title: Seroprevalence of HTLV-1 and HTLV-2 amongst mothers and children in Malawi within the context of a systematic review and meta-analysis of HTLV seroprevalence in Africa.
abstract: OBJECTIVE
  Human T-lymphotropic virus (HTLV)-1 causes T-cell leukaemia and myelopathy. Together with HTLV-2, it is endemic in some African nations. Seroprevalence data from Malawi are scarce, with no reports on associated disease incidence. HTLV seroprevalence and type were tested in 418 healthy mothers from Malawi. In addition, we tested the sera of 534 children to investigate mother-to-child transmission. To provide context, we conducted a systematic review and meta-analysis of HTLV seroprevalence in African women and children.
  
  
  METHODS
  Stored samples from a previous childhood cancer and BBV study were analysed. ELISA was used for HTLV screening followed by immunoblot for confirmation and typing. Standard methods were used for the systematic review.
  
  
  RESULTS
  HTLV seroprevalence was 2.6% (11/418) in mothers and 2.2% (12/534) in children. Three mothers carried HTLV-1 alone, seven had HTLV-2 and one was dually infected. Three children carried HTLV-1 alone, seven had HTLV-2 and two were dually infected. Only two corresponding mothers of the 12 HTLV-positive children were HTLV positive. The systematic review included 66 studies of women and 13 of children conducted in 25 African countries. Seroprevalence of HTLV-1 varied from 0 to 17% and of HTLV-2 from 0 to 4%.
  
  
  CONCLUSIONS
  In contrast to findings from other studies in Africa, the seroprevalence of HTLV-2 was higher than that of HTLV-1 in Malawi and one of the highest for the African region. The lack of mother-child concordance suggests alternative sources of infection among children. Our data and analyses contribute to HTLV prevalence mapping in Africa.
authors.affiliation: Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, UK.
authors.forename: James M
authors.initials: JM
authors.lastname: Fox
authors.affiliation: Health Sciences, University of York, York, UK.|Department of Orthopaedic Surgery, Monash Health, Melbourne, Australia.
authors.forename: Nora
authors.initials: N
authors.lastname: Mutalima
authors.affiliation: Paediatric Department, College of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Molyneux
authors.affiliation: Nuffield College, University of Oxford, Oxford, UK.
authors.forename: Lucy M
authors.initials: LM
authors.lastname: Carpenter
authors.affiliation: National Centre for Human Retrovirology/HTLV clinic, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK.
authors.forename: Graham P
authors.initials: GP
authors.lastname: Taylor
authors.affiliation: Health Sciences, University of York, York, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Bland
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Robert
authors.initials: R
authors.lastname: Newton
authors.affiliation: Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, UK.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000349:Africa / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D005260:Female; D015490:HTLV-I Infections / Q000453:epidemiology*; D015491:HTLV-II Infections / Q000453:epidemiology*; D015368:Human T-lymphotropic virus 1; D015367:Human T-lymphotropic virus 2; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D008295:Malawi / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D016036:Seroepidemiologic Studies
keywords: Africa; Afrique; HTLV; HTLV-1; HTLV-2; Human T-lymphotropic virus; MTCT; Malawi; TME; femmes en bonne santé; healthy women; meta análisis; meta-analysis; mother-to-child transmission; mujeres sanas; méta-analyse; prevalence; prevalencia; prevención de la transmisión madre-hijo; prévalence; revisión sistemática; revue systématique; seroprevalence; seroprevalencia; systematic review; séroprévalence; transmisión madre-hijo; transmission mère-enfant; virus T-lymphotropique humain; virus linfotrópico humano de células T; África