Virus Etiology, Diversity and Clinical Characteristics in South African Children Hospitalised with Gastroenteritis

Viruses. 2021 Jan 30;13(2):215. doi: 10.3390/v13020215.

Abstract

Background: Viral gastroenteritis remains a major cause of hospitalisation in young children. This study aimed to determine the distribution and diversity of enteric viruses in children ≤5 years, hospitalised with gastroenteritis at Kalafong Provincial Tertiary Hospital, Pretoria, South Africa, between July 2016 and December 2017.

Methods: Stool specimens (n = 205) were screened for norovirus GI and GII, rotavirus, sapovirus, astrovirus and adenovirus by multiplex RT-PCR. HIV exposure and FUT2 secretor status were evaluated. Secretor status was determined by FUT2 genotyping.

Results: At least one gastroenteritis virus was detected in 47% (96/205) of children. Rotavirus predominated (46/205), followed by norovirus (32/205), adenovirus (15/205), sapovirus (9/205) and astrovirus (3/205). Norovirus genotypes GI.3, GII.2, GII.3, GII.4, GII.7, GII.12, GII.21, and rotavirus strains G1P[8], G2P[4], G2P[6], G3P[4], G3P[8], G8P[4], G8P[6], G9P[6], G9P[8] and sapovirus genotypes GI.1, GI.2, GII.1, GII.4, GII.8 were detected; norovirus GII.4[P31] and rotavirus G3P[4] predominated. Asymptomatic norovirus infection (GI.3, GI.7, GII.4, GII.6, GII.13) was detected in 22% of 46 six-week follow up stools. HIV exposure (30%) was not associated with more frequent or severe viral gastroenteritis hospitalisations compared to unexposed children. Rotavirus preferentially infected secretor children (p = 0.143) and norovirus infected 78% secretors and 22% non-secretors.

Conclusion: Rotavirus was still the leading cause of gastroenteritis hospitalisations, but norovirus caused more severe symptoms.

Keywords: FUT2 secretor status; HIV exposure; norovirus; paediatric gastroenteritis; rotavirus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biodiversity
  • Child, Preschool
  • Feces / virology
  • Female
  • Gastroenteritis / therapy
  • Gastroenteritis / virology*
  • Hospitalization
  • Humans
  • Infant
  • Male
  • South Africa
  • Viruses / classification
  • Viruses / genetics
  • Viruses / isolation & purification*