Evidence map›Paper›PMID 24981041›Full record

SynthesisThe Lancet. Infectious diseases2014

Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis.

Sharia M Ahmed, Aron J Hall, Anne E Robinson, Linda Verhoef, Prasanna Premkumar, Umesh D Parashar, Marion Koopmans, Benjamin A Lopman

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05226052 (Effect of the Use of Probiotic Saccharomyces Boulardii on Acute Viral Inflammatory Diarrhea Diagnosed With Multiplex PCR Technique, Randomized Clinical Trial), which is not on this map. Cited by 571 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
571citing papers in PubMed, 10 pooled it
53.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05226052 nacompletednot on this mapstarted 2020, after this paper: background citation

Effect of the Use of Probiotic Saccharomyces Boulardii on Acute Viral Inflammatory Diarrhea Diagnosed With Multiplex PCR Technique, Randomized Clinical Trial (RCT).

TypeinterventionalSponsorInstituto Mexicano del Seguro SocialRan2020 to 2022Enrolled46ConditionsViral DiarrheaArmsSaccharomyces boulardii (Floratil 600mg), 3 capsules of placebo
3 · Its place in the literature

Who cites it

571 citing papers in PubMed, 10 syntheses or guidelines pooled it, 1,134 citations in OpenAlex.

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511 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Sharia M AhmedDivision of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Aron J HallDivision of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Anne E RobinsonRollins School of Public Health, Emory University, Atlanta, GA, USA.
Linda VerhoefNational Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
Prasanna PremkumarDivision of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Umesh D ParasharDivision of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Marion KoopmansNational Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands; Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands.
Benjamin A LopmanDivision of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: blopman@cdc.gov.
Centers for Disease Control and Prevention · USNational Center for Immunization and Respiratory Diseases · USNational Institute for Public Health and the Environment · NLEmory University · US

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundDespite substantial decreases in recent decades, acute gastroenteritis causes the second greatest burden of all infectious diseases worldwide. Noroviruses are a leading cause of sporadic cases and outbreaks of acute gastroenteritis across all age groups. We aimed to assess the role of norovirus as a cause of endemic acute gastroenteritis worldwide.

methodsWe searched Embase, Medline, and Global Health databases from Jan 1, 2008, to March 8, 2014, for studies that used PCR diagnostics to assess the prevalence of norovirus in individuals with acute gastroenteritis. We included studies that were done continuously for 1 year or more from a specified catchment area (geographical area or group of people), enrolled patients who presented with symptoms of acute gastroenteritis, and used PCR-based diagnostics for norovirus on all stool specimens from patients with acute gastroenteritis. The primary outcome was prevalence of norovirus among all cases of gastroenteritis. We generated pooled estimates of prevalence by fitting linear mixed-effect meta-regression models.

findingsOf 175 articles included, the pooled prevalence of norovirus in 187 336 patients with acute gastroenteritis was 18% (95% CI 17-20). Norovirus prevalence tended to be higher in cases of acute gastroenteritis in community (24%, 18-30) and outpatient (20%, 16-24) settings compared with inpatient (17%, 15-19, p=0·066) settings. Prevalence was also higher in low-mortality developing (19%, 16-22) and developed countries (20%, 17-22) compared with high-mortality developing countries (14%, 11-16; p=0·058). Patient age and whether the study included years of novel strain emergence were not associated with norovirus prevalence.

interpretationNorovirus is a key gastroenteritis pathogen associated with almost a fifth of all cases of acute gastroenteritis, and targeted intervention to reduce norovirus burden, such as vaccines, should be considered.

fundingThe Foodborne Disease Burden Epidemiology Reference Group (FERG) of WHO and the Government of the Netherlands on behalf of FERG.

Indexed as

Caliciviridae InfectionsDeveloped CountriesDeveloping CountriesEndemic DiseasesFecesGastroenteritisGlobal HealthHumansNorovirusPolymerase Chain ReactionPrevalence

Identifiers

PMID24981041
PMCPMC8006533
OpenAlexW2115151801

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.