High prevalence of norovirus and rotavirus co-infection in children with acute gastroenteritis hospitalised in Brazzaville, Republic of Congo.

Abstract

To evaluate the clinical severity of diarrhoea associated to viral co-infection in children with acute gastroenteritis. About 461 children under five years hospitalised with acute diarrhoea (266 males and 187 females) were enrolled in the study. Using stool samples, rotavirus and adenovirus infections were investigated by ELISA, and norovirus infections by nested duplex RT-PCR. We assessed social, demographic, clinical and behavioural conditions that might influence the occurrence of rotavirus, adenovirus and norovirus infections. Mono-viral infection was detected in 49% and mixed viral infection in 12% of patients. The prevalence of mixed infection was neither dependent on age nor sex. Three samples were infected with all three viruses. A significant association was found between fever (axillary temperature>37.5°C) and rotavirus-norovirus dual infection (aOR (CI 95%) = 2.1 (1.14-3.84), P=0.016; aOR (CI 95%) = 0.37 (0.19-0.73), P=0.004). Mixed infection was the most common during the dry season from June to October (71.4% versus 54.7%, P=0.023). Co-infection with both rotavirus and norovirus is common in under-five hospitalised children but does not contribute to the severity of the disease.