Burden of viral gastroenteritis in children living in rural China: Population-based surveillance

Int J Infect Dis. 2020 Jan:90:151-160. doi: 10.1016/j.ijid.2019.10.029. Epub 2019 Oct 28.

Abstract

Background: Despite the considerable disease burden caused by the disease, rotavirus vaccine has not been introduced into routine national immunization schedule, and norovirus vaccines are being developed without a comprehensive understanding of gastroenteritis epidemiology. To bridge this knowledge gap, we investigated the disease burden of viral gastroenteritis in rural China.

Methods: Between October 2011 and December 2013, population-based surveillance was conducted in Zhengding and Sanjiang counties in China. Stool samples were collected from children <5 years of age with diarrhea. All specimens were tested for rotaviruses, noroviruses, sapoviruses, enteric adenoviruses, and astroviruses.

Results: The most common pathogen causing diarrhea was rotavirus (54.7 vs 45.6 cases/1,000 children/year in Zhengding and Sanjiang, respectively), followed by norovirus (28.4 vs 19.3 cases/1,000 children/year in Zhengding and Sanjiang, respectively). The highest incidence of these viruses was observed in children 6-18 months of age. Among the 5 viral pathogens, rotaviruses caused the most severe illness, followed by noroviruses.

Conclusion: Rotavirus and norovirus are the 2 most important viral pathogens causing childhood diarrhea in both northern and southern China; they should be the major targets for viral gastroenteritis prevention strategies among children in China.

Keywords: Adenovirus; Astrovirus; China; Gastroenteritis; Norovirus; Rotavirus.

MeSH terms

  • Child, Preschool
  • China / epidemiology
  • Diarrhea / epidemiology
  • Diarrhea / virology
  • Feces / virology
  • Female
  • Gastroenteritis / epidemiology
  • Gastroenteritis / virology*
  • Humans
  • Incidence
  • Infant
  • Male
  • Population Surveillance
  • Rural Population / statistics & numerical data
  • Virus Diseases / epidemiology
  • Virus Diseases / virology*
  • Viruses / classification
  • Viruses / genetics
  • Viruses / isolation & purification*