Asia Pacific Journal of Pediatric and Child Health

Abstract Ref Number = APCP261

Oral Presentation

THE BURDEN OF NOROVIRUS DISEASE IN CHILDREN - A MULTI-COUNTRY STUDY IN THE PHILIPPINES, THAILAND, CHILE, AND BRAZIL

LULU BRAVO,Randee Kastner,Leyla Hernandez Donoso,Margarita RieraMontes,Thomas Verstraeten,Marco Aurelio Safadi,Auchara Tangsathapornpong,Usa Thisyakorn,Rosanna Lagos,Alexandre Linhares,Maria Rosario Capeding,Olarn Prommalikit,Miguel ORyan University of the Philippines Manila Takeda Vaccines Pte Ltd, Singapore Takeda Pharmaceuticals International AG, Zurich, Switzerland P Epidemiology and Pharmacovigilance, Leuven, Belgium Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil Thammasat University, Pathumthani, Thailand Chulalongkorn University, Bangkok, Thailand Hospital de Nios Roberto del Rio, Santiago, Chile Instituto Evandro Chagas, Belem, Brazil Research Institute for Tropical Medicine, Philippines HRH Princess Maha Chakri Sirindhorn Medical Centre, NakhonNayok, Thailand University of Chile

Background : Acute gastroenteritis (AGE) represents a significant cause of morbidity and mortality in children around the world, and noroviruses (NoVs) are responsible for almost a fifth of all AGE cases. Material : We conducted a prospective study in predominantly urban hospitals in the Philippines, Thailand, Chile, and Brazil between 2014 and 2017 in order to estimate the burden of NoVs among medically-attended AGE in children younger than 6 years of age. Children presenting with AGE were recruited into cohorts depending upon patient status (inpatient or outpatient) and the presumed place where AGE was acquired (community or hospital). Children younger than 6 years of age without AGE were also recruited as controls. Detailed demographic and clinical information was collected. Stool samples were collected and tested for NoV by RT-PCR. Samples positive for NoV were genotyped. Unadjusted proportions were calculated for each cohort, overall and stratified by country. Results : Of the 1,649 subjects included in the analysis, 41% were outpatients, 34% were hospitalized with community acquired AGE, 3% were inpatients with nosocomial AGE, and 21% were recruited as controls. While the proportion of subjects positive for NoVs varied by country, 24% of all outpatient AGE, 18% of all community-acquired hospitalized AGE, and 21% of nosocomial AGE were related to NoV. Further, NoV was found in 10% of the controls in the Philippines, Thailand, and Chile and in 7% of the controls in Brazil. Among NoV positive samples, GII.4 was the most identified genotype in all cohorts and countries, with higher frequency in medically-attended cases than in controls, and highest frequency in hospitalized cases. Conclusions : These results confirm norovirus is an important cause of medically attended AGE in children. Results from this study provide information that supports NoV vaccine development

Keywords: Norovirus disease burden diarrhea