Etiological characteristics of viral diarrhea in hospitalized children under 5 years old in Urumqi, Xinjiang, 2018−2021

  Objective  To understand the epidemiological and etiological characteristics of viral diarrhea in <5 years old children hospitalized due to diarrhea in Urumqi, Xinjiang Uygur Autonomous Region, and provide evidence for the prevention and control of viral diarrhea.

  Methods  Stool samples and related epidemiological information of <5 years old children hospitalized due to diarrhea in sentinel hospitals in Urumqi were collected from January 2018 to December 2021, and the samples were screened for the nucleic acids of five viruses, including rotavirus A (RVA), norovirus (NV), sapovirus ( SaV), astrovirus (AstV) and enteric adenovirus (EAdV), using real-time fluorescence quantitative PCR. G and P genotyping of RVA was performed by nested reverse transcription polymerase chain reaction (RT-PCR).

  Results  A total of 1173 stool samples were tested in the four years and 865 were found to be positive, with an overall positive rate of 73.7%. The positive rates of the five viruses in the four years were as follow: RVA: 40.8%, 54.4%, 53.2%, 53.9%, NV: 20.4%, 18.5%, 22.6%, 26.8%, EAdV: 11.0%, 12.7%, 8.6%, 13.4%, AstV: 2.8%, 3.0%, 0.5%, 2.9% and SaV: 3.8%, 4.9%, 0.5%, 2.6%. The proportions of single virus positive detection were 83.9%, 75.5%, 75.0% and 76.8%, respectively, and the proportions of multiple virus positive detection were 16.1%, 24.5%, 25.0% and 23.2%, respectively. The distribution by age of month showed that the highest detection rate was in age group 13–24 months (79.3%, 371/468) and the lowest positive rate was in age group 37−59 months (60.3%, 73/119), the differences in the positive rate were significant among different age groups (χ²=24.482, P<0.001). The positive rates was 72.9% in boys (510/700) and 75.1% in girls (355/473), the difference was significant (χ²=1173.000,P<0.001). The positive rate were high in winter (86.0%, 259/301) and spring ( 82.4%, 229/278), the differences among different seasons were significant (χ²=102.576, P<0.001). The positive rate was 74.5% in rural children (184/247), higher than that in urban children (73.5%, 681/926), the difference was significant (χ²= 1173.000, P<0.001). In the RVA positive cases, G9P［8］ was predominant (82.1%, 485/591), and in NV positive cases, GⅡ was predominat (94.9%, 243/256).

  Conclusion  RVA and NV were the main pathogens in <5 years old children hospitalized due to diarrhea in Urumqi. Children aged <2 years are key population for RVA vaccination. It is necessary to take targeted prevention and control measures in this area according to the predominant pathogen and disease seasonality.