Epidemiology of Pediatric Astrovirus Gastroenteritis in a Nicaraguan Birth Cohort

Author:

Rubinstein Rebecca J1ORCID,Gutiérrez Lester2,Toval-Ruíz Christian3,Hammond Kelli4,Bode Lars5ORCID,Vinjé Jan6,Vilchez Samuel4,Becker-Dreps Sylvia14,Bucardo Filemón47,Vielot Nadja A4,Reyes Yaoska1ORCID

Affiliation:

1. Department of Epidemiology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina , USA

2. Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica , San José , Costa Rica

3. Universidad Tecnológica La Salle Facultad de Ingeniería, , León , Nicaragua

4. Department of Family Medicine, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina , USA

5. Department of Pediatrics, Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence, Human Milk Institute, University of California San Diego , La Jolla, California , USA

6. Division of Viral Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

7. Department of Microbiology and Immunology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina , USA

Abstract

Abstract Background Astrovirus is a leading cause of acute gastroenteritis in children worldwide. However, few prospective studies have analyzed astrovirus in community-dwelling pediatric populations in low- and middle-income countries. Methods We assessed the incidence, risk factors, clinical characteristics, genotypes, viral coinfections, and time distribution of astrovirus gastroenteritis in 443 healthy Nicaraguan children born in 2017 to 2018 who were followed for 36 months. Children were recruited from hospitals and birth records in an economically diverse neighborhood of León city. Astrovirus-positive episodes and genotypes were identified from stool with reverse transcription quantitative polymerase chain reaction and Sanger sequencing. Results Of 1708 total specimens tested, 80 children (18%) experienced at least 1 astrovirus episode, and 9 experienced repeat episodes, mostly during the rainy season (May–October). Initial astrovirus episodes were not associated with a lowered risk against future episodes. In exploratory analyses, home toilets were associated with a lower risk of future astrovirus episodes (hazard ratio, 0.19; 95% CI, .04–.91). Human astrovirus 5 episodes, representing 15% of all typed episodes, were associated with longer diarrhea and more symptomatic rotavirus coinfections. Conclusions Astrovirus was a common cause of gastroenteritis in this cohort, and future studies should clarify the role of astrovirus genotype in clinical infection severity.

Publisher

Oxford University Press (OUP)

Reference39 articles.

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