Norovirus Genetic Diversity in Children under Five Years Old with Acute Diarrhea in Mozambique (2014–2015)

Funding Information: This study was supported by the European Initiative for Research in Neglected Tropical Diseases (EFINTD), World Health Organization (WHO), The Global Alliance for Vaccines and Immunizations—Health System Strengthening (GAVI—HSS), Fundo Nacional de Investigação (FNI) and the National Research Foundation, South Africa (M.B.T., Grant specific reference number (UID 85799). Any opinion, finding, conclusion or recommendation expressed in this material is that of the author(s), and the NRF does not accept any liability in this regard. Publisher Copyright: © 2022 by the authors.Norovirus (NoV) is the second most important cause of viral diarrheal disease in children worldwide after rotavirus and is estimated to be responsible for 17% of acute diarrhea in low-income countries. This study aimed to identify and report NoV genotypes in Mozambican children under the age of five years with acute diarrhea. Between May 2014 and December 2015, stool specimens were collected within the Mozambique Diarrhea National Surveillance (ViNaDia) and tested for NoV genogroups I (GI) and II (GII) using conventional reverse transcriptase-polymerase chain reaction (RT-PCR). Partial capsid and RNA-dependent RNA polymerase (RdRp) nucleotide sequences were aligned using the Muscle tool, and phylogenetic analyses were performed using MEGA X. A total of 204 stool specimens were tested for NoV. The detection rate of NoV was 14.2% (29/204). The presence of NoV was confirmed, by real-time RT-PCR (RT-qPCR), in 24/29 (82.8%) specimens, and NoV GII predominated (70.8%; 17/24). NoV GII.4 Sydney 2012[P31] was the predominant genotype/P-type combination detected (30.4%; 7/23). This is the first study which highlights the high genetic diversity of NoV in Mozambican children and the need to establish a continuous NoV surveillance system.publishersversionpublishe

Examining comorbidities in children with diarrhea across four provinces of Mozambique: A cross-sectional study (2015 to 2019).

Comorbidities are defined as the simultaneous occurrence of two or more diseases within the same individual. Comorbidities can delay a patient's recovery and increase the costs of treatment. Assessing comorbidities can provide local health care policy-makers with evidence of the most common multi-health impairments in children. This could aid in redirecting and integrating care and treatment services by increasing health facilities the awareness and readiness of health facilities. The present analysis aims to determine the frequency and associated factors of comorbidities in children with diarrhea in Mozambique. A cross-sectional hospital-based analysis was conducted between January 2015 and December 2019 in children up to 59 months of age who were admitted with diarrhea in six reference hospitals in Mozambique. These hospitals are distributed across the country's three regions, with at least one hospital in each province from each region. Sociodemographic and clinical data were obtained through semi-structured interviews and by reviewing the child clinical process. Descriptive statistics, and Mann-Whitney-U tests were used. Crude and adjusted logistics regression models were built. P-values < 0.05 were considered statistically significant. Comorbidities were observed in 55.5% of patients (389/701; 95%CI: 51.8-59.1). Wasting was the most common comorbidity (30.2%; 212/701) and pneumonia was the least common (1.7%; 12/701). Children born with a low birth weight were 2.420 times more likely to have comorbidities, adjusted odds ratio: 2.420 (95% CI: 1.339-4374). The median (interquartile range) duration of hospitalization was significantly higher in children with comorbidities than without comorbidities, 5 days (3-7) and 4 days (3-6), respectively (p-value < 0.001). One in every two children with diarrhea in Mozambique has an additional health impairment, and this increases the length of their hospital stay

Sociodemographic and clinical characteristics and factors associated with HIV in children with diarrhea, January 2015 to December 2019.

Sociodemographic and clinical characteristics and factors associated with HIV in children with diarrhea, January 2015 to December 2019.</p

Overall comorbidity frequency and type of associated disease, January 2015 to December 2019 (N = 701).

Overall comorbidity frequency and type of associated disease, January 2015 to December 2019 (N = 701).</p

Available participants in the dataset and criteria for removal from the analysis.

Available participants in the dataset and criteria for removal from the analysis.</p

Sociodemographic and clinical characteristics of children with diarrhea, January 2015 to December 2019.

Sociodemographic and clinical characteristics of children with diarrhea, January 2015 to December 2019.</p

Sociodemographic and clinical characteristics and factors associated with comorbidities in children with diarrhea, January 2015 to December 2019.

Sociodemographic and clinical characteristics and factors associated with comorbidities in children with diarrhea, January 2015 to December 2019.</p

Sociodemographic and clinical characteristics and factors associated with malaria in children with diarrhea, January 2015 to December 2019.

Sociodemographic and clinical characteristics and factors associated with malaria in children with diarrhea, January 2015 to December 2019.</p

STROBE statement—checklist of items that should be included in reports of observational studies.

STROBE statement—checklist of items that should be included in reports of observational studies.</p