: 17385696
references.citation: Clin Lab. 2006;52(9-10):519-25
references.pmid: 17078480
references.citation: Mol Biol Evol. 1987 Jul;4(4):406-25
references.pmid: 3447015
references.citation: BMC Pediatr. 2011 Feb 23;11:19
references.pmid: 21345186
references.citation: J Infect Dis. 2000 May;181 Suppl 2:S284-7
references.pmid: 10804139
references.citation: J Clin Microbiol. 1999 Sep;37(9):3055-8
references.pmid: 10449507
references.citation: Virology. 2006 Mar 15;346(2):312-23
references.pmid: 16343580
references.citation: Clin Lab. 2005;51(3-4):183-91
references.pmid: 15819174
references.citation: J Clin Virol. 2013 Mar;56(3):185-93
references.pmid: 23218993
references.citation: Scand J Infect Dis. 2011 Oct;43(10):804-8
references.pmid: 21696253
references.citation: J Virol. 2007 Sep;81(18):9932-41
references.pmid: 17609280
references.citation: J Infect Dis. 2000 May;181 Suppl 2:S254-61
references.pmid: 10804134
references.citation: J Virol Methods. 2002 Feb;100(1-2):107-14
references.pmid: 11742657
references.citation: Emerg Infect Dis. 2008 Aug;14(8):1224-31
references.pmid: 18680645
references.citation: J Clin Microbiol. 2003 Apr;41(4):1548-57
references.pmid: 12682144
references.citation: J Med Virol. 2006 Nov;78(11):1480-5
references.pmid: 16998875
references.citation: Pediatr Infect Dis J. 2007 Jul;26(7):602-6
references.pmid: 17596802
references.citation: J Infect Dis. 2000 May;181 Suppl 2:S322-30
references.pmid: 10804145
references.citation: J Infect Dis. 2004 Sep 15;190(6):1088-92
references.pmid: 15319858
references.citation: Eur J Clin Microbiol Infect Dis. 2007 May;26(5):311-23
references.pmid: 17447091
references.citation: Epidemiol Infect. 2009 Jul;137(7):922-31
references.pmid: 19017426
references.citation: MMWR Surveill Summ. 2011 Apr 8;60(2):1-11
references.pmid: 21471951
references.citation: J Clin Microbiol. 2010 Mar;48(3):994-8
references.pmid: 20042616
references.citation: Lancet. 2004 Feb 28;363(9410):682-8
references.pmid: 15001325
references.citation: Gut. 2012 Jan;61(1):69-77
references.pmid: 21708822
references.citation: Emerg Infect Dis. 2001 Jan-Feb;7(1):82-91
references.pmid: 11266298
references.citation: J Infect Dis. 2004 Jul 1;190(1):27-36
references.pmid: 15195240
references.citation: J Infect Dis. 2010 Sep 1;202 Suppl:S23-33
references.pmid: 20684708
references.citation: J Infect Dis. 2009 Sep 1;200(5):802-12
references.pmid: 19627248
references.citation: Pediatr Int. 2008 Feb;50(1):65-9
references.pmid: 18279208
references.citation: Clin Infect Dis. 2006 Apr 1;42(7):970-1
references.pmid: 16511761
references.citation: J Clin Microbiol. 2009 Feb;47(2):421-9
references.pmid: 19109464
references.citation: J Med Virol. 2010 Feb;82(2):321-4
references.pmid: 20029818
references.citation: Am J Epidemiol. 2001 Oct 1;154(7):666-74
references.pmid: 11581101
references.citation: Epidemiol Infect. 2008 Jan;136(1):23-33
references.pmid: 17313697
references.citation: J Med Virol. 2011 Oct;83(10):1849-56
references.pmid: 21837804
references.citation: J Med Virol. 2012 Sep;84(9):1489-96
references.pmid: 22825829
references.citation: J Clin Microbiol. 2006 Feb;44(2):327-33
references.pmid: 16455879
references.citation: J Clin Virol. 2010 Dec;49(4):258-64
references.pmid: 20869912
references.citation: J Infect Dis. 2010 Sep 1;202 Suppl:S34-42
references.pmid: 20684715
references.citation: J Med Virol. 2011 Dec;83(12):2135-42
references.pmid: 22012721
references.citation: N Engl J Med. 2009 Oct 29;361(18):1776-85
references.pmid: 19864676
references.citation: J Med Virol. 2003 Sep;71(1):82-93
references.pmid: 12858413
references.citation: PLoS Med. 2008 Feb;5(2):e31
references.pmid: 18271619
references.citation: Vaccine. 2012 May 21;30(24):3580-6
references.pmid: 22469864
references.citation: J Infect Dis. 2000 Nov;182(5):1519-22
references.pmid: 11023476
references.citation: J Infect Dis. 2010 Sep 1;202 Suppl:S168-74
references.pmid: 20684698
references.citation: Nucleic Acids Res. 1994 Nov 11;22(22):4673-80
references.pmid: 7984417
references.citation: J Med Virol. 2005 Dec;77(4):522-7
references.pmid: 16254959
references.citation: Arch Virol. 2007;152(7):1295-303
references.pmid: 17361327
references.citation: Pediatr Infect Dis J. 1999 May;18(5):420-6
references.pmid: 10353514