Abstract
Background
Human Adenovirus (HAdV) types 40 and 41 are among the most significant causes of acute gastroenteritis in children worldwide. Despite their impact, there is limited data on HAdV in Bangladesh, and no vaccine is currently available. This study explored the prevalence, genetic diversity, and clinical features of HAdV among hospitalized diarrhoea patients.
Methods
icddr,b Dhaka Hospital treats more than 200,000 patients annually, with 2% of samples undergoing aetiological surveillance. From 2020 to 2023, we tested 953 faecal samples (10% of surveillance) for HAdV using real-time PCR, followed by genotyping through Sanger sequencing targeting the hexon gene. We also collected surveillance data on clinical manifestations and co-infections.
Results
Out of 953 diarrhoeal samples, we detected HAdV DNA in 610 (64%) using real-time PCR. However, 179 (19%) were confirmed by Sanger sequencing. Among the confirmed cases, 63% were male, 68% children ≤ 5 years and 55% had co-infections. Rotavirus was the major contributor (37%) to co-infected cases, followed by norovirus (33%) and ETEC (17%). No distinct seasonal pattern for HAdV was observed during the four-year study period. Regarding clinical presentation for single HAdV infections, all patients had watery diarrhoea, with 90% having a diarrhoea duration of 1-3 days followed by 78% of cases having vomiting, 59% abdominal pain and 55% having stool frequency (>10 times). Severe gastroenteritis (Vickery score ≥11), was present in 43% of single HAdV infections. Sequence analysis identified five HAdV species (A, B, C, D, and F) with 21 genotypes. Enteric species F was the most prevalent, responsible for 77% of cases, and non-enteric species (B, C, and D) were found in 18% of specimens. Among enteric adenoviruses, genotype 41 (68%) was the most predominant, followed by genotype 40 (26%) and genotype 12 (6%) respectively.
Conclusions
The findings reveal a high prevalence of HAdV among hospitalised diarrhoea patients, with a significant number of co-infections with other enteric pathogens in a low-income setting. HAdVs showed a huge genetic diversity, including enteric genotypes 40, 41 and 12, highlighting their critical role in the disease burden. These insights can guide the development of effective vaccines in combating diarrhoeal diseases.
Human Adenovirus (HAdV) types 40 and 41 are among the most significant causes of acute gastroenteritis in children worldwide. Despite their impact, there is limited data on HAdV in Bangladesh, and no vaccine is currently available. This study explored the prevalence, genetic diversity, and clinical features of HAdV among hospitalized diarrhoea patients.
Methods
icddr,b Dhaka Hospital treats more than 200,000 patients annually, with 2% of samples undergoing aetiological surveillance. From 2020 to 2023, we tested 953 faecal samples (10% of surveillance) for HAdV using real-time PCR, followed by genotyping through Sanger sequencing targeting the hexon gene. We also collected surveillance data on clinical manifestations and co-infections.
Results
Out of 953 diarrhoeal samples, we detected HAdV DNA in 610 (64%) using real-time PCR. However, 179 (19%) were confirmed by Sanger sequencing. Among the confirmed cases, 63% were male, 68% children ≤ 5 years and 55% had co-infections. Rotavirus was the major contributor (37%) to co-infected cases, followed by norovirus (33%) and ETEC (17%). No distinct seasonal pattern for HAdV was observed during the four-year study period. Regarding clinical presentation for single HAdV infections, all patients had watery diarrhoea, with 90% having a diarrhoea duration of 1-3 days followed by 78% of cases having vomiting, 59% abdominal pain and 55% having stool frequency (>10 times). Severe gastroenteritis (Vickery score ≥11), was present in 43% of single HAdV infections. Sequence analysis identified five HAdV species (A, B, C, D, and F) with 21 genotypes. Enteric species F was the most prevalent, responsible for 77% of cases, and non-enteric species (B, C, and D) were found in 18% of specimens. Among enteric adenoviruses, genotype 41 (68%) was the most predominant, followed by genotype 40 (26%) and genotype 12 (6%) respectively.
Conclusions
The findings reveal a high prevalence of HAdV among hospitalised diarrhoea patients, with a significant number of co-infections with other enteric pathogens in a low-income setting. HAdVs showed a huge genetic diversity, including enteric genotypes 40, 41 and 12, highlighting their critical role in the disease burden. These insights can guide the development of effective vaccines in combating diarrhoeal diseases.
| Original language | English |
|---|---|
| Publication status | Published - 2024 |
| Event | 17th Asian Conference on Diarrhoeal Disease and Nutrition 2024: ASCODD 2024 - Soaltee Hotel Limited, Kathmandu, Nepal Duration: 08 Dec 2024 → 10 Dec 2024 https://www.ascodd2024.org/ https://www.ascodd2024.org/program (Program) |
Conference
| Conference | 17th Asian Conference on Diarrhoeal Disease and Nutrition 2024 |
|---|---|
| Abbreviated title | Emerging Enteric Infections and Impact of Climate Change |
| Country/Territory | Nepal |
| City | Kathmandu |
| Period | 08/12/24 → 10/12/24 |
| Other | The 17th Asian Conference on Diarrhoeal Disease and Nutrition (ASCODD) 2024, hosted by Oxford University Clinical Research Unit Nepal (OUCRU Nepal) is scheduled to take place in Kathmandu, Nepal from 8th to 10th December 2024. This year’s conference theme is “Emerging Enteric Infections and Impact of Climate Change.” ASCODD is an international interdisciplinary forum where researchers, practitioners, academics, and experts present and discuss trends, challenges, techniques, applications, and innovative solutions in diarrhea and nutrition. The three-day conference aims to particularly address issues around the impact of climate change on enteric infections and intends to seek innovative solutions through scientific research and healthcare delivery in the field of diarrhea and nutrition in Asia by bringing national and international experts to a common platform. |
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