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Published on: August 7, 2017
Risk Factors and Clinical Profile of Sapovirus-associated Acute Gastroenteritis in Early Childhood: A Nicaraguan
Nadja A Vielot1, Fredman González2, Yaoska Reyes2
1From the Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Insights
Sapovirus is a common cause of acute gastroenteritis (AGE) in Nicaraguan children. Vaginal delivery and contact with sick individuals were identified as key risk factors for sapovirus AGE.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Sapovirus is an emerging cause of acute gastroenteritis (AGE) in pediatric populations.
- Understanding risk factors and clinical presentations of sapovirus AGE is crucial for public health interventions.
Purpose of the Study:
- To identify risk factors for sapovirus-associated AGE in a Nicaraguan birth cohort.
- To characterize the clinical profile of sapovirus AGE and compare it to other enteric infections.
Main Methods:
- A case-control study nested within a birth cohort of 444 children in León, Nicaragua.
- Weekly surveillance for AGE, with stool sample testing for sapovirus using RT-qPCR.
- Conditional logistic regression was used to identify independent risk factors for sapovirus AGE.
Main Results:
- Sixty-three first sapovirus AGE episodes were identified between June 2017 and July 2019.
- Independent risk factors for sapovirus AGE included contact with sick individuals and vaginal delivery.
- Sapovirus AGE presented with diarrhea (median 6 days), less fever than other AGE etiologies, and frequent co-infections.
Conclusions:
- Sapovirus is a significant cause of AGE in Central America, with clinical symptoms similar to other pathogens.
- The novel association between vaginal delivery and sapovirus warrants further investigation into potential biological mechanisms.
- Co-infections with other enteric pathogens like diarrheagenic E. coli and astrovirus were common in sapovirus cases.
Background:
Sapovirus is increasingly recognized as an important cause of acute gastroenteritis (AGE) in children. We identified risk factors and characterized the clinical profile of sapovirus AGE in a birth cohort in León, Nicaragua.
Methods:
We conducted a case-control study nested within a birth cohort (n = 444). Fieldworkers conducted weekly household AGE surveillance. AGE stools were tested for sapovirus by reverse transcriptase quantitative polymerase chain reaction. For each first sapovirus episode, we selected 2 healthy age-matched controls and estimated independent risk factors of sapovirus AGE using conditional logistic regression. We compared clinical characteristics of sapovirus AGE episodes with episodes associated with other etiologies and identified co-infections with other enteric pathogens.
Results:
From June 2017 to July 2019, we identified 63 first sapovirus AGE episodes and selected 126 controls. Having contact with an individual with AGE symptoms and vaginal delivery were independent risk factors for sapovirus AGE. All cases experienced diarrhea, lasting a median 6 days; 23% experienced vomiting. Compared with children with AGE due to another etiology, sapovirus AGE was similar in severity, with less reported fever. Most cases experienced co-infections and were more likely than controls to be infected with diarrheagenic Escherichia coli or astrovirus.
Conclusions:
Sapovirus was a commonly identified AGE etiology in this Central American setting, and symptoms were similar to AGE associated with other etiologies. The association between vaginal delivery and sapovirus is a novel finding. Gut microbiome composition might mediate this relationship, or vaginal delivery might be a proxy for other risk factors. Further investigation into more specific biological mechanisms is warranted.
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