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ABSTRACT: Background
Successful vaccination strategies against norovirus will require understanding the burden of disease and relevant genotypes in populations. However, few data are available from cohort studies of adults living in low- and middle-income countries (LMIC).Materials and methods
We conducted a nested case-control study within a Peruvian military cohort to characterize the burden of norovirus infection, predominant genotypes, and associated symptoms from 2004 through 2011. Randomly selected case and control stools were tested for norovirus, bacteria, and parasites. The odds ratio of the association between norovirus infection and diarrhea was estimated using multiple logistic regression and co-infection adjusted attributable fractions were calculated.Results
Of the 3,818 cohort study participants, 624 developed diarrhea. Overall and norovirus-associated diarrhea incidence rates were 42.3 and 6.0 per 100 person-years, respectively. The most prevalent norovirus genogroup was GII (72.5%, 29/40), which was associated with diarrhea (AOR 3.4, 95% CI: 1.3-8.7, P = 0.012). The co-infection adjusted GII attributable fraction was 6.4%.Discussion
Norovirus was a frequent cause of diarrhea in an adult population followed longitudinally in an LMIC setting. Vaccine strategies should consider targeting adults in endemic settings and special populations that could serve as community transmission sources.
SUBMITTER: Ballard SB
PROVIDER: S-EPMC4498765 | biostudies-literature | 2015
REPOSITORIES: biostudies-literature
Ballard Sarah-Blythe SB Reaves Erik J EJ Luna C Giannina CG Silva Maria E ME Rocha Claudio C Heitzinger Kristen K Saito Mayuko M Apaza Sonia S Espetia Susan S Blazes David L DL Tilley Drake H DH Guzmán Aguilar Rene C RC Gilman Robert H RH Bausch Daniel G DG
PloS one 20150710 7
<h4>Background</h4>Successful vaccination strategies against norovirus will require understanding the burden of disease and relevant genotypes in populations. However, few data are available from cohort studies of adults living in low- and middle-income countries (LMIC).<h4>Materials and methods</h4>We conducted a nested case-control study within a Peruvian military cohort to characterize the burden of norovirus infection, predominant genotypes, and associated symptoms from 2004 through 2011. Ra ...[more]