Risk Factors and Clinical Profile of Sapovirus-Associated Acute Gastroenteritis in Early Childhood: A Nicaraguan Birth Cohort Study
Abstract
Background: Sapovirus is increasingly recognized as an important cause of acute gastroenteritis (AGE) in children. We identified risk factors and characterized the clinical profile of sapovirus AGE in a birth cohort in León, Nicaragua. Methods: We conducted a case-control study nested within a birth cohort (n=444). Fieldworkers conducted weekly household AGE surveillance. AGE stools were tested for sapovirus by RT-qPCR. For each first sapovirus episode, we selected two healthy age-matched controls and estimated independent risk factors of sapovirus AGE using conditional logistic regression. We compared clinical characteristics of sapovirus AGE episodes with episodes associated with other etiologies, and identified co-infections with other enteric pathogens. Results: From June 2017 to July 2019 we identified 63 first sapovirus AGE episodes and selected 126 controls. Having contact with an individual with AGE symptoms and vaginal delivery were independent risk factors for sapovirus AGE. All cases experienced diarrhea, lasting a median 6 days; 23% experienced vomiting. Compared to children with AGE due to another etiology, sapovirus AGE was similar in severity, with less reported fever. Most cases experienced co-infections, and were more likely than controls to be infected with diarrheagenic E. coli or astrovirus. Conclusions: Sapovirus was a commonly-identified AGE etiology in this Central American setting, and symptoms were similar to AGE associated with other etiologies. The…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 444 participants or records.
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