title: High rates of congenital cytomegalovirus infection linked with maternal HIV infection among neonatal admissions at a large referral center in sub-Saharan Africa.
abstract: BACKGROUND
  Congenital cytomegalovirus (CMV) infection is the major infectious cause of birth defects and hearing loss globally. There is a growing recognition of the potential clinical impact of congenital CMV infections in high-seroprevalence settings.
  
  
  METHODS
  A cross-sectional study of neonatal admissions at a large referral center in sub-Saharan Africa to determine the prevalence of both symptomatic and asymptomatic congenital CMV infection was performed. Real-time polymerase chain reaction was used to screen DNA-extracted sera, urine, and saliva, and an enzyme-linked immunosorbent assay was used to screen serum samples for anti-CMV immunoglobulin M. Multivariate binary logistic regression was used to identify risk factors associated with increased odds of congenital CMV infection.
  
  
  RESULTS
  Congenital CMV was detected in 3.8% (15/395) of neonates. Among these infants, 6 of 15 (40%) presented with jaundice, 1 of whom also had petechiae. Congenital CMV infection was detected in 9 of 79 (11.4%; 95% confidence interval [CI], 6.1%-20.3%) neonates born to human immunodeficiency virus (HIV)-infected mothers, and both maternal HIV (odds ratio [OR], 6.661 [95% CI, 2.126-20.876], P = .001) and jaundice (OR, 5.701 [95% CI, 1.776-18.306], P = .003) were independently linked with significantly increased odds of congenital CMV infection.
  
  
  CONCLUSIONS
  Congenital and early infant CMV infections may have important consequences for child health in sub-Saharan Africa and other high HIV and CMV seroprevalence populations globally.
authors.affiliation: University of Zambia and University College London Medical School Research and Training Programme.
authors.forename: Nyaxewo
authors.initials: N
authors.lastname: Mwaanza
authors.forename: Lophina
authors.initials: L
authors.lastname: Chilukutu
authors.forename: John
authors.initials: J
authors.lastname: Tembo
authors.forename: Mwila
authors.initials: M
authors.lastname: Kabwe
authors.forename: Kunda
authors.initials: K
authors.lastname: Musonda
authors.forename: Monica
authors.initials: M
authors.lastname: Kapasa
authors.forename: Chishala
authors.initials: C
authors.lastname: Chabala
authors.forename: Sylvester
authors.initials: S
authors.lastname: Sinyangwe
authors.forename: Peter
authors.initials: P
authors.lastname: Mwaba
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.forename: Matthew
authors.initials: M
authors.lastname: Bates
mesh_terms: D017954:Africa South of the Sahara; D000914:Antibodies, Viral / Q000097:blood; D003430:Cross-Sectional Studies; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000453:epidemiology*; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D012463:Saliva / Q000821:virology; D044967:Serum / Q000821:virology; D062606:Tertiary Care Centers; D014556:Urine / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D007075:Immunoglobulin M
keywords: Africa; CMV; HIV; congenital; neonate