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Volume 19, Number 6—June 2013

Dispatch

Endemic Norovirus Infections in Children, Ho Chi Minh City, Vietnam, 2009–2010

Phan Vu Tra My, Corinne Thompson, Hoang Le Phuc, Pham Thi Ngoc Tuyet, Ha Vinh, Nguyen Van Minh Hoang, Pham Van Minh, Nguyen Thanh Vinh, Cao Thu Thuy, Tran Thi Thu Nga, Nguyen Thi Thu Hau, James Campbell, Nguyen Tran Chinh, Tang Chi Thuong, Ha Manh Tuan, Jeremy Farrar, and Stephen BakerComments to Author 
Author affiliations: Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam (P.V. Tra My, C. Thompson, N.V.M. Hoang, P.V. Minh, N.T. Vinh, C.T. Thuy, T.T.T. Nga, J. Campbell, J. Farrar, S. Baker); Oxford University, Oxford, UK (C. Thompson, J. Campbell, J. Farrar, S. Baker); Children’s Hospital 1, Ho Chi Minh City (H.L. Phuc, T.C. Thuong); Children’s Hospital 2, Ho Chi Minh City (P.T.N. Tuyet, N.T.T. Hau, H.M. Tuan); Hospital for Tropical Diseases, Ho Chi Minh City (H. Vinh, N.T. Chinh); The London School of Hygiene and Tropical Medicine, London, UK (S. Baker)

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Table 2

Univariate and multivariate analysis of risk factors for symptomatic NoV infections, Vietnam, 2009–2010*

Risk factor NoV-positive case-patients NoV-negative control participants OR 95% CI aOR 95%CI
Mean age, mo (range) 13.3 (2–45) 16.8 (0–60) 0.97 0.960.99 0.96 0.940.98
Male sex (%) 147 (61.0) 314 (53.0) 1.38 1.01.9 1.38 0.9–2.0
Poor Z-score
18 (7.5)
75 (12.7)
0.56
0.30.9
0.61
0.3–1.1
Low income† 150 (62.2) 335 (56.6) 1.26 0.9–1.7 0.89 0.6–1.3
≥5 adults in hh 72 (29.9) 158 (26.7) 1.17 0.8–1.6 NI x
≥3 children in hh
36 (14.9)
58 (9.8)
1.62
1.02.5
1.70
1.02.9
Refrigerator in hh 187 (77.6) 506 (85.5) 0.59 0.40.9 0.73 0.5–1.2
Consumes market food
201 (84.1)
345 (58.4)
3.77
2.65.5
4.99
3.17.9
Household water source
Pipeline‡ 132 (54.8) 347 (58.6) 1.00 NA NI NI
Well 96 (39.8) 220 (37.2) 1.15 0.8–1.6 NI NI
Other§ 13 (5.4) 25 (4.2) 1.37 0.7–2.8 NI NI
Drinking water source NI NI NI NI NI NI
Pipeline‡ 116 (48.1) 334 (56.4) 1.00 NA 1.00 NA
Bottled water 69 (28.6) 122 (20.6) 1.63 1.12.3 2.18 1.43.4
Well 42 (17.4) 109 (18.4) 1.11 0.7–1.7 0.94 0.6–1.5
Other§
14 (5.8)
1.49
0.8–2.9
0.25
1.45
0.6–3.2
Toilet type
Indoor‡ 213 (90.6) 446 (75.9) 1.00 NA 1.00 NA
Outdoor 22 (9.4) 142 (24.2) 0.32 0.20.5 0.22 0.10.4
Hand washing¶
130 (85.0)
291 (89.5)
0.66
0.4–1.2
NI
NI
Attends day care/nursery school 30 (12.5) 89 (15.2) 0.80 0.5–1.2 NI NI
Contact with symptomatic persons 38 (16.5) 8 (1.4) 14.23 6.531.0 26.14 10.465.9
Rural residence# 36 (14.9) 75 (12.7) 1.21 0.8–1.9 NI NI

*Values are no. case (%) unless otherwise specified. Values in boldface indicate statistical significance at p≤0.05. NoV, norovirus; OR, odds ratio; aOR, adjusted OR; NA, not applicable; NI, not included in multivariable analysis; hh, household.
†Classified as making less than the Gross National Income ($232/mo) according to World Bank (http://data.worldbank.org/indicator/NY.GNP.PCAP.CD).
‡Reference group.
§Rain water, water from a truck provided by the government, or other water source.
¶Washing of children’s hands, either by an adult or the child, after the child uses the toilet.
#Binh Chanh, Can Gio, Cu Chi, Hoc Mon, and Nha Be districts.

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