我国诺如病毒急性胃肠炎散发病例流行病学系统性分析

Systematic analysis of epidemiological features of norovirus causing sporadic acute gastroenteritis in China

目的系统评价诺如病毒急性胃肠炎散发病例在国内的流行现状。方法在万方、中国知网和PubMed数据库中,检索2010年1月—2023年10月发表的关于国内诺如病毒急性胃肠炎散发病例的文献。筛选符合纳入和排除标准的文献,采用Excel软件和SPSS20.0软件进行数据分析,对我国诺如病毒急性胃肠炎散发病例的流行病学特征进行描述性分析。结果共纳入文献500篇,涉及全国32个省份和地区,急性胃肠炎患者784486例,共检测样本670292份。分析结果显示,近年我国诺如病毒急性胃肠炎流行株仍以GⅡ基因群为主,不同时间基因型和流行株分布存在明显差异,GⅡ.4型是各年份主要基因型,GⅡ.4/2006b和GⅡ.4/Sydney_2012为主要流行株。诺如病毒感染性腹泻全年均有发生,每年10—12月为感染高发期。诺如病毒感染在<5岁儿童中发病率最高,其阳性率存在地域差异。结论散发性诺如病毒急性胃肠炎在我国仍以GⅡ基因群为主,但流行株呈明显变异趋势,对诺如病毒感染性腹泻的防控和有针对性的疫苗研发应考虑流行株变化及时间地域等因素。

Objective To systematically evaluate the prevalence of norovirus causing sporadic acute gastroenteritis in China.Methods Relevant articles on acute gastroenteritis caused by norovirus in China published between January 2010 and October 2023 were retrieved from Wanfang,CNKI and PubMed database.The articles met inclusion and exclusion criteria were enrolled in this study.Excel software and SPSS20.0 software were used for statistical analysis.The epidemiological features of sporadic cases of acute gastroenteritis caused by norovirus in China were summarized using descriptive statistical analysis.Results A total of 500 articles were included in this study,involving 784486 cases of acute gastroenteritis and 670292 samples in 32 provinces and regions.Norovirus GⅡwas the predominant genogroup causing acute gastroenteritis in China in recent years,but there were significant differences in the distribution of genotypes and epidemic strains at different times.GⅡ.4 was the predominant genotype in each year,and GⅡ.4/2006b and GⅡ.4/Sydney_2012 were the main epidemic strains.Norovirus-related diarrhea occurred throughout the year,especially between the months of October and December.The incidence of norovirus infection was high in children under five years old and varied in different regions.Conclusions Norovirus GⅡwas the predominant genogroup causing norovirus-related sporadic acute gastroenteritis in China,but there was an obvious genetic evolutionary trend in the epidemic strains.Factors such as epidemic strains,season and geographical region should be considered when making strategies for the prevention and control of norovirus-related diarrhea and developing vaccines.