Detection rates of norovirus gastroenteritis and factors associated with the infection before and during COVID-19 pandemic: a secondary analysis of surveillance data in Guangxi Zhuang Autonomous Region, Southern China

ABSTRACT

Background: Changes in oral and hand hygiene behaviors have been reported during the COVID-19 pandemic in 2020 which may be associated with the incidence of the norovirus infection, a common cause of gastroenteritis.

Objective: To estimate the trends of detection rates of norovirus gastroenteritis and associated factors before COVID-19 in 2015–2019 and during the COVID-19 in 2020 in Guangxi, China.

Methods: A secondary analysis of Guangxi surveillance data of gastroenteritis patients was conducted. The detection rate in 2020 was predicted using an autoregressive integrated moving average modeland associated factors were analyzed using multiple logistic regression adjusted for interaction effects.

Results: Of 7,903 gastroenteritis patients, the overall detection rate of norovirus gastroenteritis was 12.8%, (14.3% before and 6.1% during COVID-19). Detection rates gradually decreased from 2015 to 2020, of which the slope of predicted line was slightly flatter than the actual line. The odds ratios of detection were double to triple increase during COVID-19 in the younger age group and having food intake outside their homes. Tourist city, season, and types of food were independent associated factors.

Conclusion: The detection rates were higher during the COVID-19 year among the population aged 45 years or less and those who consumed food outside their home.

KEYWORDS:

• Norovirus-infected gastroenteritis
• detection rate
• prediction rate
• COVID-19 period
• seasonal variation

Acknowledgments

We acknowledge the great work of all the staffs from all the sentinel hospitals of Guangxi Zhuang Autonomous Region, China, who collected the surveillance data. We also gratefully thank Mr David Patterson, the International Affairs Office, Faculty of Medicine, Prince of Songkla University for the English editing.

Author contributions

All authors participated in study conceptualization and design. The data curation was managed by YJ, HL, DT, and YP. The data were analyzed and interpreted by YZ, TL, and HL. YZ and TL prepared the manuscript, and the final version of manuscript was read and approved by all authors.

Competing interests

YZ, YJ, DT, and YP are on the staff at the Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention who are responsible for disease control; however, they declare no direct involvement of data collection doctor who works on the quality of data reported from the sentinel hospitals and had no duties involving data collection. TL declares no conflicts of interest.

Consent to participate

This was a secondary data analysis using the existing data from national surveillance system with routine consent. The data were deidentified before release to YZ, the first author.

Data availability statement

Data are available on request due to privacy or other restrictions of the Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention.

Ethics approval

The proposal for this secondary analysis was approved by the Human Research Ethics Committee of Faculty of Medicine, Prince of Songkla University, Thailand, with exempt determination (REC.65-135-18-1).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The first author was in-kind supported by a Guangxi Zhuang Autonomous Region Health Committee project (Grant number: S2022047) and a scholarship from the TUYF Charitable Trust: Research Capacity through Education and Networking on Epidemiology in Asia, the Department of Epidemiology, Faculty of Medicine, Prince of Songkla University (Grant number 5/2022).