Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis

Norovirus is a common cause of sporadic cases and outbreaks of gastroenteritis worldwide, although its prevalence and the dominant genotypes responsible for gastroenteritis outbreaks remain obscure. A systematic review was conducted on norovirus infection in China between January 2009 and March 2021...

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Main Authors: Ting-Ting Li, Qiang Xu, Mei-Chen Liu, Tao Wang, Tian-Le Che, Ai-Ying Teng, Chen-Long Lv, Guo-Lin Wang, Feng Hong, Wei Liu, Li-Qun Fang
Format: Article
Language:English
Published: MDPI AG 2023-06-01
Series:Viruses
Subjects:
Online Access:https://www.mdpi.com/1999-4915/15/6/1336
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author Ting-Ting Li
Qiang Xu
Mei-Chen Liu
Tao Wang
Tian-Le Che
Ai-Ying Teng
Chen-Long Lv
Guo-Lin Wang
Feng Hong
Wei Liu
Li-Qun Fang
author_facet Ting-Ting Li
Qiang Xu
Mei-Chen Liu
Tao Wang
Tian-Le Che
Ai-Ying Teng
Chen-Long Lv
Guo-Lin Wang
Feng Hong
Wei Liu
Li-Qun Fang
author_sort Ting-Ting Li
collection DOAJ
description Norovirus is a common cause of sporadic cases and outbreaks of gastroenteritis worldwide, although its prevalence and the dominant genotypes responsible for gastroenteritis outbreaks remain obscure. A systematic review was conducted on norovirus infection in China between January 2009 and March 2021. A meta-analysis and beta-binomial regression model were used to explore the epidemiological and clinical characteristics of norovirus infection and the potential factors contributing to the attack rate of the norovirus outbreaks, respectively. A total of 1132 articles with 155,865 confirmed cases were included, with a pooled positive test rate of 11.54% among 991,786 patients with acute diarrhea and a pooled attack rate of 6.73% in 500 norovirus outbreaks. GII.4 was the predominant genotype in both the etiological surveillance and outbreaks, followed by GII.3 in the etiological surveillance, and GII.17 in the outbreaks, with the proportion of recombinant genotypes increasing in recent years. A higher attack rate in the norovirus outbreaks was associated with age group (older adults), settings (nurseries, primary schools, etc.) and region (North China). The nation-wide pooled positive rate in the etiological surveillance of norovirus is lower than elsewhere in the global population, while the dominant genotypes are similar in both the etiological surveillance and the outbreak investigations. This study contributes to the understanding of norovirus infection with different genotypes in China. The prevention and control of norovirus outbreaks during the cold season should be intensified, with special attention paid to and enhanced surveillance performed in nurseries, schools and nursing homes from November to March.
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spelling doaj.art-222878b6832b4fe7bb6746f656842e952023-11-18T13:02:23ZengMDPI AGViruses1999-49152023-06-01156133610.3390/v15061336Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-AnalysisTing-Ting Li0Qiang Xu1Mei-Chen Liu2Tao Wang3Tian-Le Che4Ai-Ying Teng5Chen-Long Lv6Guo-Lin Wang7Feng Hong8Wei Liu9Li-Qun Fang10School of Public Health, Guizhou Medical University, Guiyang 550025, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaSchool of Public Health, Guizhou Medical University, Guiyang 550025, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, ChinaSchool of Public Health, Guizhou Medical University, Guiyang 550025, ChinaNorovirus is a common cause of sporadic cases and outbreaks of gastroenteritis worldwide, although its prevalence and the dominant genotypes responsible for gastroenteritis outbreaks remain obscure. A systematic review was conducted on norovirus infection in China between January 2009 and March 2021. A meta-analysis and beta-binomial regression model were used to explore the epidemiological and clinical characteristics of norovirus infection and the potential factors contributing to the attack rate of the norovirus outbreaks, respectively. A total of 1132 articles with 155,865 confirmed cases were included, with a pooled positive test rate of 11.54% among 991,786 patients with acute diarrhea and a pooled attack rate of 6.73% in 500 norovirus outbreaks. GII.4 was the predominant genotype in both the etiological surveillance and outbreaks, followed by GII.3 in the etiological surveillance, and GII.17 in the outbreaks, with the proportion of recombinant genotypes increasing in recent years. A higher attack rate in the norovirus outbreaks was associated with age group (older adults), settings (nurseries, primary schools, etc.) and region (North China). The nation-wide pooled positive rate in the etiological surveillance of norovirus is lower than elsewhere in the global population, while the dominant genotypes are similar in both the etiological surveillance and the outbreak investigations. This study contributes to the understanding of norovirus infection with different genotypes in China. The prevention and control of norovirus outbreaks during the cold season should be intensified, with special attention paid to and enhanced surveillance performed in nurseries, schools and nursing homes from November to March.https://www.mdpi.com/1999-4915/15/6/1336norovirusetiological characteristicsmeta-analysisChina
spellingShingle Ting-Ting Li
Qiang Xu
Mei-Chen Liu
Tao Wang
Tian-Le Che
Ai-Ying Teng
Chen-Long Lv
Guo-Lin Wang
Feng Hong
Wei Liu
Li-Qun Fang
Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis
Viruses
norovirus
etiological characteristics
meta-analysis
China
title Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis
title_full Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis
title_fullStr Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis
title_full_unstemmed Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis
title_short Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis
title_sort prevalence and etiological characteristics of norovirus infection in china a systematic review and meta analysis
topic norovirus
etiological characteristics
meta-analysis
China
url https://www.mdpi.com/1999-4915/15/6/1336
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