Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus

Christine Hehnly, Paddy Ssentongo, Lisa M. Bebell, Kathy Burgoine, Joel Bazira, Claudio Fronterre, Elias Kumbakumba, Ronald Mulondo, Edith Mbabazi-Kabachelor, Sarah U. Morton, Joseph Ngonzi, Moses Ochora, Peter Olupot-Olupot, John Mugamba, Justin Onen, Drucilla J. Roberts, Kathryn Sheldon, Shamim A. Sinnar, Jasmine Smith, Peter SsenyongaJulius Kiwanuka, Joseph N. Paulson, Frederick A. Meier, Jessica E. Ericson, James R. Broach, Steven J. Schiff

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: To estimate the prevalence of cytomegalovirus (CMV) infections among newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus in Uganda. Design and Methods: Three populations—newborn-mother pairs, neonates with sepsis, and infants (≤3 months) with nonpostinfectious (NPIH) or postinfectious (PIH) hydrocephalus—were evaluated for CMV infection at 3 medical centers in Uganda. Quantitative PCR (qPCR) was used to characterize the prevalence of CMV. Results: The overall CMV prevalence in 2498 samples in duplicate across all groups was 9%. In newborn-mother pairs, there was a 3% prevalence of cord blood CMV positivity and 33% prevalence of maternal vaginal shedding. In neonates with clinical sepsis, there was a 2% CMV prevalence. Maternal HIV seropositivity (adjusted odds ratio [aOR] 25.20; 95% confidence interval [CI] 4.43–134.26; p = 0.0001), residence in Eastern Uganda (aOR 11.06; 95% CI 2.30–76.18; p = 0.003), maternal age <25 years (aOR 4.54; 95% CI 1.40–19.29; p = 0.02), and increasing neonatal age (aOR 1.08 for each day older; 95% CI 1.00–1.16; p = 0.05), were associated risk factors for CMV in neonates with clinical sepsis. We found a 2-fold higher maternal vaginal shedding in eastern (45%) vs western (22%) Uganda during parturition (n = 22/49 vs 11/50, the Fisher exact test; p = 0.02). In infants with PIH, the prevalence in blood was 24% and in infants with NPIH, it was 20%. CMV was present in the CSF of 13% of infants with PIH compared with 0.5% of infants with NPIH (n = 26/205 vs 1/194, p < 0.0001). Conclusions: Our findings highlight that congenital and postnatal CMV prevalence is substantial in this African setting, and the long-term consequences are uncharacterized.

Original languageEnglish (US)
Pages (from-to)24-33
Number of pages10
JournalInternational Journal of Infectious Diseases
StatePublished - May 2022

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases


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