Etiology of Severe Acute Watery Diarrhea in Children in the Global Rotavirus Surveillance Network Using Quantitative Polymerase Chain Reaction.

Autor:	Operario DJ; University of Virginia, Charlottesville., Platts-Mills JA; University of Virginia, Charlottesville., Nadan S; National Institute for Communicable Diseases, Johannesburg., Page N; National Institute for Communicable Diseases, Johannesburg., Seheri M; South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa., Mphahlele J; South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa., Praharaj I; Christian Medical College, Vellore, India., Kang G; Christian Medical College, Vellore, India., Araujo IT; Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil., Leite JPG; Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil., Cowley D; Murdoch Childrens Research Institute, Melbourne, Australia., Thomas S; Murdoch Childrens Research Institute, Melbourne, Australia., Kirkwood CD; Murdoch Childrens Research Institute, Melbourne, Australia., Dennis F; Noguchi Memorial Institute for Medical Research, Accra, Ghana., Armah G; Noguchi Memorial Institute for Medical Research, Accra, Ghana., Mwenda JM; World Health Organization (WHO) Regional Office for Africa, Brazzaville, Republic of the Congo., Wijesinghe PR; WHO Regional Office for South-East Asia, New Delhi, India., Rey G; WHO Regional Office for the Americas, District of Columbia., Grabovac V; WHO Regional Office for the Western Pacific, Manila, the Philippines., Berejena C; University of Zimbabwe, Harare., Simwaka CJ; University Teaching Hospital, Lusaka, Zambia., Uwimana J; Ministry of Health, Kigali, Rwanda., Sherchand JB; Tribhuvan University, Kathmandu, Nepal., Thu HM; Department of Medical Research, Yangon, Myanmar., Galagoda G; Medical Research Institute, Colombo, Sri Lanka., Bonkoungou IJO; Laboratoire National de Santé Publique, Ouagadougou, Burkina Faso., Jagne S; National Public Health Laboratories, Fajara, The Gambia., Tsolenyanu E; Sylvanus Olympio Teaching Hospital, Lomé, Togo., Diop A; Albert Royer National Paediatric Hospital Laboratory, Dakar, Senegal., Enweronu-Laryea C; University of Ghana Medical School, Accra., Borbor SA; University of Sierra Leone, Freetown., Liu J; University of Virginia, Charlottesville., McMurry T; University of Virginia, Charlottesville., Lopman B; Emory University., Parashar U; Centers for Disease Control and Prevention, Atlanta, Georgia., Gentsch J; Centers for Disease Control and Prevention, Atlanta, Georgia., Steele AD; Bill & Melinda Gates Foundation, Seattle, Washington., Cohen A; World Health Organization, Geneva, Switzerland., Serhan F; World Health Organization, Geneva, Switzerland., Houpt ER; University of Virginia, Charlottesville.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2017 Jul 15; Vol. 216 (2), pp. 220-227.
DOI:	10.1093/infdis/jix294
Abstrakt:	Background: The etiology of acute watery diarrhea remains poorly characterized, particularly after rotavirus vaccine introduction. Methods: We performed quantitative polymerase chain reaction for multiple enteropathogens on 878 acute watery diarrheal stools sampled from 14643 episodes captured by surveillance of children <5 years of age during 2013-2014 from 16 countries. We used previously developed models of the association between pathogen quantity and diarrhea to calculate pathogen-specific weighted attributable fractions (AFs). Results: Rotavirus remained the leading etiology (overall weighted AF, 40.3% [95% confidence interval {CI}, 37.6%-44.3%]), though the AF was substantially lower in the Americas (AF, 12.2 [95% CI, 8.9-15.6]), based on samples from a country with universal rotavirus vaccination. Norovirus GII (AF, 6.2 [95% CI, 2.8-9.2]), Cryptosporidium (AF, 5.8 [95% CI, 4.0-7.6]), Shigella (AF, 4.7 [95% CI, 2.8-6.9]), heat-stable enterotoxin-producing Escherichia coli (ST-ETEC) (AF, 4.2 [95% CI, 2.0-6.1]), and adenovirus 40/41 (AF, 4.2 [95% CI, 2.9-5.5]) were also important. In the Africa Region, the rotavirus AF declined from 54.8% (95% CI, 48.3%-61.5%) in rotavirus vaccine age-ineligible children to 20.0% (95% CI, 12.4%-30.4%) in age-eligible children. Conclusions: Rotavirus remained the leading etiology of acute watery diarrhea despite a clear impact of rotavirus vaccine introduction. Norovirus GII, Cryptosporidium, Shigella, ST-ETEC, and adenovirus 40/41 were also important. Prospective surveillance can help identify priorities for further reducing the burden of diarrhea. (© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu