Abstract
Background: The Nelson Mandela Academic Hospital (NMAH) in Mthatha, Eastern Cape, is a rural central hospital, serving one of the poorest districts in South Africa. The prevalence of and risk factors for congenital cytomegalovirus (CMV) in this area are not known. The aim was to evaluate the prevalence of congenital CMV and associated risk factors for babies born at NMAH.Methods: This was a cross-sectional study to determine the prevalence of congenital CMV infection among babies born at Nelson Mandela Academic Hospital. Mother–baby pairs delivered consecutively from Monday to Friday, who gave informed consent, were included. Demographic information was collected on a questionnaire. All babies were tested for congenital CMV using a saliva swab PCR within the first week of life.Results: A total of 302 births were assessed. Congenital CMV was prevalent in 18 births (5.96%; 95% CI 3.29–8.63) and had an equal prevalence between HIV-exposed and HIV-unexposed newborns (prevalence ratio [PR] = 1.00; 95% CI 0.94–1.06; p = 0.869).Conclusions: The prevalence of congenital CMV of 5.96% is similar to findings from other resource-limited settings. There was no significant association between maternal HIV status and congenital CMV. With the prevalence of congenital CMV being as high as it is in the studied setting, clinicians are advised to have a high index of suspicion, especially when mothers are CMV seropositive.
Highlights
Human cytomegalovirus (CMV) is an enveloped double-stranded DNA virus belonging to the Herpesviridae family of viruses
Congenital CMV infection was not significantly associated with the economic status or other maternal demographic characteristics (Table 2). This was the first study seeking to estimate the prevalence of congenital CMV at Nelson Mandela Academic Hospital (NMAH) in Mthatha in the Eastern Cape province of South Africa
Studies of congenital CMV from other resource-limited settings show a prevalence ranging from 1% to 5%,2,14,16 while the prevalence ranges from 0.6% to 0.7% in resource-rich countries, where maternal seroimmunity is lower.[2]
Summary
Human cytomegalovirus (CMV) is an enveloped double-stranded DNA virus belonging to the Herpesviridae family of viruses. The prevalence of and risk factors for congenital cytomegalovirus (CMV) in this area are not known. The aim was to evaluate the prevalence of congenital CMV and associated risk factors for babies born at NMAH. Methods: This was a cross-sectional study to determine the prevalence of congenital CMV infection among babies born at Nelson Mandela Academic Hospital. Congenital CMV was prevalent in 18 births (5.96%; 95% CI 3.29–8.63) and had an equal prevalence between HIV-exposed and HIV-unexposed newborns (prevalence ratio [PR] = 1.00; 95% CI 0.94–1.06; p = 0.869). Conclusions: The prevalence of congenital CMV of 5.96% is similar to findings from other resource-limited settings. With the prevalence of congenital CMV being as high as it is in the studied setting, clinicians are advised to have a high index of suspicion, especially when mothers are CMV seropositive
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