TY - JOUR
T1 - Cytomegalovirus infections in infants in Uganda
T2 - Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus
AU - Hehnly, Christine
AU - Ssentongo, Paddy
AU - Bebell, Lisa M.
AU - Burgoine, Kathy
AU - Bazira, Joel
AU - Fronterre, Claudio
AU - Kumbakumba, Elias
AU - Mulondo, Ronald
AU - Mbabazi-Kabachelor, Edith
AU - Morton, Sarah U.
AU - Ngonzi, Joseph
AU - Ochora, Moses
AU - Olupot-Olupot, Peter
AU - Mugamba, John
AU - Onen, Justin
AU - Roberts, Drucilla J.
AU - Sheldon, Kathryn
AU - Sinnar, Shamim A.
AU - Smith, Jasmine
AU - Ssenyonga, Peter
AU - Kiwanuka, Julius
AU - Paulson, Joseph N.
AU - Meier, Frederick A.
AU - Ericson, Jessica E.
AU - Broach, James R.
AU - Schiff, Steven J.
N1 - Publisher Copyright:
© 2022 The Author(s)
PY - 2022/5
Y1 - 2022/5
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ijid.2022.02.005
DO - 10.1016/j.ijid.2022.02.005
M3 - Article
C2 - 35150915
AN - SCOPUS:85125873177
SN - 1201-9712
VL - 118
SP - 24
EP - 33
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -