RESUMO
Rotavirus is an important cause of childhood diarrhoea. A monovalent rotavirus vaccine (Rotarix®) was introduced into the Immunization Program of Brazil in 2006. In this study, we describe the incidence and burden of disease of rotavirus diarrhoea in two cohorts of children (vaccinated and unvaccinated). We followed two groups of 250 children under one year old, who were enrolled in December 2006 from a low-income residential area in Northeast Brazil. The children were monitored every two weeks for two years. Stool samples from children with diarrhoea were examined for the presence of rotavirus. Rotaviruses were genotyped using real time-polymerase chain reaction. The mean numbers of all-cause diarrhoea episodes/child (adjusted for age) in the first year were 0.87 and 0.84, in vaccinated and unvaccinated children, respectively. During the second year, the number of episodes/child decreased to 0.52 and 0.42. Only 16 (4.9%) of 330 stool samples were rotavirus-positive (10 vaccinated and 6 unvaccinated children) and only P[4]G2 rotaviruses were identified. All-cause diarrhoea episodes were more severe in unvaccinated children in the first year of age (p < 0.05), while vaccinated children had more severe episodes 18 months after vaccination. Rotavirus diarrhoea incidence was very low in both groups.
Assuntos
Diarreia Infantil/epidemiologia , Infecções por Rotavirus/epidemiologia , Vacinas contra Rotavirus/imunologia , Brasil/epidemiologia , Diarreia Infantil/prevenção & controle , Diarreia Infantil/virologia , Fezes/virologia , Feminino , Genótipo , Humanos , Incidência , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Reação em Cadeia da Polimerase , Infecções por Rotavirus/prevenção & controle , Índice de Gravidade de Doença , Vacinas Atenuadas/imunologiaRESUMO
Rotavirus is an important cause of childhood diarrhoea. A monovalent rotavirus vaccine (Rotarix®) was introduced into the Immunization Program of Brazil in 2006. In this study, we describe the incidence and burden of disease of rotavirus diarrhoea in two cohorts of children (vaccinated and unvaccinated). We followed two groups of 250 children under one year old, who were enrolled in December 2006 from a low-income residential area in Northeast Brazil. The children were monitored every two weeks for two years. Stool samples from children with diarrhoea were examined for the presence of rotavirus. Rotaviruses were genotyped using real time-polymerase chain reaction. The mean numbers of all-cause diarrhoea episodes/child (adjusted for age) in the first year were 0.87 and 0.84, in vaccinated and unvaccinated children, respectively. During the second year, the number of episodes/child decreased to 0.52 and 0.42. Only 16 (4.9 percent) of 330 stool samples were rotavirus-positive (10 vaccinated and 6 unvaccinated children) and only P[4]G2 rotaviruses were identified. All-cause diarrhoea episodes were more severe in unvaccinated children in the first year of age (p < 0.05), while vaccinated children had more severe episodes 18 months after vaccination. Rotavirus diarrhoea incidence was very low in both groups.
Assuntos
Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Diarreia Infantil , Infecções por Rotavirus , Vacinas contra Rotavirus/imunologia , Brasil , Diarreia Infantil , Diarreia Infantil , Fezes , Genótipo , Incidência , Estudos Longitudinais , Reação em Cadeia da Polimerase , Infecções por Rotavirus , Índice de Gravidade de Doença , Vacinas Atenuadas/imunologiaRESUMO
BACKGROUND: The detection of norovirus by ELISA and immunochromatographic methods may facilitate epidemiological studies into the global disease burden associated with norovirus gastroenteritis and provide a quick method of testing for norovirus infection. OBJECTIVES: To evaluate the new RIDASCREEN norovirus ELISA (3rd generation) and RIDAQUICK norovirus immunochromatographic test on a collection of samples from Brazilian children with acute gastroenteritis, and compare them against the established 2nd generation IDEIA norovirus assay. STUDY DESIGN: Reverse transcriptase PCR, the study reference standard, was used to test 726 specimens for the presence of norovirus. All 96 norovirus positive samples and a systematic selection of negative samples were tested by RIDASCREEN, RIDAQUICK and IDEIA norovirus tests. RESULTS: The sensitivity of RIDASCREEN for the detection of norovirus was 63% (95% CI: 53-72%) and RIDAQUICK 69% (95% CI: 58-78%); both were >98% specific. The IDEIA had a sensitivity of 45% (95% CI: 35-55%), significantly lower than RIDASCREEN and RIDAQUICK (p≤0.01). The sensitivity of RIDASCREEN and RIDAQUICK in detecting GII.4 noroviruses, the principal norovirus strain identified in community and nosocomial infection globally, was 78% and 88% respectively. CONCLUSION: The norovirus RIDASCREEN test may be useful in epidemiological studies of norovirus infection and the norovirus RIDAQUICK test offers an accurate and rapid method of detecting norovirus infection.
Assuntos
Infecções por Caliciviridae/diagnóstico , Fezes/virologia , Gastroenterite/virologia , Norovirus/isolamento & purificação , Kit de Reagentes para Diagnóstico , Virologia/métodos , Brasil , Infecções por Caliciviridae/virologia , Criança , Pré-Escolar , Humanos , Imunoensaio/métodos , Lactente , Recém-Nascido , Sensibilidade e EspecificidadeRESUMO
BACKGROUND & AIMS: Rotavirus vaccines were introduced in Brazil in 2006; we evaluated their effects in the state of Sergipe, Brazil. METHODS: We performed a cross-sectional survey of children with diarrhea attending emergency services in Aracaju, Brazil, between October 2006 and April 2008 and a cluster sampling survey to assess vaccination coverage. Vaccine efficacy was assessed using the screening method. Diarrhea consultation and hospitalization data (2003-2007) were obtained from state and national surveillance systems. RESULTS: Rotavirus was detected in 59 of 534 stool samples (11%) from children attending emergency services. The number of rotavirus-positive samples decreased from 18 of 74 (24%) in 2006 to 31 of 321 (9.5%) in 2007 and 10 of 136 (7.4%) in 2008 (P < .01). Diarrhea severity was greater in children with rotavirus (P < .01) but decreased over time (P < .001). Of the rotaviruses detected, 56 of 59 (95%) were P[4]G2 genotype, 1 was P[4]G-non-typeable (NT), 1 was P[NT]G2, and 1 was P[NT]GNT. Diarrhea consultations decreased from 3020 in 2004 to 604 in 2007; reductions were greatest among children under 5 years old. Diarrhea hospitalizations decreased from 2121 in 2003 to 1176 in 2007. Vaccine coverage was 90.3%. Vaccines were highly effective against the strain P[8]G1; efficacy against P[4]G2 genotype was 89% (95% confidence interval: 0.87-0.92) in Aracaju and 95% in Sergipe. CONCLUSIONS: Since vaccines were introduced in 2006, there has been an overall reduction in diarrhea consultations and hospitalizations in northeast Brazil, with the greatest reductions in young children. This might have resulted from vaccination and improved sanitation. Although a single rotavirus genotype (P[4]G2) was recovered, vaccine efficacy was high against this genotype.
Assuntos
Diarreia/prevenção & controle , Programas Nacionais de Saúde/estatística & dados numéricos , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus , Rotavirus/isolamento & purificação , Vacinação/estatística & dados numéricos , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Diarreia/epidemiologia , Diarreia/virologia , Pesquisas sobre Atenção à Saúde , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Avaliação de Programas e Projetos de Saúde , Encaminhamento e Consulta/estatística & dados numéricos , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia , Estações do AnoRESUMO
In 2006, Brazil will initiate universal immunization of its 4-million infants with a live attenuated serotype G1P[8] human rotavirus vaccine. In anticipation of the national immunization program, this study was undertaken to characterize rotavirus strains circulating among children in Recife, one of the largest cities in the northeast region of Brazil. Group A rotaviruses were detected in 102 (35%) of 290 faecal specimens collected from children under 5 years of age who presented with acute diarrhoea during a 1-year period between May 2004 and April 2005. In addition to the globally common G1P[8] serotype that accounted for 49% of strains, emerging rotavirus serotypes G8P[6] and G9P[8] represented 2% and 29% of strains, respectively. Following cell culture adaptation, RNA-RNA hybridization demonstrated that two Brazilian G8P[6] rotavirus strains shared a high level of genomic RNA homology with Malawian G8P[6] strains, and a Brazilian G9P[8] strain was related most closely to a G9P[8] strain from India. The results suggest that certain rotavirus strains have a much wider global circulation than generally appreciated. Continued global spread of such strains might challenge the efficacy of current rotavirus vaccines.
Assuntos
Diarreia/virologia , Infecções por Rotavirus/virologia , Rotavirus/classificação , Rotavirus/isolamento & purificação , Brasil , Pré-Escolar , Fezes/virologia , Humanos , Lactente , Recém-Nascido , Hibridização de Ácido Nucleico , Prevalência , RNA Viral/genética , Infecções por Rotavirus/epidemiologia , Vacinas contra Rotavirus , SorotipagemRESUMO
We identified 21 rotaviruses in 129 patients with diarrhea in a Brazilian city with high rotavirus vaccine coverage. All rotaviruses were genotype P[4]G2 with 1 mixed infection with P[NT]G9. Although virus predominance could have occurred randomly, the vaccine may be less protective against P[4]G2. Prospective surveillance is urgently needed.
Assuntos
Infecções por Rotavirus/imunologia , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/imunologia , Rotavirus/genética , Vacinas Atenuadas/imunologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Disenteria/imunologia , Disenteria/virologia , Genótipo , Humanos , Lactente , Vacinação em Massa , Rotavirus/classificação , Infecções por Rotavirus/epidemiologiaRESUMO
Acute respiratory infections (ARI) are one of the most important causes of death in children. Human metapneumovirus (HMPV), a virus first described in 2001, has now been detected in almost all continents. HMPV causes bronchiolitis and pneumonia with a clinical spectrum similar to respiratory syncytial virus (RSV). We describe the incidence of HMPV and RSV during two consecutive seasons with a high incidence of ARI in Aracaju, Brazil. HMPV was responsible for 24% of cases of bronchiolitis in the 1st season (April-May 2002) but was not found in the 2nd year (April-May 2003). RSV was recovered from 61 (55%) children with ARI in 2002 and from 72 (68%) in 2003. Children with RSV bronchiolitis in 2002 had more hypoxia but less wheezing than in 2003. The incidence of HMPV and RSV genotypes causing bronchiolitis varied between the years. Long-term prospective studies are required to better describe the epidemiology of these viruses in children.
Assuntos
Metapneumovirus , Infecções por Paramyxoviridae/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Brasil/epidemiologia , Bronquiolite/epidemiologia , Bronquiolite/virologia , Pré-Escolar , Estudos Transversais , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Metapneumovirus/classificação , Metapneumovirus/genética , Infecções por Paramyxoviridae/virologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/classificação , Vírus Sinciciais Respiratórios/genética , Estações do AnoRESUMO
We describe the epidemiologic and clinical characteristics of 111 children attending clinics and hospitals in Aracaju, northeast Brazil, with acute respiratory infections attributable to human metapneumovirus (HMPV), respiratory syncytial virus (RSV), or both in May and June 2002. Fifty-three (48%) children were infected with RSV alone, 19 (17%) with HMPV alone, and 8 (7%) had RSV/HMPV co-infections.