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Burden of Viral Gastroenteritis in Children Living in Rural China: Population-Based Surveillance

36 Pages Posted: 5 Dec 2018

See all articles by Jin-Xia Wang

Jin-Xia Wang

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

Hong-Lu Zhou

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

Zhao-Jun Mo

Guangxi Center for Disease Control and Prevention

Song-Mei Wang

Fudan University

Zhi-Yong Hao

Zhengding County Center for Disease Control and Prevention

Yue Li

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

Shan-Shan Zhen

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

Xin-Jiang Zhang

Zhengding County Center for Disease Control and Prevention

Can-Jing Zhang

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

Jing-Chen Ma

Hebei Center for Disease Control and Prevention

Chao Qiu

Fudan University

Gan Zhao

Fudan University

Baoming Jiang

Government of the United States of America - Centers for Disease Control and Prevention (CDC)

Xi Jiang

Cincinnati Children's Hospital Medical Center - Division of Infectious Diseases

Rong-Cheng Li

Guangxi Center for Disease Control and Prevention

Yu-Liang Zhao

Hebei Center for Disease Control and Prevention

Xuan-Yi Wang

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS); Fudan University - Institutes of Biomedical Sciences

More...

Abstract

Background: Viral diarrhea is a major public health problem among Chinese children. Despite established disease burden, rotavirus vaccine has not been introduced into routine national immunization; vaccines against norovirus are being developed without complete 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 active and passive surveillance was conducted in Zhengding and Sanjiang counties in the north and south of China, respectively. Diarrhea stools were collected from children <5 years of age. All specimens were tested for rotaviruses, noroviruses, sapoviruses, enteric adenoviruses, and astroviruses by polymerase chain reaction. The severity of illness was assessed using the Vesikari Score System.

Results: During the study period, the overall incidence of diarrhea was 215.0 and 398.2 cases/1,000 children/year in Zhengding and Sanjiang counties, respectively. The most common pathogen was rotavirus (54.7 vs 45.6 cases/1000 children/year in Zhengding and Sanjiang, respectively), followed by norovirus (28.4 vs 19.3 cases/1000 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.

Funding: This work was supported by the National Science and Technology Major Projects for Significant New Drugs Development (2018ZX09201007).

Declaration of Interest: The authors declare that they have no competing interests.

Ethical Approval: This study was reviewed and approved by the Institutional Review Board (IRB) of the Hebei CDC and the Guangxi CDC, as well as the IRB of the Institutes of Biomedical Sciences, Fudan University. Written inform consent was obtained from a parent/guardian of each child. The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Keywords: norovirus, rotavirus, enteric adenovirus, astrovirus, gastroenteritis, China

Suggested Citation

Wang, Jin-Xia and Zhou, Hong-Lu and Mo, Zhao-Jun and Wang, Song-Mei and Hao, Zhi-Yong and Li, Yue and Zhen, Shan-Shan and Zhang, Xin-Jiang and Zhang, Can-Jing and Ma, Jing-Chen and Qiu, Chao and Zhao, Gan and Jiang, Baoming and Jiang, Xi and Li, Rong-Cheng and Zhao, Yu-Liang and Wang, Xuan-Yi, Burden of Viral Gastroenteritis in Children Living in Rural China: Population-Based Surveillance (September 11, 2018). Available at SSRN: https://ssrn.com/abstract=3292600 or http://dx.doi.org/10.2139/ssrn.3292600

Jin-Xia Wang

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

138 Dong’an Rd
Shanghai, 200032
China

Hong-Lu Zhou

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

138 Dong’an Rd
Shanghai, 200032
China

Zhao-Jun Mo

Guangxi Center for Disease Control and Prevention

Nanning
China

Song-Mei Wang

Fudan University

Beijing West District Baiyun Load 10th
Shanghai, 100045
China

Zhi-Yong Hao

Zhengding County Center for Disease Control and Prevention

Hebei
China

Yue Li

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

138 Dong’an Rd
Shanghai, 200032
China

Shan-Shan Zhen

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

138 Dong’an Rd
Shanghai, 200032
China

Xin-Jiang Zhang

Zhengding County Center for Disease Control and Prevention

Hebei
China

Can-Jing Zhang

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS)

138 Dong’an Rd
Shanghai, 200032
China

Jing-Chen Ma

Hebei Center for Disease Control and Prevention

97 Huai An East Rd
Shijiazhuang, Hebei
China

Chao Qiu

Fudan University

Beijing West District Baiyun Load 10th
Shanghai, 100045
China

Gan Zhao

Fudan University

Beijing West District Baiyun Load 10th
Shanghai, 100045
China

Baoming Jiang

Government of the United States of America - Centers for Disease Control and Prevention (CDC)

1600 Clifton Rd., NE
Atlanta, GA 30333
United States

Xi Jiang

Cincinnati Children's Hospital Medical Center - Division of Infectious Diseases

3333 Burnet Avenue
Cincinnati, OH 45229
United States

Rong-Cheng Li

Guangxi Center for Disease Control and Prevention

Nanning
China

Yu-Liang Zhao

Hebei Center for Disease Control and Prevention ( email )

97 Huai An East Rd
Shijiazhuang, Hebei
China

Xuan-Yi Wang (Contact Author)

Fudan University - Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS) ( email )

138 Dong’an Rd
Shanghai, 200032
China

Fudan University - Institutes of Biomedical Sciences ( email )

138 Yi Xue Yuan Rd
Shanghai
China

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