ABSTRACT
Introduction: Norovirus infection is a common cause of acute gastroenteritis (AGE). Surveillance activities are important to aid investigation into effective norovirus control strategies, including vaccination. Here, we report ancillary findings related to the incidence, prevalence, and etiology of AGE caused by norovirus in Panama after adjustment of study methodology to comply with national coronavirus disease 2019 (COVID-19) mandates. Methods: In January 2020, children aged <2 years began enrolling into an epidemiological study in Panama to estimate the burden of norovirus in preparation for evaluating upcoming prevention strategies. This included an observational, longitudinal, community-based AGE surveillance study and a hospital-based AGE surveillance study. For the longitudinal study, healthy children aged 5-18 months were enrolled from January 6 through March 23, 2020, with a follow-up of approximately 6 months. The last participant was contacted on September 23, 2020. For the hospital-based study, starting on January 21, 2020, children aged <2 years who were admitted to the Hospital del Niño Dr. José Renán Esquivel in Panama City due to AGE were evaluated. The last sample was collected on September 29, 2020. Collected stool samples were tested for norovirus as well as astrovirus, sapovirus, and various enteropathogens. Unfortunately, this study was disrupted by the subsequent implementation of disease transmission control procedures for the COVID-19 pandemic, and the study methodology was revised to comply with COVID-19 mandates. Results: In the longitudinal surveillance cohort [N = 400 (Chiriquí, n = 239; Panama, n = 161)], a total of 185 AGE episodes were documented (Chiriquí, n = 85; Panama, n = 100) resulting in an overall AGE incidence of 11.6 (95% CI: 9.99-13.4) episodes per 100 child-months. The norovirus-related AGE incidence was 0.3 (95% CI: 0.10-0.73) episodes per 100 child-months (5/185 AGE episodes) and the prevalence of norovirus was 4.6% (13/282 stool samples collected). In the hospital-based surveillance cohort, at least one pathogen was detected in 50% of samples (44/88 stool samples collected) and norovirus prevalence was 6.8% (6/88 stool samples collected). Discussion: This report demonstrates how the occurrence of the COVID-19 pandemic hindered the conduct of clinical trials. However, this also created unique research opportunities to investigate the potential impact of pandemic control measures on the etiology of infectious diarrheal disease.
ABSTRACT
BACKGROUND: This prospective, multicenter study examined the importance of hepatitis viruses as etiological agents of acute liver failure (ALF) and the outcome of ALF cases in Latin American children and adolescents. METHODS: The study was conducted for minimum 12 months in 9 centers in Argentina, Brazil, Chile, Colombia, Costa Rica, and Mexico during 2001-2002. Hospitalized patients aged 1-20 years with a suspected diagnosis of ALF were included in the study and tested for serologic markers for hepatitis A, B, and C viruses. RESULTS: Of the 106 patients enrolled, 88 were included in the analysis. Median age was 5 years, and 55% with ALF were aged 1-5 years. A total of 37 individuals (43%) tested positive for anti-hepatitis A virus (HAV) immunoglobulin M (IgM) as marker of acute HAV infection; one was positive for anti-hepatitis B core antigen IgM and negative for hepatitis B surface antigen. None had markers of hepatitis C virus infection. Mortality rates in the overall study cohort (45%) and for those who tested anti-HAV IgM positive (41%) were similar. Forty-one percent of all patients and 46% of those positive for anti-HAV IgM underwent transplantation. The mortality rate in those with liver transplantation was half of that in patients who were not transplanted (28% versus 57%). CONCLUSIONS: HAV was the main etiologic agent of ALF in the population studied.
Subject(s)
Hepatitis A/complications , Liver Failure, Acute/epidemiology , Adolescent , Adult , Child , Child, Preschool , Female , Hepatitis A/mortality , Hepatitis A Antibodies/blood , Hepatitis B Antibodies/blood , Hepatitis C Antibodies/blood , Humans , Immunoglobulin M/blood , Infant , Latin America , Liver Failure, Acute/mortality , Liver Failure, Acute/therapy , Liver Transplantation , Male , Prevalence , Prospective StudiesABSTRACT
La prevalencia de la infección por el virus de hepatitis A (VHA) en un país es un indicador de su nivel de higiene y condiciones socioeconómicos. En la década del 80 se reportaron en Lima una prevalencia de 98 por ciento del anti-HVA en adultos y de 82 por ciento en los niños, con un rango de 30 por ciento al año de edad y 100 por ciento a los 8 años. Entre octubre y diciembre de 1999, realizamos una encuesta sero-epidemiológica para evaluar la presencia de anticuerpos contra el virus de hepatitis A de tipo IgG en 859 sujetos entre 1 y 39 años, divididas en dos grupos de acuerdo a su status socioeconómico. En la población adulta estudiada (menor de 20 años) se encontró una positividad anti-HAV de 84 por ciento (288/341), mientras que en la población infantil (menor de 14 años) se encontró 46.3 por ciento(163/352); siendo los de nivel socio-económico AB los mas bajos: 35.6 por ciento (57/160) y los del nivel CD de 55.2 por ciento (106/192). Concluimos que en los últimos 15 años se ha producido una significativa reducción de la prevalencia del anti-HVA en la población infantil y adolescente de Lima, lo que configura un patrón epidemiológico de endemicidad intermedia.
Subject(s)
Infant , Child, Preschool , Child , Adolescent , Adult , Humans , Male , Female , Prevalence , Hepatitis A , AntibodiesABSTRACT
The prevalence of Hepatitis A Virus (HAV) in a country largely reflects its standards of hygiene and socio-economic conditions. In The 80's, it was reported 98% positive anti-HAV in adults and 82% in children; the rate increased with age, from 30% in thosed aged 1 year old to 100% in those of 8 years old.From October to December 1999, we performed a Sero-epidemiologic survey to evaluate the presence of Hepatitis A antibody (anti-HAV) in 859 subjects (518 were children and 341 adults), aged fron 1 to 39 years old, divided in two groups according to their socio-economic status (high and very high, low and very low).Adults older than 20 years old had 84% positives (288/341). Children (between 1 to 14 years old) had 46.3% positives (163/352): 35.6% (57/160) from socio-economic group AB and 55.2% (106/192) in level CD.We concluded that in the last 15 years was performed as significant decrease in the prevalence of Hepatitis A virus infection in children and adolescent polpulation of Lima-Peru, forming an intermediate endemicity as epidemiological pattern.