Epidemiologia molecular de gastroenterite aguda causada por Norovírus em crianças menores de 5 anos a nível mundial: revisão sistemática e meta-análise

Abstract

Introduction: Norovirus has emerged as the leading etiologic agent in acute gastroenteritis in young children since the introduction of vaccines against Rotavirus. Norovirus most predominant genotypes change every 2-3 years. Methods: We describe the temporal dynamics involving Norovirus genotypes over ten years through a systematic review and meta-analysis of studies published between 2006 and 2015. 108 studies were included to evaluate the burden of Norovirus-associated acute gastroenteritis in children younger than 5 years of age. 51 studies provided information to estimate the proportion of Norovirus circulating genotypes into three periods 2006-2008, 2009-2011 and 2012-2015 using meta-analysis. Results: Over the period of 10 years, 7,072 specimens of Norovirus have been genotyped from stool samples of children less than 5 years of age. Genogroup II responded to most of specimens over the three periods in America, Africa, Asia and Europe, ranging from 89.2% (95% CI, 81.8– 93.4) in America 2006-2008 to 98.3% (95% CI, 96.1–99.3) in Asia 2009-2011. Genotype GII.4 presented as the most predominant genotype, accounting for the lowest proportion in Africa 2009- 2011 41% (95% CI, 35.1-46.2) and the highest in America 2012-2015 80% (95% CI, 67.5-89.0). Discussion: NoV GII.4 is the most common genotype involved in pathogenesis of NoV-associated acute gastroenteritis in children <5. Genotypes GII.3, GII.6 and GII.12 also respond to a great amount of NoV infections varying accord periods and continents.