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Environmental Factors Associated with Childhood Norovirus Diarrhoea in Leon, Nicaragua


Becker-Dreps, Sylvia I.; Cuthbertson, Carmen C.; Bucardo, Filemon; Vinje, Jan; Paniagua, Margarita; Giebultowicz, Sophia; Espinoza, Felix; & Emch, Michael E. (2017). Environmental Factors Associated with Childhood Norovirus Diarrhoea in Leon, Nicaragua. Epidemiology & Infection, 145(8), 1597-1605. PMCID: PMC5896004


Norovirus is detected in one in five diarrhoea episodes in children, yet little is known about environmental risk factors associated with this disease, especially in low-income settings. The objective of this study was to examine environmental risk factors, and spatial and seasonal patterns of norovirus diarrhoea episodes in children in Leon, Nicaragua. We followed a population-based cohort of children under age 5 years for norovirus diarrhoea over a 1-year period. At baseline, characteristics of each household were recorded. Households were geocoded and spatial locations of garbage dumps, rivers, and markets were collected. In bivariate analysis we observed younger children and those with animals in their households were more likely to have experienced norovirus episodes. In adjusted models, younger children remained at higher risk for norovirus episodes, but only modest associations were observed with family and environmental characteristics. We next identified symptomatic children living in the same household and within 500 m buffer zones around the household of another child infected with the same genotype. Norovirus diarrhoea episodes peaked early in the rainy season. These findings contribute to our understanding of environmental factors and norovirus infection.


Reference Type

Journal Article

Year Published


Journal Title

Epidemiology & Infection


Becker-Dreps, Sylvia I.
Cuthbertson, Carmen C.
Bucardo, Filemon
Vinje, Jan
Paniagua, Margarita
Giebultowicz, Sophia
Espinoza, Felix
Emch, Michael E.